When the ambulance comes, who pays for the service?

ravette Emergency Medical Technicians stand in front of one of the Gravette ambulances which serve a large area of Northwest Benton County. From the left, Lt. Glenn Boughman, Spencer Gillming and Star Butler, EMS coordinator.
ravette Emergency Medical Technicians stand in front of one of the Gravette ambulances which serve a large area of Northwest Benton County. From the left, Lt. Glenn Boughman, Spencer Gillming and Star Butler, EMS coordinator.

— It’s two o’clock in the morning and you waken to the sound of a siren screaming by. Thankfully, it drifts out of hearing as you turn back to slumberland.

The next morning, you wonder where it was, a fire, a burglary, an ambulance run? Over coffee with friends later, you find out. It was an ambulance.

No, it wasn’t a wreck. It wasn’t a heart attack. You learn the ambulance was responding to assist an elderly person who had fallen out of bed. There was no injury. No transport. No medical crisis.

This happens quite often for the Gravette ambulance crew. And they are happy to respond. The two EMTs on duty are glad to be good neighbors. Of course, there is no bill sent for the neighborly service.

Members of the Benton County Intergovernmental Council met several days ago to discuss the financial drain on the cities which are “footing the bill” for outsidetheir-city service.

Gravette Represented

David Smith, chief of the Gravette Volunteer Fire Department, and Star Butler, coordinator for the Emergency Services System in Gravette, attended the meeting. Attending were representatives from other Benton County cities, including Bentonville and Rogers, which also provide the service.

And it is a drain on city budgets, especially on smaller towns like Gravette and Pea Ridge which service their rural areas.

The city of Gravette and other Benton County cities, including Bentonville, Rogers and Siloam Springs, which provide ambulance services outside their city limits, as well as inside, were cautioned by County Judge Dave Bisbee that the county has no money to help in the cost of providingambulance service. Gravette provides ambulance service for Decatur and Sulphur Springs, as well as the Maysville community and rural areas in northwest Benton County and east to near Mt. Pleasant.

David Smith indicated the odds of receiving any financial help from the county at this time is probably very remote. The county, as well as the cities, is experiencing a shortfall of funds, a condition that may continue for some time.

Almost 70 percent of the responses by Gravette’s ambulance are outside the city limits, a service which the city provides 24 hours a day, seven days a week.

Insurance and Medicare pay a portion of the costs, but the service is operating at a deficit that could be as much as $50,000 for the current year. This does not include write-offs from somewho cannot pay. It also does not include the expenses involved in non-transport calls, or “neighbor-assistance” calls such as described above.

“I’d like to see the county start to contribute something,” said Bentonville Mayor Bob McCaslin.

David Cameron, Siloam Springs city manager, said the ambulance service issue is a countywide problem and the “county needs to make a commitment to finding solutions.”

Siloam Springs recently reached an agreement with West Siloam Springs, Okla., to service that area.

Several other smaller cities help underwrite the services for their citizens. He cites Lowell, which pays $400 per run for each call the Springdale ambulance makes into that smaller town.

An inter-governmental council study of Emergency Medical Services for unincorporated Benton County released in April of this year pinpoints the extent of the problem. The study recommends reimbursement to the various municipal EMS systems based on run volume.

Funds might also come from a per-capita assessment or a per-transport assessment. Another option would be creating EMS districts in unincorporated areas or utilizing a private firm ambulance response plan. Butler said this might involve problems, particularly if the firm should unexpectedly cease operation, leaving a void to fill, or if run-cost might be out of the county’s control.

Gravette ambulance offers a voluntary rural membership fee which helps supplement salary and operational costs of the Gravette ambulance.

A similar volunteer fire department assessment also operates, but both arestrictly on a voluntary basis.

Since Gravette ambulance covers such a wide area of northwest Benton County, statistics for 2009 show that the local service responded to 543 calls of which 362 were rural and 181 within the city.

Gravette also supplies a staffed ambulance at both Gravette and Decatur home athletic games, which is a courtesy gesture, Smith said.

“We’re happy to be able to do that with the city’s two ambulances.”

Up to 12 licensed EMTs are needed to provide the 24 hour service, and their salary cost is supplemented by money from the city’s general fund.

Both Smith and Butler indicated they would love to see Gravette be able to staff a paramedic on each ambulance but city finances could not cover the salary and operational costs, which would be considerably greater than the present annual deficit, as mentioned above.

"Such salaries would be a big expense,” Smith said.

Butler noted that rural runs also create extra unexpected expenses.

“Driving on unpaved country roads is particularly hard on tires and the vehicles and is especially hard during winter storms,” Smith said.

Smith also noted that having rural homes identified with numbers could eliminate the problem of finding locations. Such delays could be life-threatening.

Gravette was served by a volunteer-staffed ambulance for many years as citizens completed EMT training and volunteered their time. Later an ambulance was operated by private businesses until five years ago when Gravette assumed operation of the service.

The county cooperated by providing the first ambulance, and the city later purchased a second vehicle. All operating costs have been borne by the city for the past five years.

Personnel operating the ambulance include the following: Jeff Long, Spencer Gillming, Chris Kelley, Evelyn Allen, Jayne Christensen, Michael Harris, Justin Wallace; fire fighters Braxton Handle, Star Butler and Glenn Baughman, and back-up EMTs Brad Harris, Jeremiah Jeck and Austin Taylor.

News, Pages 1 on 10/27/2010