The Ashley County Quorum Court voted Tuesday to draft an ordinance that will allow Ashley County Medical Center to operate an ambulance service district in the delta portion of the county.
The vote, passed 7-3 with Justices Corliss McCain, Rhonda Pippen and Ronnie Wheeler voting against, comes after nearly six months of discussion about the future of ambulance service in the county.
The court will now have an ordinance drafted that will outline how the service district will operate and be funded. The justices can adopt the ordinance after a public hearing, which has not yet been set, and — if voters do not file a petition for a referendum — it will go into effect 90 days after that.
The issue started in May when the owners of FAST Ambulance Service said they would soon go out of business because of long-term operating losses. ACMC entered into an operating agreement with the company at that time to keep the service active until a long-term solution could be established, and in the interim months the Quorum has discussed several scenarios, including looking to private contractors or having the Crossett Fire Department’s ambulance service cover the entire county.
The Quorum ultimately advertised a request for proposals from potential ambulance operators, with the specification that any plan would include two full-time ambulances — one parked in Hamburg and the other in the delta — and a backup ambulance.
The justices made the choice to go with the county-owned hospital Tuesday after reviewing for two weeks proposals submitted by ACMC and ProMed Ambulance Service, the only two entities to submit proposals. The chief executive officers of the companies made pitches to the Quorum at Tuesday’s meeting.
The proposals were not identical, but they were substantially similar, with one notable exception. While both asked for a subsidy from the county, ProMed said it would require $295,000 annually from the county, and ACMC projected the need of a $542,006 yearly subsidy to operate the service.
The justices noted that the two companies had very similar cost plans in the proposals, but that ProMed projected it would collect approximately $866,000 in revenue, and ACMC projected the lesser amount of $518,500 in collected revenue.
When they asked ProMed Chief Executive Officer Ken Kelley why he projected that his company would collect that much more in revenue, he said it was based on his company’s collection rate, taking into consideration the data from Ashley County that he’d been provided.
“This is based on our collection performance,” he said.
Kelley said the only reason he believed ProMed would need a subsidy to operate in Ashley County was because of the requirement for a third ambulance, and that in the past he has been able to work with a county to reduce the amount of the subsidy it received to the point that it was eliminated.
“We are not a cookie-cutter ambulance company,” he said. “We try to match the needs of the county with the service we provide.”
Kelley said that if ProMed was chosen, the paramedics and emergency medical technicians currently working for FAST would be welcome to work for them.
ACMC CEO Phillip Gilmore said some of the discrepancy between the proposals could because the hospital was projecting a lower run volume than ProMed.
Gilmore said the hospital, “is concerned about this, committed to this and this proposal has many man hours put into it.”
The hospital proposal included that FAST owners Stephen and Dusty Smith will be hired on as managers of the hospital ambulance service.
“They have done a phenomenal job; they have poured their hearts into it,” Gilmore said. “They have given their lives to serving their community.
“FAST has worked with us and understands our philosophy and what we want to do to manage it. They want to continue, and I think they deserve to continue.”
Because the hospital is non-profit, any extra money will go 100 percent back into the ambulance fund, he said.
The hospital has already contributed $53,000 to the cause since entering into the operating agreement in May, Gilmore said, and the medical staff supports the proposal.
“I think we have tried very hard to be supportive of the county,” he said.
Before voting to go with the hospital proposal, the Quorum took a vote to declare that emergency medical services are a professional service that can be contracted and not necessarily subject to bid.
Justice Carlton Lawrence made the motion because he said if the proposals as advertised were considered a bid project, the Quorum would be forced to go with ProMed as the lowest bidder on face value.
Making the matter a contracted service would allow the Quorum to take other factors into consideration, he said.
Quorum Court Attorney Tim Leonard said if the request for proposals as advertised could be considered a solicitation for bids, the Quorum could face litigation if it didn’t go with the lowest bid. Kelley said he would put the Quorum’s minds to rest.
“I am not the suing type,” he said.
Justice Connie Timmons seconded Lawrence’s motion, and all of the justices present except for Hiram Taylor voted in favor of it. Justice Danny Rice was not in attendance.
Leonard said if the Quorum went with the private provider — in this instance, ProMed — state law would require for the county to have an election for voters to approve how the emergency services district will be funded. The law does not require an election for going with a county-owned entity, Leonard said, unless voters file a referendum.
Lawrence ultimately made the motion that the justices approved choosing the hospital, which Justice Bob Rush seconded.
The hospital’s proposal says it can start the ambulance service “immediately Jan. 1, 2018 contingent on final approval and passage of ordinance.”
The preliminary draft of the ordinance calls for the placement of a $100 per residential or commercial property annual fee to fund the district, which excludes the 10 voter precincts currently covered by the Crossett Fire Department.
During the discussion Tuesday, Lawrence proposed — and the Quorum unanimously agreed — that if, upon reviewing the district’s performance in tax years 2019 and beyond, the Quorum discovers the amount of money collected is more than the district needs, the Quorum will have the right to lower the fee.