FAYETTEVILLE — Caught between rising costs and decreasing revenue, Central Emergency Medical Services is asking local governments for more than $1 million to help the agency through the end of the year.
The board of the Washington County Regional Ambulance Authority, which oversees the operation of Central Emergency Medical Services, voted Aug. 3 to ask the members of the authority to provide $1,043,178 in additional funding. The total is divided among the members, with Washington County being asked to provide $545,140 and Fayetteville being asked to provide $357,454. The other cities’ share of the requested funding ranges from $28,655 for Farmington down to $1,750 from Winslow. Springdale provides its own ambulance service.
The cities and the county provide an annual subsidy to the ambulance service to help offset the costs of operating. The subsidy in 2021 was $1,578,689 and in 2022 the annual subsidy was put at $1,605,838.
Fayetteville Fire Chief Brad Hardin is on the authority’s board executive committee. He submitted the request for additional money to the Fayetteville City Council where it will be on the consent agenda for the Sept. 6 meetings.
Hardin said ambulance services across the country are having the same issues that CEMS is facing.
“Ambulance services across the United States are struggling,” Hardin wrote in his memo to the city. “Collection rates are down. The amount paid by Medicare and insurance companies continue to decline. The federal government recognizes the problem and is working on a program to aid the ambulance services. The estimated supplement for WCRAA is close to $1 million. Unfortunately, they predict the first payment will not occur until July 2023, originally predicted for July 2022. Aside from the decline WCRAA has seen unprecedented price increases in supplies, equipment, gear, and ambulances. Their monthly fuel bill has increased from $19,000 to $43,000. Lastly and most costly, they like everyone else are struggling with recruitment and retention. This requires far more overtime than would normally be required. For these reasons WCRAA is facing a $1,043,178 dollar deficit this year.”
Steve Harrison, CEMS chief, said the service has an annual budget of about $15 million with the bulk of the revenue coming from payments from Medicare, private insurance and individuals who use the service. Harrison said revenue from all those sources has been decreasing with changes to reimbursement rates from Medicare and Medicaid and private insurance and with an increase in people who are struggling to pay for the service on their own.
Harrison said the covid pandemic contributed to the problem, as did the recent spike in inflation and supply chain issues.
“There are a lot of reasons for the shortfall, Harrison said. “Obviously, covid had a lot to do with it. During the worst of the covid we’d run calls and people would decide they didn’t want to go to the hospital. Sometimes they were scared of getting covid if they went to the hospital but if they didn’t want to go we’d try to treat them at home.”
“The way our service is run, if we don’t transport someone, most of the time we don’t charge them,” Harrison said. “So we made the calls but if we didn’t transport them there was no reimbursement. We can’t bill Medicare or Medicaid or insurance because we didn’t transport them.”
Harrison said the service had some “backup funds” in reserve but that started to decrease in 2020 and 2021. As the pandemic continued, he said, the service also began to see a higher turnover rate among its 125 employees, which in turn increased costs through overtime. He said the ambulance service responds to between 450 and 500 calls per week.
“Our normal turnover rate for a year was somewhere around 10%,” he said. “Last year it was up to around 24%. People are getting burned out. They’re tired of covid. They’re tired of working overtime. Some of them have gone into other areas of health care or emergency services where they have more structure. We’re a 24-hours-a-day, seven-days-a-week, 365-days-a-year service. They answer every 911 call.”
Harrison said the cost of medical supplies have increased from 40% to as much as 65%. The recent increase in fuel prices also hit the service hard.
“Our fuel bill has more than doubled from late 2020 to the middle of 2022,” he said.
Washington County has not put the request for funding on the agenda for any Quorum Court committee or the full body. Patrick Deakins, justice of the peace for District 5 and chairman of the Finance & Budget Committee, said he has spoken with people on the ambulance authority board and with CEMS but has not seen the detailed request. Deakins said the Quorum Court approved about $1.1 million for new ambulances and equipment for CEMS in December and another large request will require some discussion.
“This is another one of those big conversations we’re going to have,” Deakins said.
In Benton County, the county is looking for new ambulance service providers after Northwest Health notified the county in early August it will terminate its contracts with the county to provide ambulance service to western Benton County. County Judge Barry Moehring said the contract with Northwest Health will end in January 2023 and the county has begun looking for other providers, advertising a request for qualifications for the service. Moehring said the time to respond to the request for qualifications ends Sept. 6 and the county will see what its options are at that point.
“We’re just in a holding pattern until then,” Moehring said.
Washington County ambulance service
The Washington County Regional Ambulance Authority is an Arkansas governmental interlocal authority formed pursuant to Arkansas law to authorize cities and counties to enter into interlocal contracts to provide services such as emergency and nonemergency ambulance services. The interlocal agreement is for ambulance service by and with the Fayetteville, Washington County, Elkins, Farmington, Goshen, Greenland, Lincoln, Prairie Grove, West Fork, Winslow and Johnson. It also establishes the Ambulance Authority and Central Emergency Medical Services as the exclusive emergency and nonemergency ambulance service within the cities.
Source: Washington County Regional Ambulance Authority