Ambulance district proposes sales tax

Wednesday, March 4, 2015
Kael Eden, right, emergency medical technician, and Jason Nape, field supervisor, pull a stretcher from a CoxHealth ambulance within South Barry County Ambulance District. A ballot measure in April 7 elections calls for a half-percent county sales tax to fund the district, while reducing property tax allocation for the district by 100 percent. Jason Johnston/

Property tax would be abandoned, sales tax may generate 125 percent more revenue

On April 7, area residents will vote on a ballot measure that would impose a half-percent sales tax to fund the South Barry County Ambulance District, while reducing its property tax allocation by 100 percent.

If the total sales taxable revenues of municipalities in the district remains at $98,063,323, then the projected sales tax will generate $490,316 each year for the district, according to district reports derived from 2013 Missouri Department of Revenue data.

"One-third of all calls go to people that are not contributing," said Ken Cieslinski, district board chairman. "Property owners are the only ones contributing now. The objective of the ballot is to repeal the ambulance portion on the property tax completely."

The funding for the ambulance district has been the same since the district started in May 1974, Cieslinski said. The property tax generates between $200,000 to $225,000 each year for the district.

Cieslinski said voters in 51 Missouri ambulance districts have passed similar sales tax measures for property tax relief, and voters in two districts did not adopt similar measures.

If the voters approve the measure, the sales tax could start generating funds between four to six months after the April election, said Frank Foster, the district's legal counsel with EMS Legal Services.

"There will be a period of time that maybe a year, maybe even a year and a half before the property tax is actually rolled back because the rollback to the property tax is based upon a year's worth of annual revenue of the sales tax," said Foster, who represents about 100 ambulance districts and about 125 public safety agencies. "We don't want to mislead the voters in any way. We want to be perfectly up front that there maybe a period of time of overlap with the two taxes because of the timing issue. I think any sensible estimate of what the sales tax will yield will result in an elimination of the property tax for the ambulance district."

Before the district property tax is abandoned, the district will receive an estimated $708,031in total tax revenues -- from sales and property taxes -- based on the current sales tax base, according to district documents.

The deadline to set the property tax each year is Sept. 1, Foster said.

"Assuming the projections are good, we might partially rollback early," he said. "That should give some comfort to the voters, knowing that the rollback formula is mandatory [through Missouri Statute 321.552]. The board cannot play games with this.

"It is an important issue for the voters. EMS is important to the well-being of the citizenry. And [speaking for the board], I think the taxpayers deserve a break to pay those property taxes, and this is an option to secure the future for good quality EMS."

The district owns two facilities and six ambulances, Cieslinski said. Since 1988, the district has contracted with CoxHealth to provide the emergency medical services. The current three-year contract with CoxHealth runs through 2016. CoxHealth has nine paramedics and nine emergency medical technicians who cover the district.

"The nearest trauma center is Springfield or Joplin," he said. "The ambulance district handles about 3,000 calls per year and over a quarter million miles a year are traveled with the ambulances.

"The board has been very frugal; that we provide the best service that we can with the allocation that we're given."

Four of the six ambulances have more than 200,000 miles on the odometer, according to district documents. An ambulance refit costs more than $130,000. The district must refit, retire or buy an ambulance each year to keep up with the area needs.The additional funding could pay for new ambulance equipment, such as cots and Lifepak units, which cost $7,500 and $35,000 each, respectively.

The district needs to replace four Lifepak units. They interpret heart rhythms, identify people who are having heart attacks, shock people during cardiac arrest and measure vital signs. The district also wants to get portable ventilators and an auto-pulse device that provides better blood flow during cardiac arrest.

Cox may have made out very well in the past when it could bill Part B Medicare and put its fixed costs on its Part A Hospital cost report, Foster said in an email to Cieslinski.

"That ended in 2002 when the Medicare fixed fee schedule was implemented," he said. "The hospital can no longer put its ambulance operations costs on its Part A cost report. Medicare has to be taken on assignment and pays about half the costs of the transport, according to the American Ambulance Association. So, the hospital is likely losing money on this contract. With both the Part A and Part B Medicare trust funds in deficit, it is unlikely Medicare will be upping its fixed fees in the future."

The South Barry County Ambulance District board of directors has six members. The board meets at 6 p.m. on the second Tuesday of each month in the main district facility, located at 73 Smithson Drive in Cassville.

Cieslinski said he is scheduling a town hall meeting to discuss the sales tax proposal.

The district's northern boundary is just south of Purdy, its western boundary stops at McDonald County, its southern boundary is the Missouri-Arkansas border, and its eastern boundary encompasses part of Shell Knob.

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