The Ashley County Quorum Court did not approve the City of Hamburg’s request for an ambulance subsidy to help cover the cost of ambulance service outside the city limits.
During its April meeting, the Hamburg City Council voted to present an intergovernmental agreement for the matter to the Quorum.
The Hamburg residents passed a sales tax in 2018 to fund an ambulance service after the announcement that Ashley County Medical Center would no longer subsidize FAST Ambulance, the ambulance company that was servicing Hamburg and surrounding areas at the time.
Pro-Med — the company that was awarded the ambulance contract after the tax election — gave the city of Hamburg two different bid packages, one for coverage inside the city limits only and one that included coverage outside the city limits. Hamburg Mayor Dane Weindorf said that there was a $3,000 difference in the cost for Pro-Med to serve outside of the city limits.
Hamburg City Attorney Paul Keith said during the April meeting that if the county agreed to contribute the contract difference of $3,000, the current contract with Pro-Med to serve all of Ashley County that isn’t served by the Crossett Fire Department would continue.
If the agreement was not signed, however, then Hamburg’s contract with Pro-Med would be modified as of July 1.
The agreement was presented at the regular quorum court meeting last week, but the Quorum scheduled a special meeting the justices could meet with Weindorf and the members of Hamburg’s city council to discuss the issue.
Some of the justices also said they were led to believe that if the sales tax passed, it would be the end of the ambulance discussion. The Quorum had previously ratified a temporary agreement to subsidize Hamburg’s ambulance service with up-to $4,000 a month through the end of March.
“I was under the impression that the (money) that we were giving Hamburg until March was only to help them until the sales tax kicked in,” Justice Ricky Sims said.
Justice Bob Rush said he referred back to the minutes from last July and that all of the discussion at that time said that the sales tax, if passed, would cover all areas not covered by Crossett.
“Mr. Keith made the statement at that meeting made the statement that if we had family in the city of Hamburg to call them and tell them to vote for the sales tax because we were all going to benefit from it,” Rush said.
Keith agreed that he did make that statement and said it still remains true. Keith said that they always planned to cover the whole county, but the rate structure was always an issue. Hamburg having the ambulance service would put Hamburg paying for the majority of the expense which brought up several tax concerns and the discussion about whose responsibility it is to cover the cost of the service.
Some of the justices brought up that county residents pay the new sales tax because they still buy things in Hamburg, therefore, the county residents are already paying their share. Weindorf pointed out that some residents of Hamburg and other areas go to Crossett to shop and that he himself pays sales tax in Little Rock on occasion with no benefit.
Justice Hiram Taylor said that if the sales tax is going to bring in a projected amount of $315,792 and the expenditures presented to the Quorum were for $311,596. Based on that projection, the tax paid for the service with approximately $4,000 a year to spare.
“If you’re going to get $3,000 from the county, that’s $36,000, plus assuming this $4,000, that’s $40,000 that the city is going to be pocketing,” Taylor said.
Weindorf said the city would not pocket the money, which would instead have to go to the ambulance account. Weindorf said the city would like to pay back what the ambulance cost the city and build an ambulance fund.
“We would like to build a fund in case something happens to our ambulance service and we have to start our city ambulance service, we will have the funds to do it,” Weindorf said.
Some of the justices pointed out that if the county started subsidizing Hamburg that they would have to do the same for Crossett should Crossett ask because Crossett covers areas outside of the city limits as well.
“We can’t tell them no if we haven’t told you all no,” Sims said.
Other justices asked questions about the numbers and how Pro-Med reached their total numbers.
Pro-Med Chief Executive Officer Ken Kelley said that the numbers were all projected because he had to maintain a cost of readiness.
“The subsidy amount is really designed to ensure that whoever the provider is does not lose money to the point where they have to cut back on services, equipment, and staffing; the subsidy is designed to maintain a cost of readiness,” Kelley said.
According to Kelley, the numbers are put together with several factors in mind such as the number of calls and the amount of money they are able to collect from those who use the ambulance service and their insurance providers. Kelley said they are totally equipped and staffed right now to service the county.
“We feel that the service model that we put together is adequate to meet the needs for the number of calls we will receive for 911 service and also give the service the ability to do the non-emergency work and assist the hospital with transfers,” Kelley said.
However, Kelley said the issue is that there is no way to predict those call numbers and the income they will bring in 100 percent accurately.
“You don’t have a crystal ball to project your call volume,” Kelley said. “We bid a number that gave us a level platform to where we can maintain that level of service on a go forward basis regardless of what the crystal balls shows.”
The amount that Pro-Med projected allows for fluctuation that should all balance out over time which will prevent them from consistently having to come back to the county and city and ask for more money in the future.
“We think we’ve got the right resources and the right staffing, and we think there is enough book of business here that this service will be stable and we won’t consistently have to back to the quorum courts and the councils and ask for more and more money,” Kelly said.
Justice Greg Sivils raised the question that if Pro-Med plans to keep the same staff and equipment regardless of county coverage, then why did they need the additional $3,000.
“Is that not just additional revenue, is that not just gravy on top of the potato to take the county?” Sivils said.
Kelley said that the cost per call would go up due to longer distances and transfer times because someone picked up in Portland would likely be taken to the Lake Village hospital instead of locally.
“There is added operating cost and we project about 100 calls a year outside of the City of Hamburg, so that cost of readiness divided by a 100 calls adds a lot of additional operating expenses, or cost per call,” Kelly said.
Sivils asked the difference in the cost that is billed to the patient and if it varied based on location and if the subsidy rate would change as calls fluctuated.
Kelly said that currently everyone in the county is charged the same rate, but if the service were to lose subsidy dollars those rates would have to be adjusted to cover the difference. Kelley also said that though they are all charged the same rate, the mileage varies per call so the cost is going to be higher for people further away.
Some of the justices asked if the vote could be put off so that they had time to think over all of the information provided.
Others, including County Judge Jim Hudson, said that the court needed to get the matter over with and move on.
Rush and Sivils both voted to put off the decision for another meeting.
Sivils said he wasn’t against it personally, but he had to make sure it was what was best for the taxpayers.
“In principal, I’m not against the additional $3,000 per month, but people are going to ask me why did you vote and I need a reason to tell them why I’m spending their money,” Sivils said.
After discussion, Rush retracted his vote to put off the decision and said the court had been discussing this for too long a vote needed to be made.
Before the Quorum put it to the vote, Hudson said that he wanted to help Hamburg any way he could, but stated that if the Quorum gave Hamburg a subsidy, that Crossett was going to want the same.
“I’m going to say this, if we subsidize Hamburg, Crossett is going to want one and if I were Crossett I would want the same thing,” Hudson said. “Hamburg needs the help and we need to help them, but I don’t know how we are going to do it.”
Justice Carlton Lawrence made a motion that the county subsidize Hamburg $3,000 per month and Jimmy Pennington seconded.
The court then voted six to two with six justices voting no. Pennington and Lawrence voted for the measure while justices Ron Miller, Sims, Rhonda Pippen, Ronnie Wheeler and Sivils voted no. Justice Hiram Taylor did not cast a vote.