Delta Junction city officials are trying to find a way to maintain ambulance service after the present contract expires next year. But costs are rising and funding is limited, and some area residents say they don’t want to pay taxes to support the service.
The problem and perspectives from area residents were discussed, sometimes emphatically, by city officials in a meeting three weeks ago. Mayor J.W. Musgrove told more than a hundred people who packed the community center on Sept. 28 that the city is facing a deadline on finding a way to pay for ambulance service.
“The current contract ends June 30th, Musgrove said in his opening remarks. “If the contract bid goes higher … we don’t have enough grant money to make it through FY24.”
Federal COVID-relief grants have helped the city cover most of this year’s $589,000 EMS budget and contract with locally based Delta Medical Transport. But Musgrove said that funding, from the federal American Rescue Plan, will run out at the end of the fiscal year.
“So we’ll be looking at some other method of providing the service, paying for the service and/or changing the extent of the service,” he said.
Those costs have been rising in recent years, initially because the city has been upgrading to a higher level of ambulance service than that provided previously by the all-volunteer Delta Rescue Squad. City Administrator Ken Greenleaf says the problem was aggravated by the squad’s dwindling pool of volunteers.
“It kind of exceeded the capability of an all-volunteer force,” he said in an interview before the meeting.
Greenleaf says about 10 years ago, the city contracted Delta Medical Transport to provide ambulance service, and to upgrade the level of care it provided through an arrangement with Fort Greely Fire Department. “And that has grown into a professional service that has taken care of the community quite well,” he said.
Tony White, who owns and operates Delta Medical Transport with his wife Amber White, says that professionalism is necessary in order to provide advanced life support, or ALS, a more comprehensive level of care than Delta Rescue Squad could offer.
“Twenty-four hours/365, my guys have to be ready for any call within three minutes, per standard, out the door to that residence, and take them to the clinic,” he said in his explanation of how the company maintains its qualification to provide ALS.
White is a former Fort Wainwright firefighter who transferred to Fort Greely in 2009 to help that post’s fire department develop an ALS capability. He told those attending the meeting that when he first began talking with Delta officials about taking over the city’s ambulance service, he intended to cover his costs through payments from billing patients as well as a $25,000 annual stipend from the city, later increased to $50,000, and the use of the city fire department.
He also set out to contract with other agencies and organizations, like firefighting agencies and, more recently, the Cross Road Medical Center in Glennallen.
White says the number of ambulance calls has risen dramatically in recent years, especially since the onset of the pandemic. Many of those calls came from outside Delta city limits, where the majority of the greater Deltana area’s residents live. He says many of those patients couldn’t pay the amount they were billed, which combined with the Medicare/Medicaid billing limitations and other issues led him to realize late last year that his earnings were falling far short of expenses. He says those include training and equipment costs, as well as “payroll, admin, workman’s comp, insurance, physician sponsoring, licensing, fees — before you even roll out the door.”
White says last year Delta Medical Transport only recouped about half of the $800,000 it cost him to transport Medicare and Medicaid patients, because those agencies only pay about a third of what they’re billed. In response, he asked for help from the City Council, which increased payments to $20,000 a month, and again this year, to $50,000 a month.
But Greenleaf says the federal grants that paid for that will be gone when the contract is up.
“And so, the bottom line is the city has got to face a decision point,” he said.
Greenleaf says he and Musgrove took note of suggestions from audience members that included converting to a subscription-based service, or imposing a bed tax or cannabis-sales tax, which would require the council to reverse a ban on those sales enacted six years ago. Some, like Al Edgren, think those ideas wouldn’t go over well in Delta and the surrounding area, because of entrenched opposition to generating local revenue to provide services. That’s why the city imposes no taxes.
“I don’t think that’s going to happen here,” Edgren said in response to an audience member’s comment about Fairbanks-area EMS agencies operating in part with tax revenues.
That triggered a shouting match between the mayor and some partisans, who believe taxation is the first step toward formation of a borough.
Responding to the comment about Fairbanks EMS funding, James Squyres asked “Is this guy over here just arguing for a borough? Is that what you’re doing?”
“Hey! Hold it! That’s enough!” Musgrove said in a raised voice as he and White tried to continue the presentation.
Squyres suggested the mayor was squelching debate over the funding issue: “You started debating this guy, when he was trying to tell you …”
Musgrove interrupteed: “That’s enough! That’s enough!” and finally, yelled “THAT’S ENOUGH!”
Squyres later stepped before the audience to engage in an impromptu debate with White over Delta Medical Transport before both agreed to talk about the issue later.
Finally, two-and-a-half hours after the meeting began, after more suggestions and back-and-forth between audience members and White and Musgrove, the mayor ended the meeting.
Last week, Greenleaf said the Sept. 28 meeting was the first of what may turn out to be several meetings. The second may be coming up in the near future: both Greenlead and White said that they’ve come up with some possible solutions to the problem and look forward to talking with members of the public soon about those proposals.