State of Ada Ambulance Service

A year and a half ago the Ada County Emergency Medical Service asked voters for a tax increase to fund the ailing ambulance service–with dire predictions from the Ada Commishes if it failed.
Ada EMS.jpg

Today they have enough extra staff, vehicles, and supplies to go after U.S. Forest Service contracts far outside Ada County. During the past summer the Ada County EMS provided standby services at three out of county fires for a total of $53,134. Based on the figures provided by the county it looks like they were out for 22 days with various paramedics doing the duty.

To fill the staffing gap, employees were authorized overtime pay within the county for normal calls. Ada County EMS claims the Forest Service contracted price of $100 per hour for two paramedics and an ambulance exceeds the cost of staff wages and benefits. It appears they are claiming to make a profit using county staff and equipment outside Ada County.

The GUARDIAN ran the question by two private ambulance companies and managers of both firms were unaware that Ada County was in the business of providing contract service outside the county limits. Each complained about being licensed by the agency that competes with them for the non-emergency transport business.

John Fogg, owner of Ada-Boi, told us, “They have no business competing with my business–especially outside the county.”

The Canyon County Ambulance service declined to bid on Forest Service business, saying they felt an obligation to county residents and didn’t feel the additional costs of overtime, workers comp, social security, and retirement benefits would justify leaving the county.

Bottom line: Ada County feels they made a profit selling services outside the county and residents will benefit from their astute business acumen.

With that line of reasoning the GUARDIAN wondered why other departments don’t follow suit. The assessor could contract for appraisals in Boise County, the treasurer could collect taxes from Elmore County residents, the Parks Department could manage Forest Service Campgrounds, and the Commishes would serve as a board of directors raking in the cash.

We think they have overstepped their bounds–which is the county line–and need to revisit the policy of competing with private sector businesses.

Comments & Discussion

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  1. The public is apparently unaware, but Ada County EMS DID cut service when the bond failed. If you live in Eagle or Kuna, for example, you now only have 12-hour service nearby, rather than 24-hour service. The other 12 hours, an ambulance must travel much further to provide service to you.

    Also, if you DO receive services from Ada County EMS, get ready to receive a bill averaging about $900 but sometimes far more, if you are transported to an area hospital. It is a good idea to sign up for the Neighbors for Life program for $60 a year to avoid these charges.

    The paramedics are hard-working, dedicated people who do their best under difficult circumstances. It is unfortunate that the County commissioners have not made EMS a higher priority for their Ada County constituents.

  2. I agree with Ms. Ullman. The current “flap” in no way includes the Ada County Paramedics. They are truly a bunch of dedicated, highly professional people doing a too often, thankless job.

    However, what is the leadership of the EMS service trying to do??
    Contracting for service outside the county is completley over the top. Especially when there are two private ambulance services here.

    The debacle of the county EMS situation goes back years! Overstating calls, not transporting, transporting, multiple units on the same call, trying to eliminate private transport involvement, budgets that can’t be justified are just some of the problems that we have been asked to fund over the years.

    And while we are here, will someone please tell me how the “protection program” offered by the county EMS differs, at all, from the “protection” offered by organized crime.(we urge you to pay 60.00 for something you MAY need someday. We would hate to see you get hit with a big bill down the road.) Who do they think they are kidding?

    I suppose we shouldn’t really be surprised.The leadership at ADA county EMS is poor at best. But so is the leadership at the city, the county, the state, and the federal levels. Anyone see a pattern here?

  3. I’m very pleased to live in an area that has public emergency sevices…Thank you to all who serve…My coments are directed at the management and what the rules allow, not at the EMT’s and such.

    With regard to the cost of the sevices: At least they’re not using the company vehicles to drive around when not on a call anymore… I used to see the EMT’s driving around getting lunch and whatnot…

    I think they’re required to stay with the truck in an effort to be as speedy as possible in the event of a call out, but it looked more like the truck was staying with them…and costing $$$$$ to pick up lunch or whatever… followed one about 18 months ago from downtown Eagle south to I-84 at about midnight…. changed all the lights just to have a coffee at a fuel stop…

    Wonder how much that was costing?? They stopped doing that when the extra money failed…so that’s good right? Bet the savings is huge…at least $1 a mile on a rig like that.

    As for private sevices…..I think these folks are as important as the police and fire and I sure as heck don’t want those sevices run privately…why would you?

    I agree that the contracting needs to be left to private parties…keep my public truck and crew with as low a miles as possible.

  4. Bid or no Bid
    Oct 2, 2006, 9:18 pm

    So was there a bid process? Or did Ada County EMS cut a deal under the table? If so the Commishes would have to sigh off.

    If there was not a bid by the Forrest Service why not?

