Chief resuscitates ambulance proposal (1/14/10)

Voters rejected funding for service in 2007

Jan 14, 2010

By Greg Elias

Observer staff

Three years after voters rejected the idea, Fire Chief Ken Morton has rolled out a new proposal for a Williston-based ambulance service.

The scaled-back plan would speed emergency responses without raising taxes, Morton said. The town would purchase a pair of ambulances and hire one or two people. User fees billed to patients’ medical insurance are expected to fully cover expenses.

Morton said he revived the proposal because Williston still needs a homegrown ambulance service.

“I felt so strongly, so committed to having an ambulance service for the community,” Morton said. “We have carefully crafted a proposal that costs less.”

The Selectboard debated the proposal on Monday evening. If the board signs off on the service, it would then have to decide whether to seek voter approval for bond funding or pay for it through the operating budget.

Morton’s plan is considerably less ambitious than the one rejected by voters in 2007.

That proposal entailed hiring six new employees and buying two ambulances. A grant would have initially paid for the service, but some worried about ongoing costs when the grant money ran out.

By a 3-2 margin, voters said no to a ballot item requesting $250,000 in bond funding for the ambulances and a $447,884 budget for staffing and debt payments.

A few area rescue services now serve Williston. St. Michael’s Rescue responds to about three-quarters of all emergency calls, Morton said. Rescue services in Essex and Richmond and at the University of Vermont go to the remaining calls.

When a 911 call comes in, first responders are dispatched from the Williston Fire Department. The patient is then transferred to an ambulance from St. Michael’s or the other rescue services.

But there have long been concerns about a system that uses ambulances stationed miles from Williston and the extra time it takes to hand off a patient. Morton, while careful to praise St. Michael’s Rescue, said using a single, nearby service would get patients to the hospital quicker and more efficiently.


Revenue vs. expenses

Morton presented to the Selectboard last month detailed estimates of the service’s expenses and revenue. Including payments for the ambulances, fuel, maintenance and equipment, projected annual costs are $231,915.

On the revenue side, Morton said fees of either $450 or $550 depending on the type of response will be charged for each patient transported to the hospital. Based on assumptions about the numbers and types of calls and an 80 percent collection rate, he estimates the service will generate $260,360 in annual revenue.

Morton said he has been conservative in his projections. He believes the actual revenue would probably be considerably higher. Using the conservative numbers, he estimates revenue will exceed expenses by $28,445.

Some Selectboard members, however, worry about the potential cost for taxpayers should those projections prove wrong.

“My biggest concern is that the costs will be more than the estimates and we will receive less than estimates in revenue,” Jeff Fehrs said.

Chris Roy said Morton made a persuasive case that the rescue service would in fact pay for itself. Roy said the conservative revenue numbers Morton outlined and scaled-back staffing requirements make it much more palatable than the 2007 proposal.

Selectboard Chairman Terry Macaig agreed that voters may find it much easier to support the new proposal. He said it helps that the service does not rely on a short-term grant to pay for permanent employees.

Still, staffing poses a potential future financial liability. After all, if six employees were needed in 2007, how can two new staffers — one hired immediately and another later if revenue and expenses are on track — be enough?

The Fire Department’s staffing situation has changed significantly since the last vote, Morton said, noting the size of its emergency medical services staff has more than doubled over the past three years.

The new fire station, which opened after voters rejected the last ambulance proposal, has sleeping quarters for both on-call and full-time firefighters as well as emergency medical personnel. Morton said that keeps people on hand around the clock who could staff the ambulance service.

Still, Fehrs said the potential future need to add more employees is among the proposal’s greatest risks.

“Once you have an ambulance service, you can’t turn it off,” he said.


Referendum appears likely

If the Selectboard OKs the ambulance service, it would then need to decide how to finance the equipment.

Proposed ballot wording asks voters to approve $200,000 in bonds for the first ambulance. A proposed second used ambulance to be used as a back-up vehicle may be financed through the operating budget.

Another possibility is to obtain the new ambulance through a lease-purchase arrangement. The town would make payments on the vehicle and eventually own it.

The arrangement could include an opt-out clause that would allow the town to cancel the lease if ambulance funding was cut. It would also avoid a bond vote.

But Fehrs, Macaig and Roy all said they want to give voters the last word on the ambulance service.

“I think we have to be straightforward with voters and let then say yes or no on the ballot,” Macaig said. “I don’t want people to think we’re hiding something in the budget.”

Because an ambulance service was previously rejected, the new proposal should also be on the ballot, Roy said, who worried that rolling the expenditure into the operating budget might anger voters.

“I don’t want to pull the whole budget down because of that issue,” he said.

The Selectboard will continue to discuss the proposed ambulance service at its Jan. 14 meeting at Town Hall. The meeting begins at 7 p.m.