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MTS Operations Manager explains a tough situation and information beyond the headlines

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Letter to the Editor by SCOTT LANPHIER

I have been following your recent articles regarding Allegany County and Medical Transport Service, Inc. In last nights article it was reported, “As expected the board will approve to move another pile of money from American Rescue Funds Act stash into Medical Transport Services Inc. bank account. The full board is expected to pass that resolution for another $125,000 investment into MTS.”

I would like to ensure that the readers understand this “draw” of $125,000 is from the original contracted amount of $600,000 and NOT in addition to the original amount.

The elephant in the room is the lack of funding at all government levels for Emergency Medical Services.

A large number of Allegany County residents receive their medical insurance through Medicaid and Medicare, both of which pay us less than what it costs us to provide ambulance service. A number of other residents have commercial insurance policies but have high deductible plans which pay only a small percentage of their ambulance charges leaving them to pay the difference. Some municipalities in Allegany County fund EMS, but the money received only covers a small fraction of actual operating expenses.

Our monetary shortfall is because of what the ambulance industry calls “the cost of readiness.” It costs our company a significant amount of money to have staffed ambulances and fly cars parked around the county 24 hours a day ready to respond if needed by the volunteer ambulance agencies.

We do not get paid for the cost of readiness; we only get paid when we actually transport a patient.

I am sure that many people will say the “I pay my taxes, so why am I getting an ambulance bill?” The fact is that only a few municipalities pay us for ambulance service, and the amount received doesn’t begin to cover our costs. If not for billing, we would have been out of business long ago.

Instead, we have funded the cost of readiness out of our own pocket for the last several years. It has now become apparent that this model of “free” service to the County is not sustainable. The amount that we receive from actual patient transports will not cover the cost of readiness going forward. This is why we approached the County for assistance in order to keep providing our service county-wide.

In your article you noted that “MTS appeared this month at the Ways and Means committee meeting to inform the board that the business will run out of operating cash by February 2023.” This statement is not entirely correct. In order to continue to provide the CURRENT staffing with 24 hour a day coverage, we will require funding. The alternative is that we discontinue serving the 911 system and return to our previous staffing model. Over the past few years, we have had to continually increase our staffing levels in order to ensure that the residents and guests in Allegany County receive EMS in a timely manner.

I want to be clear that Emergency Medical Services in Allegany County could not be done without the partnership and cooperation of the volunteer ambulance agencies.

About five years ago, Medical Transport Service, Inc., had one fly car per shift and one daytime ambulance to augment the volunteer EMS agencies operating in the 911 system. The demand for more resources has steadily grown over the years, and we currently staff 3 ambulances and 2 fly cars around the clock to support the 911 system.

We have doubled our call volume over the past several years. Our units operate in every municipality in Allegany County, some more frequently than others, but basically every municipality receives our services.

I mentioned the cost of readiness.

Medical Transport Service has an increased cost of readiness due to paid staffing 24/7/365, and because we are a private company, we are required to pay sales tax, property tax and fuel tax. We incur costs every hour of every day whether we are transporting or not. This staffing model is difficult because we never know if the local volunteer ambulance agencies are going to need us. Sometimes they do and other times they don’t.

Medical Transport Service’s operating budget would be sufficient to cover our costs if we did not operate in the 911 system and just transported hospital patients and scheduled transports. As it currently stands, every person in Allegany County no matter what their social-economic status receives the same level of emergency medical service.

In closing, I would like to acknowledge the County Administration Team, the Board of Legislators and all the EMS providers in Allegany County. We are one team and the only way we can continue to provide high quality EMS coverage is to work together.

(Scott M. Lanphier is the Operations Manager for Medical Transport Service, Inc)

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