Shroyer: Broken funding system leads Coshocton EMS to seek more funding

COSHOCTON − Coshocton County Commissioners are considering placing a 1-mill property tax levy for EMS general operations on the spring primary ballot. Paperwork to do such would need to be into the Coshocton County Board of Elections by Jan. 2.

Currently, the agency receives about $2.7 million annually from 4-mills in separate property tax levies and about $1.3 million in billing revenue. However, personnel costs are just under $4 million a year and will have to go up in order to be competitive with private ambulance services and fire departments elsewhere. Personnel is about 80% of the department's costs.

Todd Shroyer, director of Coshocton County Emergency Medical Services, said in June said he didn't want to ask taxpayers for anymore money, but finds it unavoidable with the state of EMS today.

"We're doing everything we can to maintain level of service, but it is what it is when you look at personnel. EMS isn't any different than anywhere else," Shroyer said. "We have a really good system, but it's a really expensive system and we've reached the point where we've got to have more money if we're going to keep it."

It's estimated the levy would bring in about $700,000 annually, but needs certified by the Coshocton County Auditor's Office. Shroyer said this would about cover the shortfall they're projecting for 2024. Current estimates has the entity out of money by February 2025 unless something changes.

Without more funding, Shroyer said cuts to personnel would need to be made and they would go from having four crews most of the time to three crews only around the clock. There are 56 employees on the roster now. Shroyer said they've not replaced three people who have recently left, making their total ambulance crew members at 28 with 31 considered full staffed.

Shroyer said he didn't want to hire anyone now if they would be laid off next year and, if more cuts need made, he hopes they can be through attrition. Paramedics top out at $21.75, but Shroyer knows they could make $30 or more almost anywhere else in the region.

"When you look at what a paramedic can do in a hospital ER versus a nurse, they're more versatile and they're half the money. But at half the money, it's twice what we're paying," Shroyer said on what paramedics are legally allowed to do when it comes to patient care, like intubation.

He knows people are going to point to the EMS station being constructed at the corner of Seventh and Walnut streets, but that's a different stream of funding. The project is estimated at $4.35 million with funding coming from bonds and a $1.95 million Targets of Opportunity CARES Act Funding grant from the Ohio Department of Development. Personnel should be moving in around the first of the year, Shroyer said.

"You have to look at it, what it would cost us in labor to make the benefit of that building. Will we get someone who will stay here for $21.75 an hour because they have a decent facility to work out of," Shroyer said.

Shroyer admits they're doing pretty well with all things considered. Their call per response averages about $800, down from the national average of $1,000, and their response time meets the national standard with ambulances getting to about 75% of calls in 8 minutes or less. Yet, that doesn't mean the system isn't in dire straits overall.

Shroyer said he recently found a report from 2008 stating rural EMS was in trouble and the financial model was broken. Nothing has really changed. He said the state is giving an increase to what they pay in Medicaid reimbursements this year, but it's a token amount going from about 15 cents on the dollar to 25 cents.

Shroyer said they've billed 1,354 calls so far this year, but have responded to around 5,000 calls. They can't bill by law if there isn't a transport. More than 60% of patients have Medicare and close to 25% have Medicaid, with some seniors having both. Only a bit more than 10% have private insurance. The average reimbursement rate for Medicare is $478 and Medicaid is $154.

"EMS in America is not going to get fixed until somebody realizes they've got to pay for it. Right now, we can't get that attention," Shroyer said. "It's a broken system. We've been in trouble for years, but COVID really brought it to light."

Leonard Hayhurst is a community content coordinator and general news reporter for the Coshocton Tribune with more than 15 years of local journalism experience and multiple awards from the Ohio Associated Press. He can be reached at 740-295-3417 or llhayhur@coshoctontribune.com. Follow him on X at @llhayhurst.

This article originally appeared on Coshocton Tribune: Coshocton County EMS seeks more funding: 1-mill levy may be on ballot