Current Budget Overview:
In 2009, the serving county commissioners established an EMS district, but initially funded it to support only a single ambulance countywide. At that time, the EMS program relied heavily on volunteers and depended on fire districts to fill the gaps. They hoped that federal and state funding would eventually materialize as a permanent solution to support growing emergency ambulance services. Unfortunately, this wait has led us to our current situation.
The existing levy only supports one ambulance for the entire county. Fire districts have been covering the shortfall to maintain our three ambulances countywide, negatively impacting fire protection services.
What do you mean by shortfall?
Example:
The projected revenue for the EMS district in 2025 is estimated at $1,392,082 from the property tax levy. If we include transport revenue from 2023 (McCall: $177,296, Donnelly: $114,225, Cascade: $112,781), the total revenue would amount to $1,796,384.
The cost of one ambulance is $1,171,233*.
Each fire district has an EMS contract costing $450,694**.
If Cascade takes the contract amount of $450,694 and adds the transport revenue of $112,781, the total revenue would be $563,475.
By subtracting the ambulance cost of $1,171,233 from the total revenue of $563,475, we find that Cascade Fire District is subsidizing EMS by $607,758 (with McCall at $543,243 and Donnelly at $606,314).
*The $1,171,233 to run an ambulance does not include the overhead costs related to housing an ambulance and its crew, which will still be covered by the fire districts. Additionally, this amount takes into account wages aimed at attracting and retaining staff.
**The $450,694 EMS contract is pulled from the current EMS revenue. It is the same contract amount (regardless of the number of calls received) because in 911 response you are paying for the readiness of two professionals who are prepared to respond at a moment’s notice.
If these funds were redirected to the fire departments, they would:
- Update outdated fire apparatus and equipment
- Complete essential building repairs
- Hire additional staff
- Offer competitive wages to recruit and retain employees
Proposed Budget: The Valley County EMS District budget prioritizes three critical areas that are vital for community safety and service reliability.
- Three Staffed Advanced Life Support Ambulances Available 24/7/365:
- Three ambulances are staffed throughout the county for quick emergency responses, which is crucial for saving lives. Staff expenses are significant but necessary; skilled professionals ensure effective emergency care. Retaining skilled staff is essential for prompt and proficient emergency assistance, preventing delays and improving community safety.
- Add Six New Staff Members by 2028:
- Our community is growing, and regardless of our individual preferences, it’s essential to adapt. At present, we do not meet national staffing benchmarks, making it crucial to tackle this challenge while also planning for the future. To achieve this, we have created a dedicated fund aimed at aligning our staffing models with industry standards by hiring six additional team members by 2028. This initiative addresses current gaps while also preparing us for future demands and revitalizing our outdated operational frameworks.
- Equipment Renewal:
- Our budget includes provisions to replace ambulances every 12 years, ensuring reliability and reducing the risk of breakdowns. This guarantees uninterrupted service and enhances community safety.
Full budget details are posted at these links:
- https://valleycountywideems.com/wp-content/uploads/2024/10/EMS-Budget-2026-Website-.pdf
- https://valleycountywideems.com/wp-content/uploads/2024/10/EMS-Ambulance-Budget-2026-Website.pdf
Funding Sources
Our EMS revenue has multiple revenue sources and is actively seeking additional ones:
- Transport Fees: Patients transported by EMS pay a fee that directly funds our services.
- Cost-Reduction Strategies: Staffing ambulances and crews within fire districts allows us to lower expenses while maintaining high standards of quality. Additionally, we can share equipment and medical supplies between agencies, and we seek cost savings by ordering equipment and supplies collectively. We have consolidated our operations under a single Medical Director and are currently reviewing care protocols, equipment, and supplies to streamline processes and remove any non-essential items.
- Full-Time Resident and Property Owner Relief: We’re exploring programs to offer relief to property owners and full-time residents when costs exceed insurance reimbursements.
- Non-Resident Fees: We are proactively exploring fees for non-residents to improve funding opportunities.
- Grants and Federal Funding: Valley County provided one-time funds from the PILT (Payments in Lieu of Taxes) Fund, which provided temporary relief but were allocated only as a bridge to modern and adequate funding. The State EMS grant serves as the main source to acquire new ambulances, rescue trucks, and enhance our equipment. It’s essential to highlight that these grants frequently do not cover the full expenses, particularly concerning apparatus costs. Local grants include The Laura Moore Cunningham Foundation, Midas/Perpetua, FireHouse Subs, Saint Luke’s CHIF grants, as well as St. Luke’s Auxiliary grants.
It’s important to highlight that the majority of available grants tend to concentrate on vehicles and equipment, which creates a gap in funding for staffing support. While the SAFER (Staffing for Adequate Fire and Emergency Response) grant exists, it requires proof of funding to sustain staff after the grant period ends in order to qualify for assistance, and it is not renewable. State legislative efforts have often been unreliable, as shown by the stagnation of Senate Bill 1416 and the negative impact of House Bill 389 on rural departments. Previous initiatives like the Idaho EMS Task Force and Senate Bill 1391 also failed. What the State has done is provide the 2020 IDAPA Code 31-3908, which allows communities to create ambulance districts, emphasizing the need for local action and diverse funding strategies. Local initiatives are vital for meeting emergency service needs and ensuring community health and safety.
Operational consolidation efficiencies made since January 2024:
- Moved from three separate medical directors to one.
- Moved to one set of protocols instead of three.
- Moved EMS to one training platform.
- Moving to one reporting program.
- Moving towards cooperative purchasing of ambulances, equipment, and supplies.