Subsidies 'a lifesaver'

For David and Goliath of local EMS companies, accountability is king

March 24, 2012|By ARNOLD S. PLATOU |
  • Chris Amos, chief of Community Rescue Service (CRS) in Hagerstown from 1994 through 2010.
By Kevin G. Gilbert/Staff Photographer

When you’re dipping into savings to keep your community ambulance service going, some say accountability is a small price to pay for financial help.

“It’s been a lifesaver, it really has,” Jonas Zeigler, assistant chief and career supervisor at Sharpsburg Area Emergency Medical Service, said about the $309,236 that Washington County government is giving the company this year.

“Thank God for it,” Zeigler said.

Chris Amos, chief of Community Rescue Service (CRS) in Hagerstown from 1994 through 2010, said the special staffing aid the county began giving its eight volunteer-owned emergency medical service (EMS) companies in the summer of 2010 was crucial.

So telling the county how you spend that money and how much other money you earn is just as important, Amos said.

“If I were a (county) commissioner, and if I’m going to put in millions of dollars and I have to trust what I’m seeing, I understand what the commissioners are saying about that,” Amos said.

“And that’s why our philosophy is what it is. ... Our books are 100 percent open. Anyone can walk in,” Amos said.

Funding the future

In this, the second fiscal year of the county’s new EMS Plan for the Future, the county government has budgeted more than $1.66 million for crews for the volunteer companies.

That is to ensure that even as the ranks of volunteers thin, prompt ambulance service is available seven days a week, 24 hours a day countywide.

The companies and the extra aid they are receiving, in quarterly payments from last July through this June, are:

  • Volunteer Fire Co. of Halfway, Md., which has an EMS operation, $60,225 total
  • Boonsboro Volunteer Ambulance & Rescue, $113,437 total
  • Williamsport Volunteer Fire and Emergency Medical Services, $114,293 total
  • Smithsburg Emergency Medical Services, $206,400 total
  • Hancock Rescue Squad, $276,537 total
  • Clear Spring Ambulance Club, $286,391 total
  • Community Rescue Service, $300,000 total
  • Sharpsburg Area Emergency Medical Service, $309,235 total
Except for the CRS allotment, each company’s subsidy is the difference between $417,383 and the average amount of money a year that insurers and patients have paid that company for help in recent years.

The $417,383 is how much it costs to staff a local ambulance to provide the around-the-clock coverage the county government and the companies agree is necessary.

For example, before the subsidy began, the ambulance company at Sharpsburg was netting about $147,000 a year from billing, said Assistant CRS Chief Dave Hays, who was a member of the committee that helped write the EMS Plan for the Future.

“They were getting $147,000 — but they would need $417,000. Mathematically impossible, correct? So you can’t expect them to have bingos and raffles and cow pie bingos, and run an EMS service, too,” Hays said.

As at CRS, “our volunteers come here to run EMS calls. They don’t come here to raise money. So the subsidy funding is derived basically in the difference between your net billable revenue and that $417,000.”

The subsidy still is in its infancy and needs to be evaluated every year, but thus far, it is doing what was intended, Hays said.

“It’s a marriage, if you will, of county government, the private corporations — which is what each of us (EMS companies) are — and the Washington County Volunteer Fire and Rescue Association,” he said.

“In that, we’ve each agreed to guarantee that you, as a citizen of this county, when you dial 911, will reasonably expect to get an ambulance seven days a week, 24 hours a day.”

Big and little

In Washington County’s world of ambulance companies, Sharpsburg and CRS are, in many respects, like David and Goliath.

Sharpsburg had 681 ambulance calls during 2011, CRS had 12,970.

Sharpsburg has 14 employees and 15 to 20 volunteers, CRS has 71 employees and about 90 volunteers.

Sharpsburg has only its in-town station, while CRS has a main station and two substations.

And then, there’s the size of their budgets.

From July 2010 through June 2011, their most recent full budget year, CRS spent a total of $3.58 million and Sharpsburg spent a total of $474,650, according to the financial reports each gave the county government.

For CRS, that spending included $2.60 million in salaries, benefits, insurance and taxes for its ambulance crews and office staff.

It also included $76,810 in loan payments and $331,559 to replace six cardiac monitors — at a cost of nearly $30,000 each — and to make down payments on a new ambulance replacing an older one and on a new, eighth ambulance. The two new ambulances are to be delivered in April.

Sharpsburg’s spending included $339,176 in salaries, benefits, insurance and taxes. It also included $22,192 in loan payments and $2,500 to buy equipment.

The ambulance crew salaries and benefits, depending on experience and job type, are set by the county EMS plan, making them virtually identical at Sharpsburg, CRS and the other six EMS companies.

When it comes to buying an ambulance and equipping it, each company faces pretty much the same price tag — $250,000.

Financial struggle

Until the county began providing the subsidy, Sharpsburg Area Emergency Medical Service was struggling through especially lean times.

The company’s bank accounts had plunged from a combined balance of $147,734 in July 2006 to $61,772 by July 2010 as money was withdrawn for operations, according to the latest financial report it filed to the county.

“At one point in time, we were getting into our reserve accounts just to make payroll,” said Zeigler, who is among the employees. “And, at one point in time, we had issues with providing uniforms.

“... It just became billing and fund drive just weren’t covering us. And it wasn’t just us. It was a lot” of the local ambulance companies, he said.

Before the subsidy began, the Sharpsburg company had mostly part-time employees, and couldn’t afford to pay competitive salaries or offer benefits, he said.

As with other area volunteer-owned ambulance companies, it was losing employees to more well-financed companies in metropolitan areas, Zeigler said.

Now that the county’s $309,236 staffing subsidy has begun, the Sharpsburg squad has more full-timers and it can afford to provide a 401(k) plan and other benefits, and the same starting salary as every other local rescue squad, Zeigler said.

“So it’s easier to retain people,” he said.

By last July, at the end of its first budget year with the subsidy, the company reported it received $150,119 more in total revenues than it spent. The revenues included $6,624 earned on its cash and investments balance, increasing it to $211,891.

The staffing subsidy also helped the company stave off a big drop in money from its annual community membership drive.

The community drive took in $23,991 — less than half the $58,829 it reaped the previous year, according to the financial reports.

Watching every dime

Zeigler said he thinks the fund drive was hurt by the recession and by the way the drive was being run. As a result, the company is using a “more attractive pamphlet and more prompt” methods in its current drive, and donations are markedly better, he said.

Before the staffing subsidy began, the company also counted heavily on gaming and other fundraising events.

But in the first year of the subsidy, the company netted just $3,764 from such fundraisers, compared to $31,672 the previous year, the reports show.

Asked why, Zeigler said the company has had problems with one of its main fundraisers and so, opted to cancel it for a year to allow time to fix the problems. This year, too, “we’re going to try some new types of fundraisers,” he said.

The company is at a disadvantage because, unlike some other fire or EMS companies, it doesn’t own a hall where fundraisers can be held often, he said.

Twice a year, Sharpsburg EMS rents the hall owned by Potomac Valley Fire Co. in the county’s southern tip for basket bingo games, Zeigler said.

Each night, when the games are over, the company has “multiple people sit there while the money is counted,” he said. “There is a lot of accountability for that. Everything is accounted for.”

As at the ambulance station itself, he said, “every dime that comes through the door is accounted for.”

The problems of money-handling that have made headlines elsewhere in the county kind of hurts all the volunteer fire and rescue companies, Zeigler said. It “gives us a black eye when that happens,” he said.

“We have no intentions of ever doing that here in Sharpsburg. Accountability is very important.”

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