Can new fees fix EMS finances?

Many ambulance companies have opted for mergers and consolidations to offset the crushing financial pressures they face.

  • In northwest Lancaster County, local leaders have come up with another option.
  • They are proposing a regional authority that would levy fees on property owners to support an ambulance service.
  • “There’s pushback on the fees,” acknowledged Marc Hershey, president of the Elizabethtown borough council and a leader in the regional EMS effort. “But there’s also feedback on, we want sustainable EMS service in our community because none of us know when we’re going to need it for ourselves, our family or our loved ones.”

Where is this happening: The regional authority — dubbed the Municipal Emergency Services Authority of Lancaster County — would cover eight municipalities.

  • They are Conoy Township, East Donegal Township, Elizabethtown Borough, Elizabethtown Township, Marietta Borough, Mount Joy Township, Penn Township and West Donegal Township.
  • They are currently served by ambulance company Northwest EMS.

Why is this happening: Financial pressures on Northwest EMS.

  • The service has an annual shortfall of more than $4 million a year, Hershey said.
  • At the same time, less than half of municipal residents contribute through the nonprofit’s subscription service, a traditional fundraising mechanism for ambulance companies.
  • While some ambulance companies have joined larger EMS providers — including some run by regional health systems — the authority structure preserves local control, Hershey said.

How would it work: The authority would charge a fee to homeowners, commercial property owners and other landholders in the eight townships and boroughs.

  • Under current working estimates, the fee for homeowners would be $75 to $95 per year, Hershey said.
  • Commercial and institutional properties would likely pay a similar fee, plus additional fees based on the number of employees, Hershey said.
  • Earch municipality has a seat on the board of the authority, which would become the region’s EMS operator, Hershey said. 
  • Local residents, meanwhile, would not have to pay any out-of-pocket costs if their insurance does not foot the whole bill for an ambulance ride.

What’s next: Before it can start assessing fees, the authority will be holding public meetings, starting March 1.

  • The authority expects to present its fee plan at a public hearing where residents and property owners will be able to weigh in, Hershey said.
  • No firm timelines have been set but he said that a plan could be introduced at a meeting this summer.
  • The authority would start collecting fees no earlier than July 2024, he estimated.

The trend: It’s no secret that independent EMS companies have been struggling financially in recent years, as documented in a 2018 report produced at the behest of state lawmakers.

  • Inflation and staffing challenges have only added to their pain.
  • “It’s a good group of people that are there to serve the community,” Hershey said. “We just want to make sure we have the business structure to help support them.”
  • It is a structure that could apeal to leaders in other areas of the state, said Heather Sharar, executive director of the Harrisburg-based Ambulance Association of Pennsylvania
  • “We are all looking for options to help EMS because we are in such desperate shape,” Sharar said.


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