HUDSON — An increase in demand for emergency medical services coupled with a drop in the number of EMS volunteers has led to the city asking voters to approve a ballot measure to re-allocate existing income tax money so more is available for EMS.

City Council voted last month to place an issue on the May 8 ballot asking the city electorate to re-designate a percentage of income tax money set aside for the city’s fire department and EMS.

Jody Roberts, the city’s communications manager, emphasized the proposal is a "reallocation [of] current taxes" and is not a new tax.

When the city income tax rate was increased by voters from 1 percent to 2 percent in 2004, 15 percent of the additional 1 percent was designated for funding the fire department and 9 percent was earmarked for EMS. The collection of the added income tax began in 2005, said Roberts.

While Roberts noted those allocations "were appropriate then," a higher demand for EMS service combined with a decline in EMS volunteers has increased the need to hire paid paramedics and EMTs to cover shifts.

The upcoming ballot issue — if it’s approved in May — would stipulate that a combined 24 percent of the 1 percent increase fund both fire and EMS. Council would have "the discretion to appropriate on an annual basis funding from that 24 percent between the two safety services," according to the language of the ordinance passed by Council.

Roberts also noted the issue "will have no negative impact" on fire department operations.

"Funds currently in the fire fund will remain in a designated fund for the fire department," she said.

Current staffing levels for EMS

The city has three and a half full-time paramedics, according to Finance Director Jeff Knoblauch, but all of them are part of the administration (including Fire/EMS Chief Jerry Varnes), so they serve in other roles besides paramedic. The city does not have any full-time field response paramedics, but Knoblauch said they hope to promote two from within the department this year.

There are currently 17 part-time paramedics, two volunteer paramedics and 20 volunteer EMTs. Knoblauch added the city is accepting applications and will conduct a written test for part-time paramedics later this month.

"We would like to hire between five and nine additional part-time medics this year," said Knoblauch.

A seven-member ad hoc group met last year to review issues related to maintaining EMS services. This group — which included Varnes, Knoblauch, paramedics and an EMT — presented its report to City Council in July 2017.

The report noted that calls for emergency service have increased from 1,200 to 1,700 during the past five years. The number of such calls are expected to continue rising because of projected population and business growth, and due to the city’s aging population, according to the report. According to the report, 11.8 percent of the population was age 65 or older in 2010; that figure increased to 14.75 percent in 2015.

In last five years, the number of EMS volunteers dropped from 47 to 22. During this five-year period, the number of total EMS staff (including volunteers) declined from about 60 to about 40. Though the number of volunteers has decreased, the report noted the number of full-time paramedics has not increased in the last decade.

"We believe the number of volunteer medics has declined primarily due to the rigorous recertification requirements as well as the significant time commitment," said Varnes.

Fewer volunteers meant that paid paramedics responded to more emergency calls, a phenomenon that increased the EMS personnel budget "to the point where total expenditures exceed funds available," the report said. That trend first happened in 2014, according to Knoblauch.

With more emergency calls handled by paid staff, this has led to a rise in overtime for those part-time EMS staffers. The report notes about 37 percent of the hours originally slated to be covered by volunteers were instead handled by paid staff annually from 2014 through 2016. That percentage had increased to 41 percent by early summer of 2017, when the report was released. 

Part-time personnel expenditures increased from about $200,000 in 2007 to approximately $600,000 in 2016, according to the report.

The overall EMS personnel budget in 2017 was approximately $1.17 million, and the annual five-year average was $977,009, according to Knoblauch.

How EMS is funded

A portion of the city’s income tax provides about two-thirds of EMS funding. The remaining one-third comes from billing insurance companies when a patient is transported by EMS. In 2017, income tax collected for EMS was $974,870 (up from $960,000 in 2016) while $509,354 in billing income was collected (up from approximately $430,000 in 2016).

During the last five years, the amount of income tax collected for EMS has increased, but the ad hoc group’s report noted that rise has "not kept pace with the increase in demand for HEMS services."

As a short-term solution, the group proposed combining the fire and EMS funds into a single account encompassing 24 percent of the one percent income tax increase. This is the proposal that voters will weigh in on in the spring.

Assuming an annual call volume of 1,700 to 2,000 calls and current volunteer levels, the group also recommended hiring two part-time paramedics at 24 hours per week and two new full-time paramedics, moves which will increase costs by about $200,000.

If voters approve the ballot issue in May, the ad hoc group noted, "it is possible that these additional personnel costs could be absorbed without additional funds through [Fiscal Year 2021]."