Community members from Longswamp Township, Rockland Township and Topton came out Thursday, Feb. 21, for a meeting to discuss the financial health and future of Topton Ambulance.
The meeting was organized by Longswamp Township supervisors and was a continuation of a Feb. 14 meeting held for the same reason. About 30 were in attendance.
“We heard that there were some challenges at the ambulance and we were looking at providing some extra dollars through a tax increase,” said township supervisor Joyce Marin regarding the reasoning behind the meeting. “Citizens came out and had a lot of questions… there were some gaps, and we weren’t in a position where we felt comfortable, so we did not pass the increase. I said I would be willing to facilitate a meeting to help us get to a collective solution.”
Josh Sheetz, president of Topton Ambulance, provided an outline of the organization’s unique situation and the overarching difficulties the industry faces.
According to Sheetz, the association has been losing money for the past five years, losing as much as $88,000 in 2016. In the same timeframe, the association has seen a decrease in revenue from calls. As a result, their end-of-year cash balance has dropped from $200,000 at the end of 2014 to $40,000 at the end of 2018.
The association is a non-profit organization, providing 24/7 Advanced Life Support service to Topton, Lyons, Longswamp Township, and portions of Maxatawny and Rockland townships. Annually, they respond to around 1,200 calls a year.
The association relies on billing revenue from ambulance calls, whether from patients themselves or insurance reimbursement, which, Sheetz said, makes up 71 percent of their income.
“One of the big things people don’t realize is that, with some of these insurances, the check that is supposed to go to the ambulance actually goes to the patient,” says Sheetz. “It’s up to [the patient] at that point to pay the ambulance. A lot of times, they keep that check, cash it themselves, and use the money for whatever they want and it never actually goes to the ambulance service.”
Another issue, Sheetz said, is the discrepancy between what they bill and what they receive from insurance companies or Medicare/Medicaid. The association bills patients $1,200 for Basic Life Support service or $1,800 for Advanced Life Support service, and they may receive less than $500 for some calls.
Generally, it costs the association around $565 per call, Sheetz added, of which only $427 is recovered through reimbursement on average. Based on ambulance calls alone, they lose $150,000 a year.
Additional revenue is earned through Longswamp Township’s existing EMS tax, which generates $32,000 for the association, and their subscription drive, which generates $85,000.
Among the largest expenses for the association are payroll and costs associated with their building, Sheetz said. Annually, they pay $380,000 in payroll and $99,000 in building costs. The association currently owes $600,000 on the 10-year-old building’s mortgage.
A multitude of solutions were proposed at the meeting, including a new billing system to improve efficiency, phone calls to support the subscription drive and fundraising.
Members of the crowd also suggested selling the headquarters or finding a way to reduce costs, either through the bank or through Diakon, which owns the surrounding property.
“We’ve pretty much exhausted all options,” said Sheetz, noting a move from the building would be considered. “You can see, if you take away the building expense, we’d be in a better position.”
“The last thing we want to see, as our name used to be on your ambulance, is for it to be disbanded or to disappear,” said Topton American Legion Commander Brandon Dalia, voicing support for the group.
Topton Borough Manager Marcus Dolny noted that the borough had been working with the ambulance to help address issues ahead of them, including refinancing the mortgage and laying out a business plan.
“Once you have those in place, then you can get into these conversations on how do we facilitate and help them in terms of funding,” said Dolny. “Whether it’s through a tax, whether it’s through fundraising, whether it’s through better education about the subscription drive, or a combination of all three.”
“Whatever we would decide to do, it really has to be that we’re making the best decision for our communities and for the people in our communities,” added Dolny.
Following the meeting, Sheetz was encouraged by the positive community support.
“Everyone’s coming together for a common goal to go over things,” said Sheetz. “We still have financial issues, but people are at least trying to help to come up with solutions in the short term. I look at it as a benefit at this point.”
Sheetz added that the organization is always looking for volunteers.