County EMS Overview Friends of the Upper Delaware River Seeks Distribution of 1 Million

DELHI - Delaware County Supervisors heard presentations regarding a year-in-review of county ambulance services and an overview and request from the Friends of the Upper Delaware River on Jan. 24.

Ambulance Year-In-Review

Supervisors awarded $1.2 million in ARPA funds to initiate a county-wide supplemental ambulance service in 2022. After numerous discussions and controversies, the majority decided a supplemental service would be most beneficial in providing relief to volunteer ambulance services and cutting back on response time.

The service, which was initiated on Dec. 1, 2023, is contracted through AMR (American Medical Response). The $1.9 million three-year contract has two basic life support vehicles and one advanced life support vehicle on a 24-hour-a-day, seven-days-a-week schedule. Two are stationed in south Hamden and another at Pindars Corners.

The county is required to pay roughly $158,000 monthly for service with restitution given for billed patients. Supervisors added a budget line of $500,000 in 2023 to make the difference between the ARPA award and contract total.

Emergency Services Director Steve Hood reported the total billed amount for 2023 was $1,899,999.96 of which the county was reimbursed $589,896.75 for a pay total of roughly $1.3 million. 

It was reported that net revenue per ambulance transport was $482.99 which, Hood said represents 23.7% of gross charges - this means the county is only collecting roughly 24% of what is being billed out for services.

One major issue with billing reimbursement is that 85% of patients needing service have Medicare or Medicaid insurance which have a state and federally-regulated billing amount, said Hood. The rate for a basic life support bill for these patients is $250 while other insurance options charge an average of $1,500. The government reimbursement rates are far below service costs, said Hood.

In total AMR responded to 1,525 calls and had 843 canceled calls. Of the responded calls, 948 required patient transport. The most calls came from the Delhi area for a total of 447. Other high-call volume towns include Bovina with 212, Stamford with 152, and Walton with 130. Average response time is 17 minutes.

Hamden Supervisor Wayne Marshfield said that the AMR contract seems to be helping the volunteers at the Delhi ambulance service. 

Hood said the ambulance service is helping residents as it responded to 1,500 calls that would have gone unanswered or had long wait times. He also reported that AMR has never missed a call and has consistently been staffed on a 24-hour seven-day week schedule.

Franklin Supervisor Donald Smith asked if AMR employs locally since they are a national company. Hood said the company does hire locally for the county service and that many of their employees are also volunteers for local departments. 

Supervisors agreed it would be beneficial to resubmit an RFP (request for proposal) for an ambulance contract after the three-year contract if it is decided to continue the service. After three years, the service will need to be entirely funded by the county budget as ARPA funds will no longer be available. 

Supervisors also discussed that ambulance services becoming a government-mandated service is being discussed at the state level. Hood reported that fire departments have always been a mandated service since their inception, but since ambulance service did not exist at the time it was exempt. Hood believes the state is moving toward adding an ambulance as a government-mandated service, which means the county or towns will be responsible for subsidizing ambulance service.

Friends of the Upper Delaware River

Supervisors heard a presentation of Friends of the Upper Delaware River (FUDR) projects and goals from FUDR Executive Director Jeff Skelding. FUDR, founded in 2003, works to improve communities and local economies through protection or restoration of the Upper Delaware River. 

Since 2021, FUDR staff have secured $1 million of the New York State budget for the watershed-wide stream program which covers Delaware County below the dams as well as Sullivan and Orange counties. Skelding said the program will require a steering committee consisting of local officials and nonprofit organizations. The program will also need an advisory committee including county and state officials. The committees will be tasked with development of a re-grant program to distribute funds to eligible projects. Qualifying applicants include municipalities, 501c3 nonprofits, universities, and other academic institutions.

Projects FUDR hopes to fund in summer of 2024 include Oquaga Creek bank stabilization located in Deposit, culvert replacement on Mellis Brook Road in Colchester, and waterline stabilization in Rockland.

Skelding asked supervisors to participate in the steering committee which would consist of four meetings annually. He also asked them to help identify opportunities for partnerships or projects in Delaware County.

The next Delaware County Board of Supervisors meeting is scheduled Wednesday, February 28 at 1 p.m.