County, city working on EMS service transition
Published 8:26 pm Friday, April 1, 2016
Last week, Washington’s City Council handed Beaufort County officials a belated Easter present — the city told the county to prepare to take over EMS coverage in the city and western areas of the county now covered by the city’s EMS personnel.
On Monday, the council instructed City Manager Bobby Roberson to inform county officials that the county will be responsible for providing EMS coverage in the city beginning with the upcoming fiscal year, which is July 1. County Manager Brian Alligood, who was the city manager before he took the manager’s job with the county, met with Roberson the day after the council made its decision. One of his questions to Roberson was how will the city and county move forward with the issue. There’s no doubt that if the county takes over EMS coverage in the city, the county’s budget will reflect that, Alligood said.
“My question was what’s the next step? Obviously, it’s my understanding that clearly that was the action taken by City Council. … That’s pretty clear to me. … What’s our next step in transitioning that? It appears to me that unless the City Council backs up and says, ‘No; we’re going to reverse our position on that,’ which would take another vote by council, Bobby’s got to have to move forward with that direction. Of course, from our side, we’ve got to start putting some plans together to make sure the City of Washington and the area in Old Ford and Clark’s Neck is covered,” Alligood said.
Alligood acknowledged that, under state law, counties are responsible for ensuring EMS coverage is provided to their residents. “Now, it can be contracted. It can be done by volunteer agencies. It can be done by the county, but, statutorily, they’re required to make sure it’s done. So, that’s something that we’ve got to, that within 90 days, we’ve got to move fairly aggressively to make sure that that’s covered. We have a responsibility to do that, and we want to make sure that’s done. We’re not going to leave the city residents or the folks in those areas uncovered. We will make sure (coverage) happens,” he said.
Alligood said he talked with Roberson about how to make the transition as smooth as possible. “So, my question was, in this transition, how do we do that? Are there opportunities for us (the county) to talk with you (the city) about your existing equipment, your existing things? If y’all are going to be out of this business, then, obviously, you don’t have a need for that. We obviously do. How do we do that?”
Roberson said he had no information about what might happen to the city’s EMS equipment, and he would have to go to the council for such information, according to Alligood.
If it has to, the county would develop a plan to take over EMS coverage in the city by July 1, but the county would prefer to have more time, Alligood said.
Alligood noted that the city is contractually obligated to provide EMS coverage outside the city limits, specifically to the Old Ford and Clark’s Neck fire districts because the county does not provide EMS coverage for those areas.
In March 2015, the city and county agreed to a contract that called for the county to pay the city $154,000 this fiscal year for EMS coverage in the Old Ford and Clark’s Neck fire districts and Washington Park. That contract included a 90-day end-of-term out, which the city is invoking. The current contract amount between the city and county is 10-percent higher than the contract in place for the 2014-2015 fiscal year. That increase reflects costs associated with the city moving its EMS program to the paramedic level.
The city and county will have to address that contractual obligation, which ends June 30, 2017, according to Alligood.
“That was a question I asked Bobby Roberson — how are we going to deal with that? He said the city attorney was working on that. I asked David Francisco, the county attorney, to contact the city attorney and have those discussion because there’s a contract in place,” Alligood said.
The city is willing to work with the county when it comes to the city fulfilling its contract with the county, Roberson said Friday afternoon. After the meeting Friday morning, Mayor Mac Hodges conducted an informal poll of the council members, who said they would be interested in extending the takeover deadline to June 30, 2017, Roberson said. The council would have to vote on that option before it could occur, he said.
The county called an emergency EMS oversight committee meeting Friday to discuss the implications of the City Council’s decision to hand city EMS operation over to the county in 90 days. Those attending, in addition to members of the standing committee, were city and county officials, representatives from EMS and law enforcement countywide and Allen Johnson, eastern regional director of the state office of Emergency Medical Services.
Johnson made it clear early in the meeting that while the county is responsible for ensuring EMS service is provided, state statute does not require the county to provide that service. In response, Alligood explained how EMS is currently set up in the county: a series of service districts that have been individually responsible for setting EMS tax rates in those districts. The rates vary widely from no tax in certain municipalities, as municipalities have to consent to the tax, to 5 cents per $100 property valuation in Pantego. He said there are several reasons why the county is moving in the direction to bring all EMS squads under the Beaufort County EMS umbrella: to flatten the tax so all county residents pay the same rate, and to drive down the cost of Medicaid/Medicare billing. The county’s EMS tax would be added to the county’s existing ad valorem tax — which is a sticking point for city officials, as they do not want city residents to be hit with an additional tax burden.
“I want it to be clear the county is not telling Washington how to run their system,” Alligood said.
Alligood had high praise for Washington’s EMS system, which has operated since 1951, and pointed out that the county did not start the EMS discussion in order to become involved in operations of individual squads.
County Commissioner Robert Belcher, also a member of the EMS oversight committee, suggested that solution might be as simple as the city lowering taxes for its residents at the same rate the county increases them to account for a flat EMS tax.
“Now we’re on the same page,” Roberson responded to Belcher’s suggestion.
Belcher also made a motion to allow a 15-month wait period in which the city would do nothing with regard to its EMS system, as well as set up a committee consisting of city and county managers, the city’s mayor, two city council members and two county commissioners to come to an agreeable conclusion. That committee would have nine months, as of Friday, to reach an agreement or be disbanded.
In the meantime, Alligood said the county would be moving forward on two tracks: the first, working toward an agreement with the city; the second, determining how the county would provide EMS service to the city if no agreement is reached.
Beaufort County Commissioners meet Monday night at the County Administrative Offices and will appoint two commissioners to the committee then. Hodges said he thought it likely that the City Council would be able to decide the city’s members by Monday.
Later Friday, Roberson said the council likely would decide on the city’s members at its April 11 meeting.
No reduction in force would occur if the transition takes place, Roberson said Friday afternoon. As for those city employees who serve as firefighters/EMTs, they “would actually move over full time into the fire-service section, which means we would not lose any employees,” he said. Those employees would retain their EMT or paramedic certifications, Roberson added, noting they could serve as first-responders if needed, if the county would agree to that.
The transition, if and when it happens, would result in the city losing about $800,000 a year in revenue, mostly from Medicaid/Medicare reimbursements, insurance payments and revenue from patients being transported to hospitals by city EMS units, Roberson said.
The city’s EMS budget — revenue and expenditures — for this fiscal year is $1.8 million.
“The only thing the city is interested in is being treated fairly in our service for EMS, that we would be treated like other entities that provide EMS in the county. … In addition, we were interested in keeping the billing and collections component,” said Roberson, adding the city has concerns that it would see a slow down in EMS-related revenue if the county took over billing and collections for EMS services. “In addition to that, we would just like to maintain the current level of service we have for all of our citizens inside the City of Washington.”
News Editor Vail Stewart Rumley contributed to this article.