Could Victor-Farmington Volunteer Ambulance tax district be coming?

With rapid growth comes growing pain, as two town boards heard first-hand this week from representatives of Victor-Farmington Volunteer Ambulance Corps, Inc.

VFVA President Jim Hood crunched numbers at two separate workshops with members of Victor and Farmington town boards before getting to the bottom line: The 47-year-old non-profit emergency service provider needs more funding to keep up with growth and volunteer trends.

Data from Victor’s Emergency Services Public Safety Evaluation, completed in January, recommends that each town in the VFVA 68-square-mile coverage area establish a special ambulance district to provide that additional funding.

In support of VFVA, each town would levy an additional tax rate of $0.35 per $1,000 valuation, Hood said. That would run the average homeowner $9.16 per month in Victor, and $5.83 per month in Farmington. If both town boards agree, it’s something that could happen within the next 12 to 18 months, he said.

It’s a bitter pill to swallow for Victor residents, who saw a 106 percent increase in taxes in 2017, and whose board is now considering the possible formation of a joint town-wide, village-wide fire district.

Why now? The answer is complicated, but includes dwindling volunteerism, trending health insurance, aging demographics, geographic challenges, and rising expectations.

For its first 47 years, VFA has been a largely volunteer agency. But — in lock-step with fire departments and other volunteer-based organizations — that workforce has dwindled in recent years. And while volunteers grow more scarce, the types of service that residents have come to expect have significantly increased over the last decades, Hood said.

“People expect that within minutes of calling 911, they’re going to have a quarter-million-dollar ambulance sitting at their doorstep with a fully trained paramedic and all the high-tech equipment required to save their lives,” said Hood. “In order to answer all those calls, we need additional funding.”

Since 1990, VFVA’s call volume has more than doubled, while its volunteer ranks have dwindled. Currently, Hood said, there are six to eight calls for service each day, and in 2015 only 5 percent of incoming calls could be handled by volunteers.

And the local population is aging — seniors 65 to 85 are twice as likely to request an ambulance, Hood said.

At the same time, health insurance coverage is morphing at warp speed, thanks to the Affordable Care Act, the decline of private insurance, and the increase of self-pay and high-deductible plans, Hood said.

Since 2011, the number of VFVA’s fully insured patients has declined by half, leaving the majority of patients unable or partially able to pay for that emergency medical service, he said.

Every time the ambulance rolls for a basic life support call, it costs VFVA $800 to respond, said Hood. Medicaid provides $95 reimbursement, and Medicare provides $347.77 reimbursement. That means VFVA incurs a loss of between $452 and $705 with each response.

Who makes up the difference? The folks who have full insurance coverage do, Hood said.

“Right now the billing model isn’t terribly fair to residents,” he said. “Last year we took about 2,302 calls. But only about 18 percent of those calls were with people who had full-paying insurance. That means that only 414 people in the towns of Victor and Farmington are the ones who are paying to have an ambulance ready for you when you call.

“The idea is to make this more fair,” said Hood. “We have a lot of residents who expect to have the ambulance available when they call 911, who really aren’t paying anything for that, so we’d like to make that more equitable.”

About 70 percent of the budget is for paid personnel, with some aimed at maintaining the four-ambulance, two fly-car fleet, said Hood. (Fly cars carry advanced medical techs but not all their gear.)

“We use each vehicle for about two lifetimes,” he said. “We buy a vehicle and refurbish it after seven years. Then we use it again for another seven or eight years. After that it’s pretty exhausted.”

VFVA currently receives $7,480 in annual funding from Farmington, and $14,580 from Victor.

“That $14,580 from Victor would allow us to run for about four days, or handle 36 of our 2,302 calls,” Hood said.

Victor Councilman Dave Condon asked Hood if residents would “see a change in the $600 ambulance ride?”

The answer was no, the special tax districts would just help stabilize that.

Victor Councilman Dave Tantillo requested that the VFVA Board of Directors be made up of 50 percent Victor residents and 50 percent Farmington, and include a mix of non-medical people who have strong business sense.

For the most part, that’s already the case, Hood said.

VFVA also responds to calls on the New York State Thruway, and ironically, each trip requires them to pay the toll. If responders don’t take the “right” exit on their way to the hospital, the Thruway Authority bills them a penalty rate up to $100.  

No matter. Emergency medical response is something VFVA volunteers and staff take seriously.

“We believe there’s something special about community-based ambulance services,” he said. “We treat our patients as our neighbors, not as customers.”

“When you hit 911, you expect somebody to be there,” said Victor Supervisor Jack Marren. “Nobody wants to be laying there, thinking about the what ifs.”