County Seeks Public Input Regarding Ambulance Service

By Gordon HopkinsJefferson County Commissioners are seeking public input about the future of Ambulance District #33.Commissioners recently 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 this year.Property taxes are an especially contentious issue in Nebraska and commissioners continue to struggle with ways to cut costs. A major expense for the county is the ambulance service it provides. Of the 93 counties in Nebraska, Jefferson is the only one that operates its own ambulance service.The county held a hearing Monday evening, September 26, 2022, to give Jefferson County taxpayers the opportunity to discuss the tax levy and the ambulance service was one topic. Fairbury City Councilperson Doug Brown asked, “What are the chances that the other 92 counties are wrong?”Commissioners are looking at other options. It is unknown at this time how much going to a private firm or a volunteer system would save the county or impact response times.“Hamilton (County) had it like us until recently. And they’ve gone into an arrangement with the hospital in Aurora,” said county commissioner Mark Schoenrock. “We’re seeing maybe if that’s a model that we might be able to follow here. I don’t know, but it’s probably something we’re going to have to look into a little bit further.”One individual attending the hearing, Mike Slater, who owns property in Jefferson County but lives in Kansas, warned, “I live in a county that is volunteer. They can’t find enough volunteers to man the ambulances. So, they’re not running. And they’re going to go to a county ambulance system that they say will cost us $1.7 million a year. So please don’t complain about your ambulance service. Because you’re far better off than a whole lot of people.”Revenue and Operating ExpensesCounty commissioners met with acting ambulance director Alan Rosenthal on Tuesday, October 11, and he said, “I would say within the last probably 24 to 36 months, we’ve seen a pretty significant increase in what it’s costing us to operate, just based on keeping wages competitive and the increase in diesel fuel and even ambulances have gone up astronomically, like, within the last 12 months with the shortage of vehicles.”Revenue has not kept up with the increased expenses. Rosenthal said, “And I think last year our revenue increase, probably, maybe in the 10 percent range. I think we were busier than normal.”Rosenthal estimated the ambulance services received 900 to 1,000 calls a year. He also noted, “Medicare and Medicaid haven’t really adjusted what they’re paying.”Medicare and Medicaid are in the process of gathering data for a possible increase but Rosenthal noted that process has only recently begun and is not expected to be complete any time soon, “They’ve been reaching out and COVID kind of kick the can down the road, because they didn’t want to put that additional kind of administrative requirement on everybody.”Shortage of AmbulancesRosenthal said the last ambulance purchased by District #33 was two years ago.“We can we can get by for now,” said Rosenthal. “To be honest, if you were to purchase it, you wouldn’t see it for two years. I mean, that’s the kind of timeframe. Maybe 18 months, if you’re lucky.”“We’ve even gotten emails from ambulance manufacturers that said, we need to reach out to our congress people,” said Rosenthal. “So, they’re encouraging us to, you know, get on board to (write) some of these letters and reach out to legislators so that they actually take some action to direct what could ultimately become kind of a crisis as far as the ambulance industry is concerned.”Schoenrock noted the sheriff’s office is having the same difficulty with obtaining new law enforcement vehicles.Volunteer ServiceSome Nebraska counties use a volunteer service, such as Thayer County. Rosethal noted, “I don’t know exactly what they run, but I know their call volume is quite a bit less than what ours is.”Schoenrock said, “I have to admit, I’m still uncomfortable with a totally volunteer service. You know, I mean, it’s during the work day and most of our volunteers, you know, they’re off doing their job someplace. How does that work? How does that work? If we have full time staff here, we know we are going to have an immediate response here in Jefferson County. If you’re over there, and let’s say your wife is having a heart attack at two in the afternoon and all the volunteers at work.”Schoenrock asked, “If we were a volunteer service, how would that work?”Rosenthal answered, “I don’t think it would.”“If you pull that service away and try and make it volunteer,” explained Rosenthal. “You’re not going to maintain it as an ALS service. You’re just not.”An advanced life support (ALS) ambulances is staffed by a paramedics and transport patients who require a higher level of medical monitoring. Rosenthal said, “It’s a skilled position.”Schoenrock said, “Honestly, for myself, personally, that’s very important to me, to maintain an ALS service for Jefferson County.Open ForumAll this has led commissioners to conclude some way must be found to get the ambulance service off of the tax levy. County Commissioner Michael Dux said, “You know, we’re just right there with our levy limit. And our ambulance department is part of the levy limit. We’re going to have to do something.”Dux recommended holding a public forum to get public input, “Just have an open forum for the public and see what they want to do.”I think Mike makes a good point. We need to have a public forum to have the input of our citizens,” Schoenrock said. “When we do this, to explain, here are all the benefits, here’s the costs. What do you want to do?”

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