Summit County’s 30 million question, Part 2: Reviving cash-strapped ambulance service | SummitDaily.com

Summit County’s 30 million question, Part 2: Reviving cash-strapped ambulance service

Summit Daily staff report
news@summitdaily.com

Summit County Ambulance Service has been chronically underfunded since the Great Recession.

This is the second installment in a four-part series on Summit County's ballot item 1A.

Summit County Ambulance Service is one of the last remaining ambulance services on the Western Slope that operates as an enterprise fund. That means it's part of the county government, but financed like a business.

For a long time, the model has worked. Its collection rates once dwarfed those of other counties, with the agency recouping nearly 70 percent of its billings while other services struggled to hit even 50 percent.

Then, in 2007, the Great Recession hit. Fewer people came to vacation in Summit County and call volumes dropped in the High Country. A rise in unemployment meant that even when calls did come in, more patients were uninsured or underinsured.

In addition, a growing number of people — roughly 15 percent of transports — have health care coverage through Medicare, which pays out only 28 cents on every dollar billed by the ambulance service.

"By accepting Medicare, we are legally obligated to completely write off the remaining 72 cents and cannot bill the patient for the balance," SCAS director Marc Burdick told the Summit Daily in a 2013 interview.

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Today, the collection rate is 60 percent. Four of 10 transports don't pay for service. Collection rates are projected to drop to 52 percent over the next eight years, according to county officials.

Long-distance transports to Denver used to be SCAS' lifeblood, generating more than $3,000 per call. That's almost double the revenue from an in-county transport.

However, long-distance transports began to evaporate after St. Anthony Summit Medical Center opened its doors, eliminating the need to take many patients to hospitals on the Front Range.

"The hospital opening was an extremely good thing for our community. It's exactly what our community needed," Burdick told the Daily. "But it affected us."

The current funding deficit is $600,000. County officials say that is likely to grow to $2 million in eight years as collection rates decrease and operational expenses like fuel, vehicle replacements and employee costs increase.

"We've done a good job for a long time of operating the ambulance as a fee-for-service enterprise, but there isn't an ambulance service in the mountains that can survive without a second source of revenue," Commissioner Thomas Davidson said in an interview last month. "It's important to note that we'll still be providing the service at a better rate and that offering a discount is incredibly important for our local population."

The agency struggled to find ways to continue to deliver the same level of service with far less money. Training budgets were slashed, equipment and vehicles that would otherwise have been replaced have aged and positions have been eliminated.

To help make ends meet, the agency has scaled back ambulance coverage across the county, removing one 12-hour-per-day vehicle year-round and cutting another year-round vehicle that served Keystone 10 hours per day on the weekends.

Positions have also been eliminated, including three paramedic II jobs.

"As staff left for a variety of reasons, we did not fill those positions," Burdick said. "The paramedic II position is fairly unique and SCAS uses these positions to fill a variety of specialized areas such as supporting training, quality improvement, disaster preparedness and the public access defibrillation program."

Over the past year, Summit County officials explored ways to resolve the ambulance service's financial problems, including privatizing the agency or merging it with fire service agencies with emergency medical response capabilities. The county recently reached a partnership with the Red, White and Blue Fire Protection District. It's also pursuing partnerships with Lake Dillon Fire-Rescue and Copper Mountain Fire Rescue.

However, county officials believe that an increase in property taxes is necessary to maintain basic services. That's why the county placed Referred Measure 1A on the November ballot.

In total, 1A requests $3.73 million in temporary annual funding for the ambulance service and upgrades to the 911 and water-quality systems over eight years, or almost $30 million before sunset. Though the ballot language does not specify the amount of funding each portion will receive, county officials say that an estimated $1.45 million per year will go toward updating Summit's emergency dispatch system and $600,000 is set aside for water-quality improvement.

The measure would provide about $1.65 million per year in funding for ambulance services. Should the ballot measure pass, county residents and property owners who receive ambulance services would be eligible for a fee discount in order to recognize their contributions to the system via the mill levy.

If approved, 1A would result in a tax of $19.25 per year per $100,000 of residential property value for eight years.

"The model was to run the ambulance service as an enterprise, but with revenues dwindling and expenses rising, we're getting to the point where it will be impossible to sustain," assistant county manager Scott Vargo said. "What we're asking isn't anything out of the ordinary. Several ambulance services receive a portion of their funding from property taxes, including in nearby Eagle County and Steamboat Springs."

Caddie Nath, Joe Moylan and Ben Trollinger contributed to this report.

ABOUT THIS SERIES

This is second installment in a four-part series on Summit County’s Referred Measure 1A, which will soon appear on election ballots across Summit County. Mail-in ballots go out to voters on Oct. 14. Early voting is Oct. 20 through Nov. 3. Election Day is Nov. 4. Question 1A calls for $3.73 million in temporary annual funding for 911 system upgrades, ambulance service and water-quality protection. Funding sunsets after eight years. The first part in this series, published on Oct. 10, addressed the 911 system upgrade. Part 2 focuses on ambulance service funding. Part 3, which centers on the water-quality component, will run on Oct. 12. An overview of the entire ballot question will appear in Oct. 13 paper.