County Seeks Public Input On Ambulance Service

By Gordon HopkinsJefferson County Commissioners expressed their commitment to maintain an ALS (Advanced Life Support) ambulance service in the county at a meeting on Tuesday, June 20, 2023. However, they also acknowledge it will be a struggle to pay for it. Of the 93 counties in Nebraska, Jefferson is the only one that operates its own ambulance service.Commissioners believe the ambulance service has widespread support in the county. Commissioner Mark Schoenrock said, “When I was out campaigning last year, I knocked on 1,000 doors talking to people. And this issue always came up. They said whatever you do, we want to keep ALS in Jefferson County. So our citizens really value this. And we represent them.”“We’ve got to figure out how to pay for it,” Schoenrock added. “Right now it eats about a quarter of our budget.”Commissioner Michael Dux said, “Well, we just got an email last week. The individual said they want to raise taxes to support the ambulance. Okay, that’s fine. We cannot raise taxes to support the ambulance. We’re against the levy limit. We cannot tax anymore.” Last year, commissioners completed what they repeatedly called the most “challenging” budget season in many years. Inflation, ongoing supply-chain issues and worker shortages have all resulted in dramatic increases in operating costs for the county, which was forced to raise the tax levy by 4.66 percent.So Jefferson County Commissioners will be seeking public input about the future of Ambulance District #33. OptionsSchoenrock said, “All options are going be on the table. I mean, we have set preliminary discussions about expanding the ambulance district to the entire county. Of course, then we’d have to have discussions with that part of the county that’s not in the ambulance district. We have had discussions with the City of Fairbury, Jefferson Community Health and Life. They need to be active partners in this. Right now, they’re not. We don’t get any reimbursement for the City of Fairbury or the hospital.”“Except for the taxes,” Dux added.Schoenrock said, “Because we can’t go on like we are right now.” ALS versus BLSAmbulanceAn 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.Ambulance Director Jeff Klaumann told commissioners about a recent call that illustrated the distinction between ALS and BLS, “The guy was having severe chest pain and his heart rate was about 160. And we have a medication that we can give.”Klaumann noted that a BLS ambulance would not have been able to provide that medication.Medicare and MedicaidRevenue has not kept up with increased expenses. Schoenrock said, “It seems to me like a big problem is the reimbursement rate for Medicaid and Medicare.”“They did improve their rates. There was legislation that here that raised the rates,” Commissioner Gale Pohlmann noted. However, no one at the meeting knew what the new rates would be or when they would go into effect. Public ForumDux said, “We haven’t set a date yet. We want everybody invited. We want certain parties to make sure they’re there. We’re going to have a public forum.”Holding a public forum was first suggested last year when commissioners were holding public discussions about budgets.Dux said, “We’re thinking the end of August is probably a good time.”“So this is kind of the initial effort,” said Schoenrock. “So we do see us having a community forum like Mike said, you know, to get it out there and figure out what is the plan. What’s the best plan.”

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