County Remains Committed To Ambulance Service

By Gordon HopkinsIn an attempt to both inform the public and gather input regarding the future of Ambulance District #33, Jefferson County Commissioners held a public forum Thursday evening, August 24, 2023, at the Jefferson county Courthouse.The forum had been in the works for a while. County Commissioner Mark Schoenrock explained why they were asking for input from the public, “We don’t have a monopoly on good ideas.”The meeting lasted two hours and more than 100 people were in attendance.Tax LevyWhile commissioners are committed to keeping the ambulance service, there is still the matter of paying for it. Of the 93 counties in Nebraska, Jefferson is the only one that operates its own ambulance service and it eats up a large portion of the county’s budget. Rising costs and rising salaries have made the service increasingly more expensive to fund.Until a few years ago, Hamilton County also had its own ambulance service. Commissioner Gale Pohlmann said, “Hamilton County abruptly got rid of the ambulance service. Commissioners made a motion to set a deadline when they would no longer would be involved with ambulance. It was seconded and passed. And that was it. So they scrambled. We’re not going to do that.”Last year, Jefferson County Commissioners were forced to raise the tax levy by 4.66 percent and much of that was due to the cost of the ambulance service. It is the hope of commissioners to find a way to alternative revenue for the ambulance service and/or find a way to get the ambulance service off of the county tax levy.Schoenrock said that the highest ticket items on the county’s budget are, “Roads, ambulance and law enforcement, that’s going to be the top three in the county budget. All the other things that the county does are much less than that. But those three services are the things that comprise, still by far the largest percentage of the county budget.”As he has pointed out many times before, Schoenrock noted the problem with cutting budgets, “Well, you don’t want to pay more taxes. Then when you ask people, well, what do you want to cut? Guess what people say? We don’t want less law enforcement. We want to keep the ambulance service. We don’t want less gravel on our roads.”There is a limit to how much the county can tax. The only way the county can increase the tax levy above that limit is by a vote of the people.Brian Blobaum, CPA, of Blobaum & Busboom PC, spoke at length about the county’s budget. He noted that this year will not require a tax levy increase due primarily to an increase in property valuations, but he also pointed out that is likely to change in the future, “So a year ago, there was a lot more concern. And there’s concern because the valuations are going to go up and down and we go through the next cycle of Ag and we’ll probably see the reverse happen. This would tighten back down.”Blobaum said valuations were likely to remain the same or increase one more year, “Because the valuations are based on a three year rolling average.”ALS versus BLSAmbulance Director Jeff Klaumann noted the importance of maintaining an ALS (Advanced Life Support) service.An ALS ambulance has a paramedic on board, along with an EMT (Emergency Medical Technician). The ambulance is equipped with airway support equipment, cardiac life support, cardiac monitors as well as a glucose-testing device. The ALS ambulance also carries medications onboard. Patients in an ALS ambulance can receive a higher level of medical monitoring and include those who need continuous IV drips, those on a chronic ventilator, and those who require cardiac monitoring.This is compared to a BLS, or Basic Life Support, ambulance, which is staffed by EMTs. A BLS ambulance service would be less expensive to operate but would provide a much lower level of care.Klaumann said, “We are a 24/7 operation. We have two people on duty 24 hours a day, seven days a week, and two on standby.”“We have three ambulances for advanced life support,” said Klaumann. “We are basically a mobile ER (Emergency Room). We can do just about everything that they can in the ER, but on scene.”Senator BrandtNebraska Senator Tom Brandt (District 32) was also in attendance. He said, “We’ve had some really good discussion so far here tonight. I live in the part of the county that is served by a volunteer force and a lot of them are sitting right here, from Plymouth. And one thing about ambulance and firemen, they run toward the danger. And a lot of you meet people on the worst day of their life for the first time. Thank you.”The Senator discussed possible future legislation that could impact ambulance services, “Two resolutions were introduced this year, one by Senator (Myron) Dorn for an interim study to study the crisis in rural medical service in the state of Nebraska. The other one was introduced by Senator (Mike) McDonnell, retired fire chief from Omaha, and that was in regard to how much it cost to do these things.”Commissioners have examined ways to get the ambulance service off the county’s tax levy. Senator Brandt discussed the possibility of doing that at the legislative level, “An idea brought forward was to sever the ambulance levy from the county levy. I can propose that. It’s going to be an uphill battle in the legislature. Immediately everybody will pounce on this and say it’s a tax increase.”RumorsCommissioners expressed frustration at the “rumor mill” surrounding the issue, with many people in attendance convinced the county intended to cut the ambulance district’s budget or eliminated it all together, despite repeated denials.“There’s all kinds of rumors out there,” said Commissioner Schoenrock at the beginning of the meeting. “I don’t know where some of this stuff comes from but a lot of what’s out there is pure misinformation.”Senator Brandt said, “And I think some of what I’m hearing tonight people are talking past each other. I would be very concerned if I thought I was gonna lose a service, like district 33. I think commissioners are proposing is to keep what you’ve got with eight full time people, but have it funded by more than just the county.”The Way ForwardWhile a number of possible alternatives to funding the ambulance service were discussed, including partnering with the City of Fairbury and Jefferson Community Health and Life, the purpose of the forum was informational and no decisions were made.

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