Exeter Ambulance Board eliminates manager position

By Reggie Ellis

The Exeter District Ambulance voted 4-1 on May 18 to eliminate its district manager position.

Board President John Kunkel said the decision was made for financial reasons.

"This has nothing to do with performance," Kunkel said.

Former district manager Don White cleaned out his office following the meeting. White, who has worked for the district since 1986, first as an EMT and later as district manager in 1989, received a two-month severance package. "I don't think it would be wise to comment at this time," he said.

Elimination of the management position was the first item under scheduled matters on the agenda. The motion to eliminate the position was made by board member Sonny Lowry and seconded by Jake Tormohlen. Kunkel and Kerry Elbisi also voted in favor of the motion.

Board member Chris Brewer was the lone dissenting vote. He voiced his opposition before the vote and asked to study the issue further to come up with cost-saving alternatives. He left the meeting early following the vote and resigned the next day after 12 years of serving on the board. Brewer said on advice from his counsel, that he can't discuss the issue at this time.

"You can see my response to the decision in that I have resigned," he said.

Employees were split on the issue, but none made any comments on the record as Kunkel has placed a gag order on all district employees. None of the other board members are talking, referring all questions to Kunkel. However, a letter addressed to the board was submitted prior to the decision by Kim Damico, one of two paramedics with the district as of May 20.

"Tulare County is facing major changes in the structure of [Emergency Medical Service]," she wrote. "Your timing could not be more inappropriate!"

Damico's statement is in reference to Tulare County joining the Emergency Medical Services Agency in February 2004. The county is also in the process of transitioning from Emergency Medical Technicians to paramedics, which are certified to administer additional medications and trained on additional life saving procedures. Damico goes on to write that the Central California EMS is preparing a centralized dispatch for all ambulance companies and installing additional policies, procedures and paperwork for the upgrade.

Daniel Lynch, director of Central California Emergency Medical Services who oversees EMS in Fresno, Kings, Madera and Tulare counties, said he doesn't see Exeter's decision affecting their level of service. "They are still an agency in the county with good graces," he said. "It's more procedural on their end, but it's not an issue for us."

Kunkel said assistant manager Lori Trowbridge will act as interim manager taking on additional duties. Kunkel said the money saved from the decision will be used to increase services by extending hours on the district's secondary ambulance crew.

"We are looking for ways to cut the budget," Kunkel said. "We eliminated the board's stipend and cut back on EMTs. The only area we hadn't cut was from management."

Dave Armstrong, accountant for the district, said White's position cost the district $71,000 per year including salary, medical benefits and retirement. Because someone will have to be paid to take on those duties, Armstrong estimated the district may save about $35,000 during a full fiscal year. Still not enough savings to purchase a new ambulance ($100,000) or pay for an EMT-IIs annual salary with the district minus medical benefits and a retirement package.

The elimination of White's position is the latest of a series of cost-cutting measures in the last two years. The financially-strapped district closed its Farmersville station in November 2003 in response to a $150,000 budget gap. Stationing an ambulance in Farmersville full-time was a drain on district finances. As a special tax district formed in Exeter, only property in Exeter is taxed to fund the district. However, Exeter Ambulance is the primary EMS in Farmersville and Woodlake and helps back up calls in Lemon Cove, Three Rivers and Badger.

Armstrong said the closure saves the district $60,000 a year. In January 2004, the district cut back from two to one full-time ambulance crew that worked 24 hours per day, seven days per week. There was another ambulance operated by per diem employees, who were only paid to respond to calls if the primary crew was already responding to another call.

The problem with cutting crews, Armstrong said, is that call volume is the district's primary source of funding. In other words, if the district doesn't answer any calls, they can't bill for any calls. And even when they aren't billing calls, they are still paying EMTs to be on the job.

About three months ago the district decided to add another crew to work 40 hours a week. Kunkel said the money will be used to extend the hours for that crew to offer more service to the district and surrounding communities. The problem with adding another crew is that more ambulances mean buying more gas. Through April, the district has already spent $10,800 on gas, nearly $2,000 more than it budgeted for with two months left in the fiscal year.

Armstrong said the measures have helped the district become more financially stable but not entirely solvent. The district's policy is to keep a minimum of $250,000 in the Local Agency Investment Fund, a savings account for public agencies with a 2% interest rate. The district currently has $250,000 in that account. As of press time, Armstrong said the district has $86,000 in its checking account.

Armstrong said costs continue to escalate and revenues continue to drop. Medical and Medicare reimbursements make up a large portion of the district's revenues and that percentage rate has dropped each of the last few years. Also, the district cannot deny medical service to anyone, regardless of whether they have insurance or are able to pay. He said on average, the district collects 50 cents on every dollar it bills out.

Kunkel said the alternatives to cutting back are to take a tax increase to the voters or dissolve the district and have a private company provide the area with emergency medical services.

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