Ark. county threatens aggressive ambulance billing if cities don’t split EMS costs

Logan County said it has no other options for keeping the ambulance service running

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Photo/qimono, Pixabay

Alex Gladden
Times Record, Fort Smith, Ark.

LOGAN COUNTY, Ark. — Logan County says it needs cities to pay for emergency medical services, or the county will start more aggressively billing people who use the ambulance.

If the county starts billing people more aggressively, it would take people who do not pay their ambulance bills to small claims court or put liens on their properties, County Judge Ray Gack said.

The other option would be for the county to cut EMS resources.

The nine incorporated cities and the county are supposed to split the cost of ambulance services proportionally to their populations, Gack said.

For the past six years, cities have not had to pay for EMS because the county had a surplus of money after a new director discovered a number of EMS runs had not been billed. The county was able to go back and bill clients and insurance companies, creating a fund of more than one million dollars.

County Treasurer Teresa Graham said that Magazine was the first city to stop paying in 2012. Booneville stopped paying in 2014. Paris quit in 2015 when the county first got the surplus.

For six years, that surplus reserve was enough to fully fund EMS. But last year the money ran out, Graham said.

“We had a pool to draw from but our pond is dry,” Gack said at the March 8 quorum court meeting.

The county’s 2021 budget for EMS was $1,895,690 which was based on 2020 actual numbers. The majority of revenue for that budget comes from billing insurance companies and clients who use the service.

But there is a portion that does not cover. For 2021 it will add up to $155,000, and that is up from around $90,000 for several years prior. Graham said the county will use funds from a 1-cent sales tax to make up the difference this year.

All the cities proportionally get money from that sales tax, and in 1982 they pledged to pay for EMS out of that fund.

At that March 8 meeting, Gack said looking forward, he did not think he would be able to get the cities to cover their portion of the 2022 amount that isn’t covered by insurance or clients.

“Are they going to do it? No probably not,” Gack said at the meeting.

He said that at least he would be able to tell his constituents he had made an effort, and the cities refused to pay.

“Look, this is what the deal is. They’re not paying, so we’re going to have to aggressively bill you to get the money to come here and keep this thing operating,” Gack said he would tell his constituents.

Gack said he would do his best to try to get the cities to pay their share. One justice of the peace even volunteered to speak to the Booneville City Council to try and convince the city to hand over the money.

“There’s no way to force them, but I want the general public to know that we’ve done our part,” Gack said. “They’re going to have to answer to their citizens in their cities.”

But in a later interview, Gack changed his tune. He said that because he planned to meet with all the mayors, he thinks that they will see reason and pay.

“I think they’ll (the cities) all see a need for an ambulance service, and everybody will do their part to keep it up and running,” Gack said March 18.

He said at the same time that he does not expect cities to refuse to pay.

“I anticipate everybody is going to what to do what’s good and what’s right,” Gack said.

Paris and Booneville are the largest cities in Logan County. Paris pays 20% of the total, while Booneville pays about 18%. Those percentages will likely change, Gack said, when the county gets new population counts from the U.S. Census Bureau.

Paris Mayor Daniel Rogers said he would be willing to begin paying his city’s portion again, something they had been doing until the county developed the surplus.

Rogers said Paris paid the bill until six years ago when the county developed a surplus. In his view, the 1982 agreement stated that the cities were only to pay their part while the county had a deficit.

“I’m more than happy to do our part to help with that,” Rogers said.

Paris’ part of the bill generally equaled about $40,000.

“Every city is responsible for their portion,” Rogers said.

The Booneville city mayor did not respond to repeated requests for comment.

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(c)2021 Times Record (Fort Smith, Ark.)

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