Help me convert Ruraltown EMS from volly to paid.

[spenac]

Here is the situation: Ruraltown EMS is currently a volly service. We have 2 ambulances but the second is just used when the main unit is in for repairs. We have a 3 bay station with small office, 2 sleeping rooms, kitchen area, as well as class/party room(no alcohol allowed). Utilitys and insurance are paid by our city/county. We are the only ambulance in a county of 3000 square miles with a population of 3000 people and 1500 homes. We currently do not bill for anything just because as vollys we don't have time to do it. We have everything already here just like other vollys, including full ALS equipment. We now have about 300 calls a year, hospital is in next county about 45 miles away. Even with a simple stubbed toe transport it takes you about 2.5 hours to get back in service. The vollys are finding it harder to leave work to go save lives. So we went to Ruraltown city/county officials and told them we need to start being paid. Now some big wig official looked on line and found some calculator program that says it will cost each homeowner over a thousand dollars more per year in taxes if they pay us. We have argued that the only total payroll including taxes would be less than $250,000 based on 6 full timers and 2 part timers, paramedics $12/hr and EMT-B's $10/HR. We currently have 3 paramedics and 3 basics ready to go full time and 1 each that want to work part time. That averages only to about $166 per home not including any business or vacant land that the city county gets taxes on.

Any more details needed?

What else can we do to convince them it will not cost tax payers that much more money per year?

Yes your help is needed to assist us become professionals. Thank you in advance.

Signed,

Wantabe Professional

EMS Director

[HellsBells]

I would say that you should write up your findings and stats, and projections and present it to town council. Another option would be to contact the local newspaper and inform them of your difficulty to retain the proper volunteer staffing levels in the face of a growing call volume

[JakeEMTP]

I realise spenac , you are describing a very rural service. Somewhere in that 3000 sq. miles there has to be some industry. If you approached them and explained in detail, your predicament, perhaps they could apply some pressure to the county gov't. After all, they are in business and should understand that to function properly, some influx of cash is required. It would indeed be to their benefit to have professional, full time ALS service and I'm sure they haven't got a clue as to how you run now.

As Hells Bells stated, the newspaper is an excellent idea.

[spenac]

I realise spenac , you are describing a very rural service. Somewhere in that 3000 sq. miles there has to be some industry. If you approached them and explained in detail, your predicament, perhaps they could apply some pressure to the county gov't. After all, they are in business and should understand that to function properly, some influx of cash is required. It would indeed be to their benefit to have professional, full time ALS service and I'm sure they haven't got a clue as to how you run now.

As Hells Bells stated, the newspaper is an excellent idea.

Actually you'll find here in Ruraltown like many rural USA countys there is no industry. There are small farms, ranches. No big industry.

Newspaper would be good idea. Problem is it's a once a week paper and it's owned by one of the city/county officials so either won't print or will edit. All storys being printed are slanted opposing going paid.

[Michael]

Website?

[dahlio]

What about threatening to not volunteer. It's harsh, but so is missing work, and then present them with the cost of a private service vs. the cost of using what you got and being paid...

Whatever you do decide, good luck.

[flight-lp]

We currently do not bill for anything just because as vollys we don't have time to do it.

Here lies a big problem. You are performing a service, why would you not charge for it? Obtain the services of a 3rd party billing service, cost is minimal, especially with your call volume, and it would provide some extra assistance.

If the powers that be won't listen, take it to the community. Get their thoughts and opinions. Explain the benefits to them, let them come forward to the community officials. If that doesn't work, explain the consequences of not having any EMS. That usually gets some attention.

Another thought would be to apply for a grant for funding............

[emtannie]

I can relate to your dilemma because we are in a similar situation here.

