Will changes to ambulance service be worth the cost


Will the upcoming changes to the current ambulance service and the money needed to accomplish this, be worth it for Kimball county residents? That is a question that has been on the minds of many Kimball residents in recent weeks.

In the past, the Kimball Ambulance Service was a basic life support service.

Carla Goranson took over the ambulance service in November 2011. Among the many changes made, upgrading the crew became a priority. Currently, the Kimball County Ambulance employs a staff of three drivers, eight EMRs, seven EMTs, one A-EMT and one paramedic.

The drivers not only have clean driving records but have both CPR and First Aid training. EMR stands for Emergency Medical Responder and those people have no less than 70 hours of training in addition to CPR and basic first aid. An Emergency Medical Technician or EMT has a minimum of 160 hours of training and an A-EMT is an advanced EMT with the 160 hours plus an additional 200 of clinical hours. A paramedic is a professional that has more than 1,000 hours of training and thousands of hours of clinical training which takes no less than two solid years of education.

In addition to upgrading the training and certifications of the ambulance crew, Goranson worked to build on and grow the service while keeping an eye on the budget supplied by the Kimball County Commissioners.

After her first fiscal year as director of the ambulance, she actually returned $174,730.89 back to the county of the money that had been earmarked for the ambulance. This represented just 53 percent of the available budget, however, once they added in collected revenues of $123,605.74 they only actually needed $76,575.37 of the $374,912.00 budget – meaning that they only used 38 percent of what the Commissioners budgeted for them.

The very next fiscal year of 2013/14, the Commissioners lowered the budget to $367,202, the ambulance expended $206,797.58 and collected $124,967.33 in revenue which meant that the ambulance turned back $81,830.25 of the projected budget. Only 40 percent of the ambulance was funded by tax payers money for that year.

The 2014/15 fiscal year was similar. The Commissioners dropped the budget to $335,580, expenditures totaled $236,665.39, however collected revenues increased to $141,233.72 showing that again, only 40 percent of tax payer’s money was used.

The financial report for the 2015/16 fiscal year is a bit more difficult to understand as the County purchased a new ambulance. The ambulance budget for that year was $416,988 with expenditures including the first payment of the new ambulance at $346,261.81.

Collected revenue jumped again up to $209.369.86 so that, again, just 40 percent of the tax-payers money was used to fund the ambulance, even with a $62,308 down payment on a new ambulance. Not including the first payment of the new ambulance, the service only used 26 percent of the amount budgeted by the Commissioners.

According to the contract entered into by the Kimball County Commissioners, Kimball Health Services and Regional West Medical Center this month, Kimball County will no longer be paying for the ambulance service. However, they will still pay $48,000 annually to Regional West Medical Center, up to $70,000 to Kimball Health Services and $42,000, per year for the next five years, for the new ambulance.

These expenditures total approximately $160,000 of tax-payer dollars annually, however, the current ambulance service spent just $76,575.37 in 2012/13, $81,830.25 in 2013/14, $95,431.67 for the 2014/15 year and $74,583.95 not including the ambulance purchase or $136,891.95 including the ambulance purchase.

Moreover, Regional West Medical Center, in Scottsbluff, will receive all revenues generated by the Kimball County Ambulance. As the numbers above show, revenues have steadily increased from the 2012/13 fiscal year by over $60,000 for a total of over $209,000. That money generated from Kimball County residents was going back into the county. Now, any revenues generated will go directly to Scottsbluff county.

The only consolation is that RWMC will pay back to Kimball Health Services approximately $35.00 per hour when the ambulance is on duty, meaning that some money will eventually make it’s way back into Kimball County.

Ken Hunter, CEO of Kimball Health Services, explained that per the contract and agreement with RWMC, there will be a higher level of medical professionals on the ambulance once they take over the service.

Currently, a paramedic is not always available, as the one paramedic in Kimball County works both for the hospital and also for the ambulance. As that person cannot be in two places at once, the new contract means that at least one, and potentially two, more paramedics will need to be hired to cover both the hospital and the ambulance.

Paramedics are able to intubate and administer pain and cardiac drugs that other EMT and A-EMT may not.

According to Hunter, approximately 25 percent of transfers are not covered with a paramedic with the current ambulance crew, but once KHS and RWMC take over the Kimball Ambulance Service, they intend to have a paramedic on call for one of the two ambulances 24/7.

Currently, RWMC has similar working relationships with Sidney, Oshkosh, Chadron, Ogallala and Gordon.

*Numbers may not add up exactly, as the ambulance service often receives money outside of the county through donations, memorials and other monies.


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