 - The Town of Shoshoni signed an agreement this week pledging to send all of its proceeds from the proposed local .75 percent sales tax to the Fremont County Association of Governments to support emergency medical services.){kind=link}
(Shoshoni, WY) – The Town of Shoshoni signed an agreement this week pledging to send all of its proceeds from the proposed local .75 percent sales tax to the Fremont County Association of Governments to support emergency medical services.
The agreement differs from the one Fremont County, Riverton, and Lander have signed, promising to send 54 percent of sales tax revenues to the Fremont County Treasurer to support EMS, with 31 percent going to the City of Riverton for commercial air service, and 15 percent going to FCAG to support public ground transportation.
The Shoshoni Town Council voted not to join that agreement last month because it would have required them to fund services that they “got no benefit from,” and because town officials would have had “no control over how that money was utilized,” Shoshoni Police Department Chief Chris Konija recalled during a special meeting Thursday.
The situation has “changed dramatically” since then, however, Konija said, explaining that Fremont County is now “looking at a fundamental change in how ambulance service is administered.”
Joint powers board
This week, the Fremont County Commission voted in favor of transitioning local ambulance operations to a joint powers board.
The Riverton City Council approved a similar motion Tuesday evening, specifying that it would support FCAG serving as the joint powers board that would take over local ambulance operations.
Under that governance structure, Konija said the local EMS system would be “returned to local control – but not just local control from one entity: local control through (FCAG),” an organization that already includes a representative from Shoshoni.
FCAG has also already endorsed a recommendation from its Regional Ambulance Service Evaluation Committee – which Konija chairs – to support a locally governed public model for Fremont County’s EMS system.
“Under this model, the county or a newly established public entity (such as a Joint Powers Board, an EMS District, or an entity under direct FCAG or county oversight) would assume full direct operational responsibility for all functions currently performed by the private provider,” the RASEC report states. “(Fremont County) would no longer rely on an external contractor to deliver the service; instead, it would directly provide – or directly oversee through a public entity – every aspect of ambulance operations.”
The publicly-run service the committee recommended would be developed in two phases, beginning with a model where fully paid, full-time employees would staff three ambulances in Riverton, one ambulance in Lander, one in the Fort Washakie/Ethete area, one in Dubois, and one dedicated transfer truck.
In phase two, the committee said the system would move to a “hybrid” model that would offer the same “core full-time deployment,” but with additional paid volunteer response vehicles positioned in “low call-volume rural areas” like Jeffrey City, Crowheart, and Shoshoni to “improve response times without the full cost of additional 24/7 units.”
Currently, by contrast, Fremont County operates five ambulances, including two in Riverton, two in Lander, and one in Dubois – a distribution that “results in extended response times in areas without dedicated ambulances,” according to the report, which cited a survey of 429 Fremont County residents that showed “widespread concern about the current state of ambulance service,” with 72 percent of respondents saying they were worried about coverage in rural and remote areas.
“Confidence in timely response is notably low, with only 32.9 percent of respondents expressing confidence that service can respond in a timely manner,” the report states.
Respondents also express concern about “billing opacity under the current private provider, coverage gaps during transports, and a desire for greater transparency and local accountability,” according to the report.
The current system is operated by Frontier Ambulance – a private provider that was selected through a competitive Request for Proposal process for a multi-year contract with Fremont County.
Under the contract, Fremont County retains ownership of all ambulances, equipment, and facilities, which are leased to Frontier Ambulance at no cost.
Fremont County also pays Frontier an annual subsidy to “augment user fee revenues,” according to the report.
That annual subsidy has totaled about $1.8 million in recent years, the report says – but it is projected to grow to $2.8 million in the future, “reflecting increased operational costs, the need for competitive provider compensation, and sustainability requirements.”
Funding
The RASEC report was accompanied by a spreadsheet that indicates it would cost more than $6.5 million per year to operate the more robust system the committee recommended.
That system would generate approximately $3.3 million in revenue, however, leaving a funding gap of about $3 million, according to the cost tool.
That gap could be covered by revenues from the proposed .75 percent sales tax voters will consider passing in August, RASEC Committee Member Mick Pryor said this week.
Funding opportunities are also available through Aug. 1 through the state’s Rural Health Transformation Program, which prioritizes grant applications that represent “partnerships” among local entities, Pryor noted.
“They very much want you to work together,” he told the Fremont County Commission on Tuesday.
That’s part of the reason members of RASEC approached the Wind River Inter-Tribal Council this week seeking their formal support “to partner with FCAG and the county to move ambulance service forward,” Pryor said.
Konija called it a “historic meeting” during which the WRITC “agreed to submit a resolution” expressing “their intention” to request to join FCAG.
“They agree that this affects all of us and that we all should work on this to solve this together and the best course to do that is FCAG, where all parties are represented as an equal seat at the table,” Konija said.
To show their support for all local governments having that “seat at the table,” the Shoshoni Town Council approved a resolution Thursday authorizing the conveyance of oversight of local emergency medical services to FCAG – contingent upon the admission of the Eastern Shoshone and Northern Arapaho tribes as “full members” of the group.
“This is a big step forward,” Shoshoni Mayor Joel Highsmith said, noting that FCAG has been discussing the prospect of tribal representation for more than a year. “We welcome (them). They’re an important part of our county.”