Emergency services levy priorities are questioned

Concerns about how revenue from an emergency services levy will be distributed were brought to the attention of the Flathead City-County Health Board on Thursday.

Rural fire chiefs told the board that the levy, approved by voters in June, was intended to provide a basic level of medical service across the entire county. Because of that, outlying quick response units and ambulance services that rely on fund-raisers and volunteers should be the priority for funding, the chiefs said.

They said city ambulance services already have taxpayer support and the ability to charge for their services, and should not be getting the lion's share of the new money.

The 2-mill levy is expected to raise about $300,000 a year, and was intended to provide additional training, equipment and supplies for volunteers and professionals who respond to medical emergencies. As projected by the health board, the levy funds would be allotted on a formula that clearly reflects population numbers and therefore tilts toward Kalispell, Whitefish and Columbia Falls to a large extent.

Creston Fire Chief Gary Mahugh outlined why some in the emergency response community have concerns about the health department's distribution plans.

In the months leading up to the election, he said, there were several meetings with the main topic of how to distribute the levy, but no particular method was settled on. There was agreement that the health board would ultimately parcel out the money, with a general goal of providing a "base level of service" across the county.

"It was still in development," Mahugh said.

Many in the emergency response community were surprised when, just days before the election, the health department came out with a funding breakdown that gave the Kalispell and Whitefish ambulance services more money than had been discussed in the previous meetings, Mahugh said. He said that was apparently the result of input from the Whitefish and Kalispell city managers.

"The plan that was developed was trashed, and I believe it happened at the 11th hour," said Mahugh, who believes the breakdown does not reflect the input of the county's rural emergency service providers.

He said some emergency responders who campaigned for the levy plan in their communities now feel as though they were misled.

The Kalispell Ambulance service stands to get about $51,000 per year, compared to roughly $40,000 under the previous levy proposal.

Kalispell Fire Chief Randy Brodehl urged the board to support the city's ambulance in the "population-based" breakdown that was "presented to voters" as a projection just prior to the election.

He said the city ambulance services about 3,000 runs per year, half of them outside city limits.

Brodehl noted that a high proportion of the county's elderly population lives within the city ambulance service area, and a majority of patients have Medicare or Medicaid, services that reimburse roughly 40 percent of what is billed by the city.

Some health board members agreed that providing a base level of medical service in all parts of the county should be a priority, but they also said the board has an obligation to city ambulance services.

Board member Duane Larson, a member of the Kalispell City Council, said the board has an obligation with voters to stick with the appropriations that were outlined before the election.

Health board member Doug Smith, who also is a volunteer with the Bigfork ambulance, said he's concerned that the Kalispell ambulance may be forced to reduce its service area because of financial reasons.

"Even though I'm with Bigfork ambulance, I must support the Kalispell ambulance," he said.

Smith said he is more concerned that there are fire departments that provide no medical services listed on the health department's funding breakdown.

He said those departments should not get levy money, and that funding distributions should be based on the needs of particular services.

Others noted that the privately operated Marion ambulance and Three Rivers ambulance in Columbia Falls face the same collection problems as the Kalispell and Whitefish ambulance services, but they are currently not slated to receive any levy funding. That is an issue that will have to be considered, said board member Duane Larson.

Despite the concerns that have been raised, Mahugh said most emergency responders believe the levy will be beneficial if managed properly.

He urged health board members to remember the levy passed because of "community-based" support, and therefore its management should be based on "bottom-up, not top-down" considerations.

The board decided to delay a vote approving any funding distribution until a December meeting. Distributions won't be made until January, Larson said.