Playing ‘Chicken’ Over Service

What’s going on in Benton County right now sounds like a big game of “chicken” over rural ambulance service.

The potential losers are an estimated 32,000 people who live in unincorporated Benton County. They could find themselves with no ambulance service, should voters reject a proposed $85-per-household yearly ambulance fee.

The issue is coming up in a Feb. 11 special election.

Only registered voters who live in the unincorporated areas affected by the vote will decide the issue.

That excludes voters in any of Benton County’s cities and voters who live within the Northeast Benton County Emergency Medical Services District.

People who live within the NEBCo jurisdiction already took care of their own ambulance needs, creating an EMS district and agreeing to pay an annual fee that they not long ago voted to raise to $100 a year to have their own ambulance at the ready. The fee is collected with county property taxes, as this new fee would be for the rest of rural Benton County.

Note: This is all about having service available, not the per-patient cost that will be billed to insurers or to the private individuals who actually use the service.

Twenty-four-hour-a-day readiness is expensive, made more so as cities and rural regions get more populated, requiring more ambulances and more trained personnel.

City residents pay for their emergency services through city governments, which have traditionally extended that service beyond their boundaries to serve rural residents.

The tradition is apparently about to end. Cities in Benton County expect the county government to subsidize the emergency services to the rural county.

And they have negotiated agreements for set sums to make runs beyond city jurisdictions.

The amounts per city vary but the Benton County Quorum Court has budgeted to pay those fees only through the first quarter of this year.

That’s how this game of “chicken,” played by county and city oft cials and, more importantly, the aff ected voters, factors into the situation.

The Quorum Court passed an ordinance creating an emergency medical services district for unincorporated areas not in NEBCo’s district and establishing this $85 service fee.

Some of those who would have to pay the fee objected and forced the issue to referendum. That’s the vote critical to so many families living outside the cities.

There is a lot of money on the line. Negotiated agreements for 2014 between Benton County and seven city fire departments for rural ambulance service total about $942,000. That’s the cost the EMS service fee would arguably defray.

If the election fails, the county must either fi nd another way to pay the cities for the services or the cities must make this hard call on whether to send their ambulances on rural calls.

No emergency service provider would want to sit by and not respond to a rural wreck or a farm-related accident or a life-threatening fi re. That imaginary line between city and county jurisdictions is hard to respect when life is at risk.

Yet, who should pay for the increasing frequency of rural calls? If the county doesn’t pay the cities, should city residents lose some other service to accommodate their rural neighbors?

Yes, there is the argument that rural residents pay city sales taxes. But that tax revenue gets eaten up through many city services, not the least of which is the ready availability of an ambulance for an accident or fire at some city location.

Then there are maintenance costs for the streets traveled to spend those tax dollars, the expense of police protection aff orded inside the city, water delivery and who knows how many indirect services that sustain the restaurant or retail outlet that attractedthe rural customer.

There is a direct cost, too, for cities to provide ambulance service, involving additional personnel and equipment to ensure that their own jurisdictions and these rural areas can be protected.

Reminded that the county has only funded its subsidies through March, some of the cities are already rethinking their own budgets for this year. Their options certainly include, as Siloam Springs’ city manager announced last week, ending rural ambulance service “the moment the funding from the county dries up.”

Would the county fi nd another way to pay? Or not?

Who will blink?

The county has been conducting town hall meetings on the issue, trying to alert affected residents to the upcoming vote. County Clerk Tena O’Brien estimates about 19,000 citizens are eligible to vote.

The problem, of course, is that this is a special election in the heart of a cold, cold winter with lots of distractions that may keep people away from the polls.

A relative handful of the eligible voters will likely decide the question. Some of them sought this election and are clearly willing to risk the availability of ambulance service for themselves and their neighbors.

Early voting starts Feb. 4 and extends through Feb. 10.

Election day is Feb. 11.

BRENDA BLAGG IS A FREELANCE COLUMNIST AND LONGTIME JOURNALIST IN NORTHWEST ARKANSAS.

Opinion, Pages 10 on 01/26/2014

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