On Windy Hill: Emergency! Taxpayers need resuscitated

Monday morning, an advisory committee is set to recommend to Osage County commissioners to maintain the current level of ambulance service in the county, and accept an annual contract that is $153,000 more than the only other bidder’s, and $94,000 more than the current annual cost of the service.

The county’s current four-year ambulance provider contract, with Osage County EMS or TECHS, Inc., will expire at the end of the year, and in planning for next year’s budget the commissioners put out a request for proposals, drawing two proposals from OCEMS and American Medical Response.

OCEMS’s bid for the current level of service – two full-time ambulances in the county – was $573,000 for each of the next three years and $596,000 annually for 2019 and 2020. While there appeared to be some confusion over the request for proposal criteria on the part of AMR, its bid specified $420,000 for 2016, with the price negotiated yearly until 2020. AMR’s representative later clarified publicly that the company would honor its annual bid for five years.

OCEMS’s current contract is for $479,000 annually.

During its deliberations last week about its recommendation, the ambulance committee discussed a recent public forum on the ambulance contract, noting few people who commented mentioned the cost of the ambulance service. County commissioner Ken Kuykendall, who is also on the ambulance committee, noted that most of the speakers at that forum were in some way connected to emergency services. Also noted was that many spoke in favor of retaining OCEMS as the provider. That is understandable, I think, because emergency services providers naturally develop camaraderie with people they work with daily while they’re trying to help us all, and a lot of these folks have worked together for almost four years.

Commissioner Kuykendall rightly noticed that taxpayers hadn’t spoken out against a tax increase for ambulance services, but I think it should also be noted that most people probably don’t think about ambulance services until they need them, and usually don’t spend much time thinking about how much it costs. And while the commissioners should be commended for seeking public input, many of the county’s taxpayers didn’t get the invitation.

OCEMS took over the services in 2011, and also took on a challenge to develop its business, services and presence in Osage County. But its bid showed that the cost of doing business in this county had risen. Discussion during the forum and last week’s ambulance committee meeting noted OCEMS had done many “extras” for the community, such as presence at events and maintaining non-contracted at-ready units. OCEMS representatives said their bid reflected that costs had risen due in part to more calls than expected for non-emergencies. Simply too many people in Osage County are using the ambulance service for non-emergency medical services or as their “primary medical care”.

AMR’s proposal would be able to shave its costs with efficiencies offered by a nationwide company, which could also absorb fluctuating operating costs if necessary, according to the AMR representative.

AMR’s involvement in the most recent bidding process did not come without criticism of the company, though. The company had been Osage County’s provider for a number of years before OCEMS won the contract for 2011.

As an outsider to the emergency services world, I have to say most of the criticism I heard at the forum and discussed last week seemed to be personality conflicts between responders and AMR staff, along with added anecdotal criminations for good measure.

When it was all hashed out at the forum, ambulance committee members and commissioners seemed to agree most of the problems back then stemmed from the fact that only one ambulance was assigned to Osage County at the time, and emergency services were dispatched from Topeka. Administrative hassles caused some headaches, but all agreed the service in the field was as it should be. With two ambulances staffed in 2011, along with the county establishing an emergency dispatch center, things seem to be working OK now.

Also agreed was that taxpayers couldn’t afford to have an ambulance in every town in the county, and the committee eventually agreed taxpayers couldn’t afford to add a third ambulance at this time. But that’s not to say they didn’t consider it.

While I haven’t been following local government as much as I should in recent years, I tried to pay attention to the ambulance discussion because I had written about the service changeover four years ago, when the county’s ambulance service more than doubled its burden on taxpayers. Less than 10 years ago, in a county in which the population has not grown during that time, taxpayers were spending around $160,000 a year for ambulance services.

With that in mind, I have to say comments I heard from commissioner Kuykendall last week concerned me more than any other in the discussion.

The commissioner indicated he and county commissioners across the state were worried about the new budget law just passed by the Kansas Legislature, which had a clause that limited the amount counties and cities, and possibly other entities, could raise taxes without holding a tax election.

His comments implied he would consider approving the higher priced contract just because it would boost next year’s budget, which might or might not be set as the benchmark budget year, and with the mechanics of the law yet to be understood by many it will affect most.

“If it’s set on ’15, we’re in trouble,” Kuykendall said of the county’s future potential taxing authority. “If it’s set on ’16, we’ve got to raise stuff because who knows when we can raise it again.”

Frankly, though I’ve heard that even the lawyers that work with the Legislature don’t yet understand all the implications of the new tax law, I think this tax lid put on cities and counties might be the only bit of relief offered for average taxpayers. It seems the Legislature was saying, “Taxpayer, we’re going to have our way with you, but we’ll show a little mercy by making local government hold an election before raising taxes.” So much for local control, though.

I don’t agree with the commissioner that this warrants an immediate tax increase, though. It might alleviate his concerns to know that many tax elections have been won with just a little effort put forth demonstrating a definite need. If the county needs more ambulance services in the future, what’s wrong with asking the people if they want to pay for it?

Before commissioners decide to raise taxes just because it might not be as easy in the future, growth of county government in the not too distant past should be remembered. Commissioner Kuykendall was involved with the ambulance changeover four years ago, when not only did the cost of ambulance services more than double, taxpayers also footed the bill for a new dispatch center and personnel. Government grew, but the same number of taxpayers are paying for it. (Weird to note: At the time, commissioners were able to slip part of the new expenses into the next budget without much of a noticeable increase because of the previous year’s inclusion of funds for a quadruple murder trial.)

Kuykendall did show concern about taxpayers, though, saying some would be whining to him about higher taxes if the cost of ambulance services rose. I think we have reason to whine. County commissioners are not the only people who should be concerned about the new laws passed this legislative session. None of us know how for sure how our finances are going to be affected. I think it’s easy to surmise that if we paid taxes this year, we’re going to pay more next year.

So what is all this long-windedness leading to?

I agree with the ambulance advisory committee on maintaining the current level of service. Osage County taxpayers’ knees would buckle under the burden of the $864,000 to $923,000 annual cost that would come with adding a third ambulance.

As with the uncertainties about the new laws expressed by commissioner Kuykendall, taxpayers have many reasons to be uncertain about the future of Kansas and their ability to maintain business, hold a job, or just live here. I don’t agree we should take the high bid for services and raise taxes and add to the uncertainty of the financial security of Osage County’s residents. With this contract the commissioners have the opportunity to give citizens a tax reduction, which they should.

If there is question about quality of services, from whichever company is selected, commissioners need to remember it’s their responsibility to hold vendors accountable and ensure services meet standards as contracted.

Regardless of the commissioners’ final decision on the ambulance services, I want to make a request to them and all of our local government officials: In light of the disdain state legislators showed constituents and taxpayers this year, your citizens would appreciate some respect and consideration when it comes to making budgets and levying taxes. Remember you are public servants; you were not only elected to serve citizens, you were entrusted with that responsibility.


On Windy Hill, Wayne White sometimes writes about things he thinks about. He not only lives on a windy hill, he’s been known to be a windy writer.


One Response to On Windy Hill: Emergency! Taxpayers need resuscitated

  1. unome says:

    Amen, brother!

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