The Aspen Ambulance District is looking for sustainable funding alternatives for its operations, as the current funding model is predicted to run out of financial reserves by 2018.
Members of the ambulance joint operating committee met with the Pitkin County commissioners during Tuesday’s commissioners work session to discuss possible options to bring the ambulance district’s level of funding to a more sustainable level.
The Pitkin County commissioners have served as the board for the ambulance district since it was created in 1982. At the same time, the commissioners contracted with Aspen Valley Hospital to provide ambulance service.
In 2008, the revised intergovernmental agreement between the district and the hospital identified the creation of a joint operating committee to provide oversight of the ambulance service and address matters of importance to both parties.
“We’ve been talking about this level of funding for many years,” said Gabe Muething, former operations manager for the ambulance district. Muething is now the director of the district and part of the joint operating committee. “We felt like we needed to tighten up our operations first before we came back to the community and asked for something. Hopefully the good management we’ve shown for the last 32 years and not asking the public for anything extra will earn us a little trust.”
The ambulance district has undergone significant operational changes in the past four years to increase service and efficiency while reducing costs. The changes have come in the form of a reduction in the number of ambulances in service from six to four, reducing staffing levels and equipment, increasing revenue-based activities and adjusting operations to reflect changes in workload.
The ambulance district provides multiple services to both the community and the hospital. The scope and role of the district has changed dramatically in the past few years and is being tasked with duties not typically associated with a hospital-based emergency medical-services system.
These services are not limited to medical-emergency response — they also cover prevention, education and emergency management.
According to Muething, the Aspen Ambulance District still retains a funding model that is not sustainable over the next five years. With the current funding model, the district will reach an unacceptably low level of reserves in 2017 and will lose all reserves in 2018.
“The needs of the department include the areas of living quarters, office space, education and training, vehicles and aging equipment,” Muething said. “We’re in a building that was constructed in 1991. At the time, it was a fantastic building, but it isn’t adequate anymore. Our vehicles and equipment have changed and grown, and the building hasn’t.”
Muething pointed out that the building is owned by the county and was built on hospital property.
“Nobody really knew what to do with the building for many, many years,” he said. “Unfortunately, the maintenance was lacking. Fortunately, as of 2012, the county has been taking care of the building and doing a fantastic job. We still have concerns about the building — do we fix it, replace it or remodel it?”
The ambulance district’s current model of revenue is based on two sources: mill-levy collections and patient-service charges. Patient charges for service are reflective of local, regional and national averages. The ambulance district’s fees for service are in the upper third of the regional average and have been evaluated to be in the acceptable range for the district. There was an 11 percent reduction in the volume of service charges since 2009.
The district’s mill levy was put in place at a rate of 0.82 mills when the district was created in 1982, and it was put into perpetuity. After the passage of Colorado’s Taxpayer Bill of Rights in 1992, that rate decreased significantly to the current rate of 0.22 mills. With that current mill levy, the ambulance district collects $1.75 per $100,000 of assessed property value.
The committee wants to discuss approaching the community about freeing the district from parts of the Taxpayer Bill of Rights — a process called “de-Brucing” after bill author Douglas Bruce — to allow for sustainable funding.
De-Brucing would allow the ambulance district to collect up to the original 0.82-mill levy based on the operational and capital needs of the district. At a rate of 0.82 mills, the yearly rate would jump to $6.52 per $100,000 of property value.
“The Aspen Ambulance District has never been de-Bruced,” Muething said. “We’re collecting 0.22 and currently have no ability to go above that.”
The Pitkin County commissioners also serve as the ambulance district board and can set the mill levy anywhere from 0 to 0.82, whatever the board feels is necessary to provide a responsible provision of service. If the commissioners do decide to adjust the level of the mill levy, it would still require voter approval to change.
The commissioners were receptive to the idea of adjusting the mill levy and asked the committee to return in August with specific funding recommendations as well as possibly including ballot language to de-Bruce the existing mill levy.
It also was recommended that the committee notify the Pitkin County Clerk’s Office of a possible question on the November ballot regarding the existing mill levy.
Commissioner Rachel Richards suggested the committee push to have the mill-levy proposal on the upcoming fall ballot.
“In a way, 2014 is very prime,” she said. “There’ll be a lot of turnout with the governors race and the Senate races and things like that. At least so far, I’m really not hearing about a lot of other mill-levy questions backing up. It would be good to think about going this year.”
“Hopefully the good management we’ve shown for the last 32 years and not asking the public for anything extra will earn us a little trust.”