    EDITOR NOTE–It is an “annually renewed contract called upon when needed” (by the USFS). The commishes tell us it was done in open meeting at some point.

  5. As the county EMS is chartered for service to the Ada County residents is it really prudent to expose the liability of this tax supported local group in areas outside of their legal boundaries?

    Maybe some of the counties legal beagles ought to be exploring that.

  6. Wow!
    Maybe the fire department should contract out its trucks and firefighters to fight the blazes our ambulances are sitting at!

    In agreement with the other commenters: I think the folks IN the ambulances do a great job, and I’m very grateful they’re around — well, at least sometimes they’re around, apparently.

    But I think it’s time to post a challenge to the BG and its readers: Is there any government unit, agency, unit, whatever, that isn’t run by idiots, does what it’s supposed to do, doesn’t waste taxpayers’ money, plays by the rules …

    If so, that could make a *really* interesting feature, something so unusual that it probably has never been done anywhere!

  7. Speaking of the fire department, I am surprised none of you pointed out that there are fire depts. with trained medics far closer to most of the areas the ambulances serve. Also the fire dept. is usually the first to the scene anyway so wouldn’t it be more important to have medics stationed with fire depts.?

    In response to Sharon’s comment on the bond, that is the people speaking, not the elected official. So what would you have done in that situation, gone against the voter? I also think that Kuna and Eagle have a 24 hour fire depts. with trained medics on staff. So by doubling up on services, aren’t we spending more money we don’t have to? I don’t think the Ada County Commishes are to blame as much as the EMS Board, I think that is just another platform for you to run on Sharon.

  8. Excellent. I have long thought that it was remarkable that ACEMS has been allowed to compete with those which it has statuary responsibility to license for non-emergency transport. This unfortunately is one example, John Fogg can cite

    I am not sure what your findings were regarding understaffing for Ada County, but from what I’ve been told Medic 60, Medic 68, and Medic 58 (or Medic 34 when staffed with 1 person) were noticeably not staffed.

    I am sorry that you are needed but I am glad for your work and dedication. There are many questions many people truly can’t ask (for many reasons.) Perhaps you could start a local “Center for Public Integrity”.

  9. It sounds like another article in the Guardian backed by special interest and funded by Union representatives.

    Forest contracts are a for bid venture. Meaning, any service that meets the specifications can bid. The private Ada Boi, do not offer the same capability as Ada County EMS. Ada Boi does not have paramedics and Northwest Paramedic Associates has so few paramedics they can hardly keep their contract in Elmore County appropriately staffed.
    As far as the fire department pretend paramedics go – it’s the fire departments that are the BIGGEST consumer of tax payer dollars per incident in the County not to mention their over inflated budgets and mil levies.

    They are the one’s doubling up on administrators, vehicles and now paramedics!!! They should just say home and put out fires when needed. No study has shown fire based EMS is superior in anyway. In fact if you look at Detroit EMS, D.C. EMS,San Fransisco EMS, NYC EMS, etc, are all EMS departments that were absorbed by the fire departments. Now, these EMS departments are plagued with a mismanagement and future separation of the ambulance services from the fire department is on the horizon. EMS is NOT the same as fire fighting, don’t confuse the two.

    If you don’t want the current ambulance service to be probusiness with private contracts and similar ventures, support it with tax dollars so they dont have to.

  10. It is clear that voter1 is a paramedic or works for acems in some way. Meridan, Kuna and Boise Fire Departments are slowly adding paramedics to there engine companies, and someday have the whole county covered. They are not “pretend paramedics”. They are very qualified and some are even former ACEMS medics. It is a threat to ada county ems. Why doesn’t anyone talk about the cities giving ACEMS free rent in their fire stations, or the old fire station in the Northend being used by the county for free.

  11. It would be interesting to see how much funding is wasted on the local fire departments paramedic programs. How many calls do they respond to, how many patient contacts do their paramedics get annually, how many skills and interventions do they do?? And, most importantly, do they actually augment the current EMS system?? I’m not disputing the fire departments paramedics certification, rather it’s their usage I’m concerned with…hence the “pretend” comment.

    The County is already covered by paramedics, boisean, and they respond to thousands of calls every year – in every square inch of the County. What happens if the Fire Dept ran the ambulance service and a call originated outside their protection district??? Would they respond – they don’t on fires, there’s proof of that.

    What this place needs is a consolidated Public Safety Agency with Fire, Police and EMS operated under one arm to make the emergency services more efficient for the tax payer. That would end alot of needless arguments.

