Washington County Ambulance Advisory Committee formed

WASHINGTON - The Washington County Board of Supervisors approved the establishment of the Washington County Ambulance Advisory Committee during its meeting Tuesday morning.

Supervisor Jack Seward made the motion, saying the purpose of the committee would be to explore the options on how to move forward with establishing an ambulance service in Washington County. The board will be co-chaired by Seward and Supervisor Richard Young with membership open to a representative from each city within the county, Washington County Mutual Fire Aid, the Washington County EMS Association, Washington County Hospital and Clinics, Washington County Public Health, the Washington Economic Development Group (WEDG) Director and others approved by the committee co-chairs.

The current contract with Washington County Ambulance, a private organization, has been extended until June of 2020 and may not be able to be extended again. For this reason, a group has been working since July to find a viable option, he said.

Because of rule changes with Medicare and Managed Care Organizations (MCOs) and changes in the Iowa code that effect emergency medical services (EMS) and quick responder services (QRS) these entities are in jeopardy, he said. The proposed changes in section 132 of the Iowa Code state that if a service does not reach 100 calls per year, based on a three-year average, they will not be certified.

According to the Emergency Health Services Federation, QRS is a non-transporting service that uses EMS providers to respond to calls before the ambulance is able to get there. If QRS ceases to exist, an extra component of care will be missing.

Seward said this would be detrimental to Washington County because should this pass, it is possible five of the seven QRS services in the county would no longer exist. He said state law does not require cities or counties to require ambulance services like they do police and fire. Currently, the county budgets $490,000 annually for ambulance services. The funds are raised form the county's general levee with an assessment of about 39.7 cents per $1,000 valuation, he said.

Moving forward, Seward said the committee will be looking at six possible options:

1. Continue to provide ambulance and emergency services to residents or discontinue the service and save tax payers nearly $500,000 annually

2. Contract with an established provider from outside the county

3. Form a 28-E agreement with all municipalities in the county to share the costs

4. An outside group to form a nonprofit for the county to contract with

5. For the Washington County Hospital and Clinics to operate the service

6. Establish a county operated ambulance and QRS service

Seward said the committee will study and try to determine the possible cost of each option as close as possible as well as find ways to cover the additional costs. He said the assumptions are the public would like to see the ambulance service remain in the county and that the most viable option could be for the county to own and operate the service. He said if these assumptions are true, taxes may need to be raised and would have to be approved via a voter referendum.

He said if a ballot initiative was needed, it would take place March 3, 2020. The vote would authorize a tax levy for five years. Once that time frame expires, another vote may be needed. Seward said this is all based on assuming the public wants the service to be county run. If this is not true and the vote fails, the committee is 'between a proverbial rock and a hard spot.”

Seward said one of the first things the original group did was look at bringing in an outside company to contract with but saw red flags based on other counties experiences.

'Because of the problems other counties have had with outside entities, it doesn't look like that's a viable option to continue to provide the level of service that we currently enjoy,” he said. 'There are things that we fund at the county level ... that are not required by law, but because the general public says it's the right thing to do, we go through with it. That's what we're facing right now.”

The decision was approved by a vote of 4-1 with Supervisor Richard Young abstaining.