How to pay, whom to pay

The Lincoln Parish Police Jury Ambulance Service Committee spent at least some time in its first few meetings talking about how to pay for rural ambulance and rescue service in 2023 and beyond.

But by early July, the tone changed from how to pay to whom to pay. Now, as the committee seems to be nearing a recommendation to the jury on providers, it has yet to discuss publicly how the parish might pay the bill — which, at minimum, will be $645,604 and could be $1 million.

Though the topic came up briefly at Thursday’s committee meeting, the panel appeared confused as to whether a finance recommendation was its responsibility.

“Were we asked by the police jury to try to figure out how to help them pay for it, or were we only asked to make a (provider) recommendation?” committee member Dr. Jackie White asked.

Addressing jury President Richard Durrett, who’s also on the committee, she asked “Did the police jury want us to come up with a plan for them?”

“I don’t know if the police jury decided that,” he answered.

How it started

The jury approved formation of a “joint ambulance service committee” on Feb. 8. The panel was given no specific authority, nor did it have a definite membership other than that it include members from Simsboro, Grambling, Dubach and Choudrant. It ended up including more than just that.

But at the time, the only option the jury had was to hammer out a new agreement with the city of Ruston for the Ruston Fire Department to continue providing ambulance and rescue service outside the city limits.

“At that point, the first meeting, the only player was the city of Ruston,” the jury’s legal counsel Assistant District Attorney Lewis Jones said. “ Pafford was not interested, neither was Acadian. The only questions was, how are we going to pay for the service? That’s what we were talking about because that’s all we had.

“ The directive when the committee was created was simply to form an ambulance service committee. If you want to talk about financing, I believe that’s certainly within your authority to make a recommendation.”

The committee, whose members were appointed by Durrett, met for the first time on April 28. The group included representatives from the police jury, all parish municipalities, including Downsville, which is partially in the parish, as well as members from RFD, the parish fire district — upon whose board Durrett sits — a citizen at large and a representative of the medical community.

Minutes from the April 28 meeting show the panel talked in general about financing options, including the possibility of tacking a fee on utility bills. The city told the committee it would provide both EMS and rescue service for $645,604 annually.

Splitting providers?

The committee met next on May 12. They wanted to know the cost of RFD’s providing EMS only and the parish fire district’s doing rescue. That was the first mention of the fire district’s performing rescue as the primary agency.

“I don’t think it will work if you try to split it up,” Grambling Police Chief Tommy Clark said during the meeting.

“I think we’re trying to reinvent the wheel, and we shouldn’t be doing that,” Simsboro representative Stephen Yeich said.

In June, the panel learned the fire district was interested in doing parishwide rescue, and that it will cost $547,148 for RFD to provide just EMS parishwide.

“We’d be very interested in getting into the rescue business, and we’re discussing the cost,” fire district board Chairman Richard Aillet said.

The committee set another meeting to resume considering its options and how to pay for them. The panel was still seeking information on adding a fee to utility bills.

At first, it had talked about tacking the fee onto water bills, but decided that was too cumbersome because of the number of water districts in the parish. It turned to electric bills.

Shifting focus

The focus of the meetings changed July 7. That’s the day the committee voted 7-3 to recommend to the jury that it enter a one-year, non-negotiable and nonrenewable $645,604 contract with the RFD to continue providing both services through 2023.

It’s also the day Pafford EMS representatives showed up with an unexpected proposal for ambulance service only. The company doesn’t do rescue.

Until then, the committee didn’t think it had any option for ambulance service except RFD. But Durrett said a Pafford representative called him after the committee’s June 24 meeting saying the company had had “a change of heart” and wanted to submit a proposal.

Pafford said it would station one dedicated advance life support ambulance in the parish 24/7 for $360,000 annually.

The company also said it would donate $50,000 to the parish fire district for purchase of vehicle rescue and extrication equipment. The fire district still had not given the committee a proposal.

That meeting was the committee’s first in which financing was not a focus.

On July 12, the jury voted 3-6 against retaining RFD for the single year.

In early August, the committee asked Pafford to submit a detailed proposal. The panel still had no numbers from the fire district.

Durrett said the fire district was waiting to see what EMS provider is selected before finalizing their figures.

Options emerge

Six months after its formation, the committee elected a chairman: Charlie Edwards. Until then, it had been relying on Jones, who is not a member, to run the meetings. Edwards is one of four jury appointees on the committee.

On Aug. 16, the fire district board adopted its proposal: a three-year plan with first-year costs ranging from $619,000 to $643,000. On Aug. 18, the committee discovered it could cost $1 million to provide ambulance and rescue service to rural residents for just one year with Pafford and the fire district.

That same meeting, Edwards told the panel the idea of adding a service fee to utility bills was dead. There was a brief mention of unlocking $10 million in proceeds from the sale of the former Lincoln General Hospital in 1996 but no discussion.

Today, the proposed Pafford contract is still at $360,000 for 2023 — $310,000 if it drops the donation to the fire district, as Aillet asked at last week’s meeting.

“I’d rather keep the fire district activities separate from (the ambulance) deliberation,” he said.

The Ruston offer is still $645,604 but for a five- year term with a cost-escalation to cover inflation. And the fire district is tweaking its proposal to decrease its first-year capital cost.

The committee is supposed to get that proposal by Thursday.

But even once the panel makes its provider recommendation, as Edwards told the police jury Tuesday, “that still leaves the one big bear in the room — financing.”