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Commissioners adopt North Fork Ambulance District service plan

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Delta County Commissioners Doug Atchley, Mark Roeber and Don Suppes passed a Resolution to adopt the North Fork Ambulance District Service Plan at their June 25 meeting.

North Fork Ambulance District (NFAD) will serve in three counties: Delta, Montrose and Gunnison. Montrose County has adopted the service plan and Gunnison County is expected to adopt the service plan this week.

The NFAD service area includes 1,550 square miles, with 75 miles of paved two-lane highway and over 300 miles of county road, ranging from paved to primitive. The service from Hotchkiss extends west on Hwy. 92 to Payne Siding, encompasses part of Redlands Mesa, and continues east on Hwy. 133 to Paonia. From Paonia, the service area continues north up Stephen's Gulch to the Mesa County line, and northeast of Paonia on Hwy. 133 into Gunnison County, through Somerset to the top of McClure Pass. The service area also extends southeast from Hotchkiss on Hwy. 92, through Crawford and into Montrose County, and runs to Mile Marker 56 at the Gunnison County line on Black Mesa.

Kathy Steckel, executive director of North Fork Ambulance (NFA), shared the steps the NFA has taken, and is taking, to become the North Fork Ambulance District.

As personal background, Steckel served on the NFA board for seven years, as part-time director for four years and has served as the executive director for three and one-half years. She is one of the NFA's Advance Life Support providers, takes on-call shifts, and provides patient care.

In presenting the NFAD service plan, Steckel was accompanied by board members, NFAD consultant, NFAD attorney, and several supporters of the North Fork Ambulance becoming a district.

The commissioners had received letters of support for NFAD and the letters became a part of the record.

For 49 years the NFA has been funded through membership fees, grants, donations and ambulance transport fees. This vital service has never received public funding.

Income sources are not keeping pace with rising expenses, causing a budget shortfall. Most insurance companies, including Medicare and Medicaid, set limits for reimbursement, causing NFA to write off over 50 percent of what it bills. NFA billing rates and write-offs are comparable to other EMS agencies.

NFA is also experiencing a growing aging population as people retire in the North Fork Valley.

Conservative stewardship by NFA board members established a reserve fund. In the past few years NFA has had to dip into the reserve funds.

Over the past several years NFA has explored options to continue ambulance services.

In 2015 NFA held five public meetings in and around the valley to establish priorities.

First priority was response time; second, raise the level of care provided; third, become financially sustainable.

To address these priorities, NFA took the following action.

First, NFA has kept ambulances operating from all three stations, Crawford, Hotchkiss and Paonia, using on-call labor to staff three stations. To support and encourage crew members NFA delivered necessary training, equipment and support needed, as well as providing a financial reward. The first on-call pay was established in 2009. This strategy is successful, and NFA maintains on-call crews in all three stations.

Second, NFA raised the level of care, which was met with enthusiasm by crew members who were willing to raise their level of certification. Grants were written and donations received to purchase three Quick Response Vehicles to get Advance Life Support personnel to the scene of emergencies quickly. Advance Life Support providers are able to administer EKGs on scene, start cardiac medications, as well as manage pain and seizures, and sooner than ever before in the North Fork Valley.

The third priority of financial sustainability has been more complicated. To increase income from transports, in 2015 the Board updated membership terms to capture medical billing income while maintaining benefits to members. In 2016 and 2017 NFA increased membership and wrote grants, many of which were approved. Donations from the community and local service clubs have been at an all-time high.

The budget remains in the red.

In January 2017 the financial committee began serious research into public funding.

In June 2017 the board voted to form a special district and seek voter approval for public funding. To meet special district requirements, the board has completed a 10-year financial projection, written the service plan, surveyed the public and is now seeking adoption of the service plan from the three counties involved (two of which have adopted the plan).

Steckel said, "We are now ready to move forward to obtain approval from the voters in November."

Steckel said the average cost to a North Fork Valley property owner will be about $41.00 per $100,000 assessed residential property value. If a home has an assessed value of $200,000, the cost will be $82.00 per year.

Commissioner Suppes asked how the mill levy for NFAD compares to the mill levy for Delta County Ambulance District. Steckel said it will be the same.

Commissioner Roeber said, "You have taken your first step, and it is a good first step. Everybody has worked so hard and now it is time for the voters to decide."

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