Move by county to take nonemergency calls hurts private services, they say
By Cynthia Sewell
The Idaho Statesman (Boise)
Copyright 2006 The Idaho Statesman
Distributed by McClatchy-Tribune Business News
John Fogg has owned his small business for 27 years. Lately, one of his competitors has been aggressively seeking new clients.
With this new competition, Fogg’s business has declined about 40 percent, forcing him to let go two-thirds of his staff.
Fogg said his competitor has an unfair advantage — it is taxpayer subsidized and he’s not.
Fogg owns Ada-Boi ambulance service. His competitor is Ada County’s ambulance service.
“The county is actively expanding from 911 service — the service taxpayers expect,” Fogg said. “Ada-Boi is going to go broke. We are going to go out of business.”
The county’s only other private ambulance service experience in the past two years mirror’s Fogg’s.
“Our calls are down by almost half,” Kari Vogt said. She and her husband, Karl, have owned Northwest Paramedics for 11 years.
Ada-Boi and Northwest are the two countywide private ambulance service providers.
Both Fogg and Vogt said they cannot bid competitively against the county for service contracts.
“The county can underbid us because they have so much taxpayer money, so much subsidy,” Fogg said. “They can give it away, and they do.”
Under Idaho Code, each county must determine how it will provide ambulance services to its residents. Either the county provides all emergency and nonemergency ambulance services, or private providers provide all services, or a combination of the two.
Ada County uses a combination of county and private ambulance services.
According to county code, the county provides all 911 service and some nonemergency or standby service. Private ambulance services may provide nonemergency or standby services only, not 911 service.
A nonemergency transport may include transferring a patient from the hospital to his or her home or to another facility, such as a nursing home. Standby service may include being on site at sporting events, such as football games.
The county set up a special countywide taxing district, called emergency medical services, to fund all 911 ambulance service in the county.
Less than one-third — 28 percent — of the EMS $11.8 million budget comes from taxes, said Troy Hagen, director of Ada County Paramedics.
No 911 money is used for nonemergency or standby services, Hagen said.
Last year, voters rejected a two-year levy to provide EMS with an additional $4.8 million to cover a projected shortfall in the county’s ambulance district budget.
This forced the county to find other sources of revenue. Increasing nonemergency and standby services seemed the next logical step, Hagen said.
While Fogg and Vogt are reporting their business is down almost 50 percent in the past year since the county started it new business model, the county is reporting, “We are in the black for the first time in years,” Hagen said.
The county’s fiscal year ended Saturday, and it will be several months before the numbers are in, but Hagen said revenue from nonemergency ambulance service is “keeping our 911 system afloat.”
Ada County has a contract with the U.S. Forest Service to provide ambulance, equipment and staff to wildfires, including those outside Ada County. The Forest Service pays the county $100 per-hour plus mileage to cover costs for one vehicle, two staff and equipment.
This year, county EMS provided service at three forest fires in neighboring counties for which the Forest Service paid $53,134.
The county has had this contract for at least a couple decades, Hagen said.
Before this summer, the last year Ada County Paramedics responded to a Forest Service call was in 2001.
The U.S. Forest Service contracts with multiple emergency providers around the state, Hagen said. The county is not obligated to respond when the Forest Service calls, only if it has available resources.
But Vogt is concerned county EMS resources will be tied up in nonemergency transport or providing service at an out-of-county wildfire when a major emergency takes place in the county.
“I hope our board of commissioners remedy this before someone dies,” Vogt said.
Hagen said the county has taken precautions to prevent this. The department separately schedules its 911 and nonemergency staff and resources, so 911 resources are not used for standby calls, like the forest service contract.
Additionally, all tax dollars go toward 911 service only, not non-emergency services. Nonemergency resources and expenses are funded entirely by fees charged for nonemergency services.