  12. Talk about Dejavu! Voter1’s last post was first made 25-30 years ago when the ACEMS was born. The EXACT same arguements were made then with the substitution of the terms “Paramedics and EMT’s”. All we are saying as citizens is quit wasting our money! The best advice the “commishes” can get right now is they better get the “damage control ” going in high gear.

    If this issue gets picked up by the “mainstreamers”, that little hiccup you guys had with the closed meeting problem is going to seem like a “nice walk through Julia Davis Park on a warm fall afternoon”. We don’t really care when all these things happened. It is on your watch now, and you will pay the price!

  13. Lets see; $15.12 per hour x 4 paramedics x 1.5 (time and a half)= 90.72 per hour. Now add benefits which for the County is probably 30%+ and you get a total of $117.93 per hour! Add some incremental cost for the use of the ambulance and it’s hard to make the math come out with a positive revenue figure when you only get $100.00 per hour from the Forest Service. Maybe I’ve missed something?

    EDITOR NOTE–That appears to be correct considering someone would have to fill in the schedule in Ada County most likely on overtime.

  14. Like all other problems in government, this is a leadership problem folks.

    I bet they anounce a multi-million dollar plan to study the problem. Then they’ll hire a bunch of former govenment types to come in and kick around for a while until the problem is old news again.

  15. I agree with Voter1 about the appearance that Guardian is definitely backing special interests or union movements. The way this, the second, article is written CLEARLY indicates one-sided argument. It is biased and does not present clear facts and only opinions. I have no live for the county or county public safety. But, it appears the Guardian has lost its objectivity and succumbed to pressures from the special interests.

  16. Wow. So much to say from people that have no idea how the system actually works or what a paramedic truly is and does (exception is Sharon Ullman who has done many ride alongs with ACP in the past and been a big supporter – THANKS). You’re all up in arms about ACP making money on cotnracts that are from the forest service and staff leaving town. I think it’s funny really.

    The fine citizens of Ada County showed their support for EMS and said no to a tax bond that would have allowed ACP to live off of your tax laurels yearly, just like the fire dept does and not have to make a conformity to public sector practices. Less than 1% of the public voted and turned that propopsal down. So… what do you expect? Rates go up, the service starts looking for ways to fund itself because growth is surpassing revenue. ACP has traditionally not competed with the private sector, but the public has spoken leaving not many other funding options available; like transfers.

    Every other large (with little tax payer funding) EMS sevrice in the nation does these transfers and obtains contracts in order to make the necessary revenue to support the 911 ambulance service. The membership program serves as a stop gap measure to protect citizens from an exorbitant bill due to high rates. Any one that thinks the membership program ($60) is a bad deal has never been transported by the ambulance service. $500 co-pays (after insurance) are not uncommon.

    Which is the better deal (do the quick math and get back to me)? This is a voluntary program that citizens can use to show their support for the ambulance / paramedic service in Ada County. If you don’t like it or the idea, don’t participate but blog on your own dime; it’s a good thing for alot of people. Oh, remember this…. whens the last time you expected to have an emergency or a heart attack? No one ever does and it happened to almost 19,000 people last year in Ada County. Those odds come out to about 1:13. When that happens to you, a loved one, or a friend of your, who do you want to come and take care of them and how long do you want it to take? Then ask yourself how much are you willing to pay for that service.

  17. To respond to the above comment about the “Free rent” from the fire stations… what a joke! You expect another government entity to pay rent when they already have extra room and a fully funded taxpayer budget with less than a fire a day / year and ACP has to scrounge for $ on fee for servce revenues. And… when they haven’t had extra room ACP split the remodel costs with the respective Fire Dept (Boise Fire Station #3). As for the old fire station in the northend that now houses M57, Boise Fire literally begged ACP to staff that station so they (BFD) could move into their JR Simplot requested Boise station #2. In fact they couldn’t move into that station unless the 17th and Ridenbaugh location was staffed 24 / 7. ACP did them the favor, not the other way around. The ONLY reason ACP is there is because Boise Fire didn’t want to have to battle with the North End Neighbors Assoc. Again, I beg you, blog on your own dime or take the time to come and get the facts from the agency you are accusing of mismanagement. I have no doubt the Director or Deputy Directors would be happy to set the record straight if you really wanted the facts or cared to know.

  18. I would be interested to see how receptive the Ada county Paramedics would be to all the Fire departments estblishing thier own Paramedic provider status and abulance service. While it would be a huge benefit to the public by reducing response times etc. I think the Ada County Paramedics would fight to hold on to thier little monopoly.

  19. Regarding Skeptics comment – $100 per hour covers 2 paramedics, not 4. It makes it easier to come up with a positive number when you don’t cut the revenue in half. Incremental cost for the ambulance (mileage) is also covered by the FS.
    Yes, you missed something, but good job speaking before you had the facts.

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