Why Bellefonte’s 2019 tax increase is affected by EMS costs

Dec. 08--BELLEFONTE -- Bellefonte Borough Council is poised to move forward with a tax increase of almost 1.5 mill for 2019 that's due in part to rising emergency medical services costs.

"EMS is struggling and we need to make sure we have those services available," said Council President Joanna Tosti-Vasey at last Monday's meeting.

The tax increase breaks down to a 1 mill increase for the general fund, one-fifth mill increase for EMS and a one-quarter mill increase for funding a grant match for the rehabilitation of Kepler Pool in Bellefonte.

An average homeowner in Bellefonte can expect a $75 tax increase, said the council secretary.

Bellefonte EMS provides services to 10 municipalities in the Bellefonte area and Bald Eagle Valley. According to Executive Director and ambulance Chief Scott Rhoat, eight of those municipalities will likely contribute some part of their 2019 budget to Bellefonte EMS services.

Bellefonte EMS' budget is around $900,000 annually, and the contributions from the eight municipalities in Bellefonte's coverage area will total around $54,000. Bellefonte Borough's contribution is about $20,000-$22,000.

Locally and statewide, EMS is facing problems with increasing costs, dwindling funding, stagnant wages and a lack of qualified applicants, said Rhoat, who has been with Bellefonte EMS almost 12 years.

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"We projected in the future ... that the cost of expenses was going to pass that line of reimbursement and income," he said. "Because as far as EMS ... we can't just raise our prices when our expenses go up. Because it's dictated by the insurance companies, especially Medicare and Medicaid."

For a call that results in ambulance transport, Medicare reimburses 60 cents on the dollar, while Medicaid only reimburses 20 cents on the dollar. The rest of the cost for treating a patient and transporting them to a hospital can't be recouped, said Rhoat.

"The only way we've been able to maintain a balanced budget is by continuing to cut costs," he said. "(Now) there's nothing left to cut, and sometimes it's cutting to the point where it is detrimental to the organization."

The starting wage for an emergency medical technician with Bellefonte EMS is $9.57 an hour. EMTs work 12 hour shifts, starting at either 6 a.m. or 6 p.m.

Over the years, Bellefonte reduced five full-time EMT positions by attrition. Now, Rhoat has five or six part-time workers doing the work of one full-time EMT. Most work other jobs. In fact, Rhoat said, 80 percent of his staff work at least one other job. Half of that group works two other jobs to make ends meet.

And they're having trouble retaining employees, Rhoat said, because wages aren't competitive. Seventeen dollars an hour is the accepted competitive starting wage for an EMT, he said.

Revenue streams are drying up quickly, especially with Centre Crest Nursing Home (now Centre Care) moving out of Bellefonte EMS' coverage area in 2020.

With the contributions from Bellefonte Borough and seven other municipalities, Bellefonte EMS plans to increase wages by at least a dollar an hour and replace two of three ambulances and stretchers that must be updated before 2021.

Long-term, Rhoat said, he would like to bump starting wages up to $17 an hour and restore the five full-time positions that were lost through attrition.

Rhoat said that as a taxpayer, he understands why people don't want their taxes to go up. But EMS is something that benefits everyone, even if they don't notice it day by day.

"Until somebody does not show up at your house, you don't care," said Rhoat. "But when your house is on fire, or a family member is having a heart attack, or your child ... (has) fallen down the steps and is unresponsive ... you don't really think about it because it's always there. Well, it may not always be there."

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