Moffat County Commissioners forgo county EMS review
February 6, 2012
“I don’t understand how the (Moffat County) Commission could vote against free information. I was kind of hoping we could have this evaluation done by outside experts with a fresh set of eyes, and now I am not really sure what to do next to improve the EMS system in Moffat County.”
— George Rohrich, chief executive officer of The Memorial Hospital in Craig
In November 2007, when the Moffat County Commission signed off on a voter-approved mill levy for construction of a new The Memorial Hospital in Craig, it was done with an understanding health care services would not be affected, including EMS.
At least that was commissioner Tom Gray's interpretation of the agreement.
However, TMH has been maintaining EMS each year at a net loss.
George Rohrich, TMH chief executive officer, said it costs the hospital $100,000 to $200,000 more a year to operate an ambulance service than the program generates in revenue.
Three factors play a role in the hospital's inability to generate enough funds to maintain EMS self-sufficiency: employing a trained staff of emergency medical technicians, low call volume and collection rates of about 40 percent.
Unfortunately, low call volume and collection rates come with the territory in a rural setting, said Rohrich, who conceded TMH could offset the majority of its EMS deficit by transitioning to a volunteer EMT workforce.
"But, it adversely affects your response time," he said. "I have trained employees 10 or 15 feet away from an ambulance waiting to respond to a call. If it were volunteers working jobs all over town, it would take a lot longer.
"We're not willing to sacrifice that level of care."
It's not uncommon for ambulance providers in rural settings around the state to receive local government subsidies to augment the costs of EMS operations.
Currently, TMH subsidizes its ambulance service out of pocket.
In an effort to examine deficiencies in ambulance service as a whole, Rohrich and Tom Soos, director of the county's office of emergency management, sat down Jan. 12 with the Moffat County Commission to discuss bringing in state experts to evaluate the county's EMS system.
The service is provided by Emergency Medical and Trauma Services, a branch of the Colorado Department of Public Health and Environment.
An EMTS consultative visit examines 15 elements of an EMS system as established by the 1996 National Highway Transportation Safety Administration and costs $15,000 to $25,000.
However, grant funding is available through the Statewide Emergency Medical and Trauma Services Council for up to 100 percent of the assessment cost.
Although the evaluation is readily available, EMTS must be invited by the county's governing body to conduct the EMS assessment.
Last week, Soos presented county commissioners with an invitation letter for approval. It was denied by a 2-1 vote.
Gray and commissioner Tom Mathers voted against the invitation letter.
"The Memorial Hospital is in better fiscal shape than they have been in my memory," Gray said. "To some degree, it begs the question why now? Is this a solution looking for a problem?
"It's a tried and true methodology in government to have an expert tell you you have a deficiency and the solution is typically more money."
Commissioner Audrey Danner, who voted in favor of the EMTS assessment, took issue with Gray's comments.
Because of ambiguity in state statutes, Danner argued it's not any one entity's responsibility to provide ambulance services and the burden of financing an EMS system should be done collaboratively.
"I can't fault someone for doing their job, but I think it's something to consider because we are already funding ambulance service outside of the Craig proper area," Danner said. "And I take strong exception, Tom, that just because the hospital is doing well, then this is something they should continue to fund.
"The thing that sticks out to me is the fact that we as a community get the final say as to whether or not we implement the recommendations. I don't see how I can vote against information that addresses EMS services in Moffat County."
Mathers said he agrees it would be up to the county to decide whether to implement EMTS recommendations, but he fears potential public backlash of not revising the EMS system post assessment.
"They could say we need an ambulance with a full-time staff in Maybell and Dinosaur and an extra one here in Craig," Mathers said. "If they recommend it to us and we don't do it and we have some major catastrophe, how do we deal with that?
"I just see this as costing us extra money."
Mathers said he was torn in his decision.
"I oppose this hoping we can have a conversation to see how we can really fix this problem because I think this can be fixed internally between the county and the hospital," he said. "I'd rather do that than have an outside source come in and tell us how they think we should fix it."
After the meeting, Rohrich voiced his disappointment with the commission's decision.
"I don't understand how the commission could vote against free information," Rohrich said. "I was kind of hoping we could have this evaluation done by outside experts with a fresh set of eyes, and now I am not really sure what to do next to improve the EMS system in Moffat County."