Funding an EMS system is a complicated and challenging task. No matter how big or small, agencies struggle to maintain sufficient income in order to provide service. Dwindling reimbursement levels and taxpayers who are generally opposed to raising assessment rates have the potential to spell doom for an EMS organization.
Ramona Municipal Water District (RMWD) General Manager David Barnum put it well when he said the issue is about “how do you pay for the level of (EMS) service that this community wants.”
It is not cheap to provide a quality EMS service that the public expects to respond quickly 24 hours a day, 365 days a year. Ambulances must be purchased, maintained and staffed with trained, competent medical providers. Even in systems that employ dynamic system deployment strategies, the margin between revenue and expenses can be slim.
Quite honestly, communities, and their elected representatives, have to stop expecting something for nothing. Recent bankruptcies and closures of EMS companies have shown just how razor thin profit margins can be. While not knowing all of the details in this case, the fact that there hadn’t been a raise in the assessment fees for the RMWD in almost 20 years should raise alarms for the community.
The converse is also true. Government officials and elected representatives cannot limit the options of a department while maintaining a stranglehold on the department’s funding. EMS is a business; whether it’s private or public-based, it has to adapt to its environment to survive.
I’m not advocating for one approach or another. That decision is up to the local experts and community. But rejecting any option early in the process can close the door to creative solutions.
