PORT JERVIS—The primary ambulance service for Matamoras, Deerpark, and Port Jervis didn’t want to take this road, but it is asking for help.
For years now, the non-profit Port Jervis Volunteer Ambulance Corp., Inc. has been losing money due to a confluence of factors. Rising operating costs, fewer volunteers, laws that make it hard to get fully reimbursed from health insurers, and most importantly, a client base that is predominantly on Medicare and Medicaid, have all put the ambulance in the red.
Business Manager George Ewings said there was talk of closing down the 57-year old non-profit, but for many reasons, they decided not to.
“We all got into doing EMS for the same reason, it was to help people,” Ewings said.
Over the past nine months, Ewings and operations manager Michael Dymon, have been working with the three municipalities on funding for half of the unpaid calls they take in those places.
“We know it’s a big chunk of change, that’s why we only asked for half,” Ewings said.
Last year, the ambulance answered over 2,400 calls, half of which were in Port Jervis, a quarter in Deerpark and about 8 percent in Matamoras. The funding they are asking for is proportional to the calls they take in each area.
In the recently-approved 2016 budget for the Town of Deerpark there is $42,000 for the Ambulance Corp., which is the entire amount it asked for. Deerpark Supervisor Gary Spears said that while it was in the budget, the amount that will be dispensed is not beyond negotiation. “That’ll be further discussions,” he said.
Port Jervis has also heeded the call, although budget season is just starting for cities so it is too soon to say what, if any, the city can contribute of the $89,000 asked of it.
After talking with Spears, Port Jervis Mayor Kelly Decker also put $42,000 in his proposed budget for the ambulance. However, due to a proposed tax rate of 14.4 percent, which turned into 17.4 percent after a clerical error was corrected, the funding for the ambulance was removed from the budget as the mayor and city officials looked for ways to cut down on expenses.
The city has helped in other ways however. Just this year it relieved the ambulance from paying taxes on its two properties—their current location on Church Street and another property they own on Orange Street.
As for Matamoras, it is not clear yet whether they will be able to help with the roughly $14,000 requested of them.
“They have a bunch of things going on with an IT tax, so we’re still working on it,” said Ewings, who sent the council president an email in August. “It may not happen this year, but we’re hopeful for next year.”
Ewings said he felt bad asking the city, town, and borough to help close the over $300,000 funding gap, but without the added revenue, the ambulance would not be able to provide its 24-7 A-list service to the community.
“In the city of Port Jervis, we have an average response time of 5 minutes from the time we’re dispatched to the time we are on scene,” Ewings said. “If we were not to be here tomorrow, that would increase to 35 minutes, easily.”
Ambulances are not cheap to maintain or staff, and Ewings estimates they spend $50-$60 an hour to keep the organization running.
They pay over $300,000 a year just in payroll, and that is only for 5 paid staff and 15 per diems. The other 65 on their roster are volunteers, but of those 65, Ewings and Dymon estimate only about 10 are active.
The vehicles alone are a huge expense—to insure, maintain and equip them to meet all of the requirements is a huge cost. One new stretcher setup alone costs $40,000 Dymon said. Some medicines they use can cost $200 a dose, and whether they use $20 in medication or $200 medication on a person, they may or may not get reimbursed for it.
Then there is the building maintenance and supplies, fuel for the ambulances, and liability insurance, which altogether add up to a budget of over $600,000 a year, which just covers the bare essentials.
“People don’t realize what it costs,” Dymon said.”People kind of [think] ‘Oh the ambulance just shows up at the door, [and] I get a $6,000 bill.”’
The ambulance has tightened its belt in many ways already: instead of buying new vehicles, they are repairing the three ambulances and two donated first responder vehicles they already have, the newest one being from 2005.
They have cut down on overtime and are working on recruiting more volunteers. Seven people are currently in training, two are being re-certified, and seven more have applied.
However training for EMTs and first responders has become a more time-intensive curriculum than it once was, and coupled with the fact that people are working more and volunteering less, it is hard to convince people to sit through a training program in Goshen over several months, even if the training is paid for.
They have also been looking at grants, but there are not that many for EMS. For the ones that are EMS-specific, “you’re probably one of 100,000 agencies putting in for it,” Ewings said.
They also make a little more money through assistance calls in areas where more residents have commercial insurance, which are lucrative but limited in number. Last year 17 percent of their calls were outside their three main coverage areas of Port Jervis, Deerpark, and Matamoras.
A small fraction of their budget comes through donations, but they estimate it is less than 10 percent.
One positive development since April this year is that the ambulance has started working with a new billing agency, which they say has produced positive results.
They are also working on a relationship with Bon Secours Hospital in Port Jervis to do transfers.
Before Westchester Medical Center partnered with Bon Secours Hospital and started running its daily operations in May, the ambulance began the process to become one of the hospital’s transport providers for non-emergency transfers.
“The plan is, if someone were to live in the area, we would have a second ambulance … that would take the person home,” Dymon said.
Right now the hospital uses for-profit companies whose closest dispatch location is Middletown. Ewings said sometimes those transport companies come from even further afield if they are out on another call, so the fact that the Port Jervis Ambulance is local, he says, is an advantage.
“We’re hopeful, but we’ll see how that works,” Ewings said.
With a new billing agency, a potential partnership with Bon Secours on the horizon, and the promise of municipal funding, “I think by the end of 2016 you’re going to see a very different Port Jervis Ambulance” Ewings said.
Once the ambulance’s financial situation is more stable, there are many things they would like to do to expand. They would like to buy another badly-needed vehicle and more equipment, and build a new and bigger station on their Orange Street property.
And looking much further in the future, Ewings’ dream is to one day open a community paramedic program, which he describes as a visiting nurse service, but with paramedics.
“I think there’s a bunch of opportunity for us in the future, it’s just getting the funding to make all that opportunity happen,” he said.
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This article was updated on Nov. 30 to reflect the change in the Port Jervis budget.