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By Al Everson
posted Oct 12, 2009 - 9:16:28am
With a few misgivings and a strong message about the austerity of local governments, the Volusia County Council has approved a subsidy for the private ambulance agency serving the county.
"We're your ambulance service. We work for the citizens of Volusia County," EVAC Executive Director Mike Mellon told the council, as it debated the aid request Oct. 1.
EVAC was granted just under $3.4 million for the 2009-1010 fiscal year. The subsidy is approximately 1/5 of EVAC's $17.1 million operating budget for the new accounting year which began Oct. 1.
EVAC is the name of a private foundation established in 1981 to provide emergency-medical response and transportation to hospitals. The county has given EVAC the exclusive right to transport injured or ill victims from the scene of an emergency to a hospital.
There is a two-tier emergency-medical-response system in place in Volusia County, whereby EVAC and local fire departments scramble to emergencies. If an EVAC unit arrives on the scene first, its emergency personnel treat the injured and load them onto ambulances or medically equipped helicopters. If, however, a fire department's paramedics and emergency-medical technicians treat the injured and stabilize them until EVAC arrives and transports them to a hospital. Some cities, such as Deltona and Port Orange, have asked for the right to take patients to hospitals, but the County Council has thus far steadfastly refused to break EVAC's monopoly on emergency-medical transports.
The subsidy for EVAC comes out of the county's general fund.
Although EVAC bills patients, insurance companies and government medical-insurance programs for its services, many of those bills go unpaid. EVAC writes off millions of dollars' worth of bills as uncollectible or as charity cases each year.
In addition, reimbursements from such government programs as Medicare and Medicald have not kept up with the rising costs of keeping EVAC's units on the road, according to Mellon.
"The Foundation also emphasizes continued challenges in revenue," reads a summary given to the council. "It anticipates FY 2009-10 uncollectible accounts, entitlements and charitable care will total $13.5 million."
The prices of fuel, medical supplies and insurance are going up, he said, and experienced paramedics are in demand.
Besides paying the higher prices for things, Mellon explained, EVAC proposed to use part of the subsidy from the county to give employees a 2-percent pay raise and a $500 bonus. That caused some heartburn for the council.
"We denied our employees a 2-percent raise this year," Council Member Andy Kelly told Mellon, referring to the county workforce.
Council Member Josh Wagner wondered aloud if EVAC really needs all the cash for which it had asked.
"I'm having a hard time with the subsidy," said Wagner. "I don't understand why you can't take half the subsidy now, and we readdress the issue in six months."
Council Member Jack Hayman called upon his colleagues to grant the subsidy to EVAC, but only "with the contingency that these funds not be used for raises."
Hayman also urged Mellon and EVAC to be more careful about spending.
"I think every government agency in the United States realizes we haven't bottomed out vet," he added. "With the unknowns we have, I've had to change all my concepts about money."
The council voted 6-1 in favor of EVAC's request. Wagner was the sole dissenter. Even though part of the subsidy will not be used to give raises and bonuses, the amount of the county's aid to EVAC was not reduced, as Mellon said the money would be needed to ensure continued emergency coverage.
On a somewhat related note, the County Council called for an in-depth discussion about the possible consolidation of fire services — meaning the unification of county and municipal fire departments — throughout the county. The possible combining of local fire departments would involve emergency medical services, as well. The time, date and location of such a discussion, which would take the form an informal council meeting, have not yet been set.
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To the other counsel members who acquiesced, (caved) to the demands of a private company, we will watching your performance very closely, making note of your voting decisions. Be careful. The electorate is paying attention. We have a very long memory. At the end of the next county election cycle someone else could be occupying your seat.
All the other departments in our region have consolidated fire/ems programs? Why not Volusia? Consolidate the EMS and save some $$$!
How does it work, when Evac chagers taxpayer's money for their service and are colletcing tax money from them as well????
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