When you present your case to your town council, make sure you have completely done your research. I did some quick calculations, and I would do some homework on your salary statistics. Although on the surface it appears that your total payroll costs will be less than $250,000, it may not be. 365 days x 24 hrs x $10/hr x 2 staff = $175,200, but that does not take into account benefits, holiday pay, or overtime. Depending on what benefits are offered, you can add at least 30 - 50% to that $175000 figure, and that is based on the $10/hr rate. These benefits not only include medical/dental, but disability and life insurance, pension plans, and other possible benefits. You may want to ask around to someone you know who does payroll for another business and ask what the additional costs are, or perhaps your state website has some information on that.

As well, you have to calculate not only the operating costs for your ambulances, but you have to generate enough income to put some funds into reserves for capital replacement. How often do you plan on replacing an ambulance? Three years? Five years? Ten years? These are all things that have to be considered, as the municipality will have to generate income to put a certain % of funds away every year so that when a new unit is needed, there are funds available. They will also have to do the same for larger items on the ambulance, like stretchers, stair chairs, AED's, etc. They then have to account for annual operating costs - maintenance, repairs, restocking of basic supplies, and miscellaneous items. What about uniforms? Who pays for those? And how much? This has to be considered as well... and does paying for a uniform include boots? A winter jacket? These are all items that have to be agreed on.

The above are probably why their figures show that it will cost about $1000 per household. I did a business plan for our ambulance service several years ago and found very similar figures here. Since I spent 15 years as a commercial bank manager and have a degree in economics, I was the one who was "volunteered" do do the same thing you are doing.... to try and get more funding for our service and our staff.

I wish you all the best. We have had some success, but are not full time paid yet..... but at least we get paid per call and our calls get billed for, and the pay at least offsets some of the costs of leaving a day job. We also don't have to pay for our annual recertifications and continuing education as the municipality pays those.

It is a long road, and I wish you well. Feel free to pm me if you have any questions.

[spenac]

Thanks for the comments. Remember this is a scenario, based on many rural areas that claim they can not pay, thus the name Ruraltown.

First thing to remember is that the city/county has been funding everything but payroll, with the assistance of occasional donations from the public. So only new expense is payroll related(hourly pay, payroll taxes, and workers comp).

The $250,000 does cover payroll, overtime, and payroll taxes. No benefits at this time beyond a paycheck for what you have been doing for free.

3 full time and 1 part time Paramedic @ $12hr and 3 full time and 1 part time EMT @ $10hr equals payroll of $205,920. That leaves over 21% to cover workers comp and taxes. But for safetys sake lets ask for payroll of $300,000, that brings only $200 per house additional tax per year. Again that would actually be lower when you would add what you would collect from all vacant land(think about it 3000 square miles = lots of vacant land that is still taxed) and businesses.

flight-lp brought up a huge source of untapped income, that of billing for services. If you started billing on the cheap $500, you are billing for $150,000 a year, so based on a bad billing/collection service you could expect still to get at least $25,000, and with a good billing/collections company much more unless like where I am and you get lots of illegal aliens that you can't find to bill. With the mileage and time should be billing much higher.

Now grants as someone mentioned, lots of those. Some will fund an entire new ambulance or even a new station, but those are hard to get. Lot's of small grants that can be used for supplies and equipment. But again you already have all of it to start and it has already been funded by city/county so is not a new expense. Only new expense is payroll.

Again that brings us back to on the very high side additional $200 per house additional tax per year, not that much to ask.

You can as was mentioned put info on a web page but probably your web page is part of city/county that funds you so will be censored(yes their is much censorship in our land of free speech especially in small towns).

Ah the threat of not volunteering. Nice but the city/county says oh well quit we're not required to have an ambulance service you'll be saving us money. Now this is where you'll finally get the public screaming. They'll be who's going to come when I stub my toe or wipe my nose when I sneeze, or oh yea help grandma when she quites breathing. You will get some out cry but sadly many still will say nothing because I've never needed an ambulance why should I pay, they forget the truth of the scripture that says something like time and unforseen events befall us all.

Hey keep the ideas pouring in so maybe we can help a real volly service find a way to become professional.

[Michael]

You can as was mentioned put info on a web page but probably your web page is part of city/county that funds you so will be censored

Start an independent website?