Interim Ambulance Director Todd Smith, left, at a Fremont County Commission meeting in 2013.
(Fremont County, Wyo.) – In July, the Fremont County Commission and the Fremont County Ambulance Department came to a one-year budget agreement in order to provide full-time ambulance crews across the county. However, in doing so, the department is dipping into its reserve fund, an unsustainable move in the long run.
The challenge in the coming budget season will be to find a way for the department to be self sustaining and meet the needs of the communities.
“We are a county agency that doesn’t get county funds,” Interim Director Todd Smith said in a recent interview. Right now the department pays for itself through fees and costs related ambulance services. Medicare, Medicaid and Indian Health Services, he said, are the primary sources of revenue for the department. Smith said that there are no county general funds, raised from property taxes, that are given to the department for operations.
The change in this year’s budget, moving most employees to full-time status, Smith said, was due to the Affordable Care Act that mandates health insurance be offered to any employees working more than 29 hours a week. So the department changed its model, and now runs two full-time crews at all times in Lander and Riverton and one in Dubois. There are few volunteers who work with the department any longer.
Smith said if the revenue shortfall isn’t addressed not as many ambulances will be available at all times, which will likely result in longer response times to calls. On a recent ride-along, County10.com witnessed a moment where all Riverton and Lander ambulances were taken up with calls; Dubois was the lone ambulance not out on a call. Had there been another emergency, it could have taken 45 minutes or more for one to have come available to respond.
Smith’s predecessor, Lauri Wempen, had suggested several options for additional funding including forming a special EMS District for levying property tax, get buy-in from municipalities or increasing service fees.
Smith, noting that service fees were increased in recent years, is in favor of a special sales tax to fund the department. In order to implement such a system, the matter would have to go before voters. Smith said he is interested in learning whether or not the people of Fremont County would be willing to pay .5 percent more in sales tax in order to maintain ambulance service.
The funding situation has been mentioned occasionally in commission meetings since July, however, no decisions have been made.
To make things more difficult, Smith said retaining volunteers and recruiting new Emergency Medical Technicians is harder than it appears. To become an EMT Basic, candidates must undergo 240 hours of training. Smith said that additionally they’ll get 10 to 15 people to sign up for the course, but then inevitably a couple people drop out and rarely more than two or three want to stay on with the department.
Dubois is one location where more volunteers or employees are needed. After handing out more than 600 flyers this fall and going door to door to raise interest in an EMT Basic class, Smith said there were only five responses and only two of those committed to taking the class. But the class needs more than two participants to be financially viable.