Ken-Tenn EMS status depends on stakeholders’ choices

KenTenn EMS, which provides ambulance service to the cities of Fulton, South Fulton, Hickman and Fulton County, has experienced an overall decline in memberships of 7.9%, from July 2020, through April 2024.

A breakdown of services areas, shows a decline, over the course of the same time period , of 1.7% in Fulton County, 4.4% in the city of Fulton, 12.6% in South Fulton, and 15.4% in the city of Hickman.

Based on those downward trends, revenue loss equals to a total of $65,148, with $612 in loss coming from Fulton County, $12,960 in loss from the city of Fulton, $18,720 from the city of Hickman and $42,240 in losses from the City of South Fulton, $4,000 of that city’s loss from the closure of Park Terrace Assisted Living.

KenTenn EMS currently operates from two bases, one in Fulton and one in Hickman. Each base houses two ambulances. Those bases are manned by six two-person crews, a total of 12 people, working 24 hour shifts, 24 hours on and 48 hours off, to provide the current level of emergency care now offered.

The KenTenn EMS received no state or federal dollars, derived from taxes, and does seek out grant funding to assist with equipment and supplies.

For the past two years, the cities of Fulton, South Fulton, Hickman and Fulton County have provided a $10,000 annual subsidy to the ambulance service, to maintain operations.

Statistics recorded show a comparison of member vs. non-member use of the service, for runs made in 2023, with the City of Fulton showing 84% of ambulance runs made there, provided to members, and 16% provided to non members.

In South Fulton, 65% of ambulance runs made there were provided to members and 35% to non-members.

In Hickman, 43% of ambulance runs made there were provided to members, and 57% of ambulance runs made there were provided to non-members.

Members may opt to pay a monthly $17 membership fee designated on water bills issued. Non-members make the choice not to pay the $17 per month membership fee.

Water customers who choose to decline paying the monthly fee must sign a document at the respective city hall, confirming their decision not to pay the fee for ambulance service. Some may believe that since they have medical insurance, they are covered, however a number of factors go in to determining what the insurance will actually pay to the KenTenn EMS, and insurance billing alone will not cover the cost of the system’s operation.

The City of Fulton records 34% of the response locations for the ambulance service in 2023. The City of Hickman records 18% of ambulance runs made, the City of South Fulton, 15%. South Fulton, in the county has 10% of runs recorded in that location, Fulton County East, 6%, Mayfield, 6%, Fulton West, 3%, Union City, 3%, Martin, 1% and other, 4%.

The KenTenn EMS operates on an annual budget of $1.6 million.

Fleet expenses total $250,000 for the ambulance, $50,000 each for the cardiac monitor load system/cot and durable and medical supplies. The ambulance vehicle itself gets, on the average, six (6) miles per gallon. Annual maintenance costs total approximately $10,000.

If the ambulance service were to be forced to operate on billing revenues generated only, just personnel costs alone would not be covered. In the past 11 months of the current fiscal year, the average charge, or bill, per ambulance service run, was $1,265. The average revenue per run was $368, or a collection percentage of just under 30% of what is billed.

The amount of the KenTenn EMS $1.6 million budget not covered by billing is $800,000. Currently, membership fees paid cover $750,000, but that $50,000 deficit will only continue to rise with increases in equipment and medical supplies.

Personnel costs, which account for 72% of the budget, or nearly three-fourths of the cost, include salaries, health insurance, benefits and workers compensation insurance.

Service area residents who have the option of paying their monthly ambulance fees included on their water bill, number 186, out of a possible 191 meters in Fulton County, or 97%, generate annual revenue for the KenTenn EMS at $40,620. Fulton County’s population, according to the 2022 Census, is 6,382. The Hickman-Fulton County water meter participation is 138 out of a possible 249, or 55%, with $36,360 in revenue generate annually.

In the City of Fulton, there are 1,366 meters, with 1,009 residents participating in the fee payment through water bills, or 74% participation, generating $249,264 in annual revenue, with Census statistics listing the population at 2,301.

In the City of South Fulton, there are 1,656 meters, with 1,186 of those meter holders participating, equating to 72%, and generating revenue in the amount of $255,876 annually. South Fulton’s population is listed, according to the Census at 2,245.

In the City of Hickman, there are a total of 910 meters, with 430 meter holders participating in paying the monthly ambulance fee through their water bills, or 47%, generating revenue annually at $97,008, when not considering the addition of the Fulton County Detention Center participation. When the Detention Center is added to the credit of the City of Hickman, the revenue generated increases to $138,456, with $63,144 of that total derived from business generated revenue sources.

In Fulton County, currently, water meters number 249, with 138 meter holders participating in the fee payment procedure, or 55%, generating annual revenue in the amount of $29,592.

In consideration of the rising costs of equipment, supplies, and personnel, as well as a decline in membership, equating to decreased funding, all options are being considered, to assure the provision of ambulance service to the local area.

While KenTenn EMS currently has two ambulances covering approximately 230 square miles in their service area, there are eight states which have fewer than three ambulances covering every 1,000 square miles of land. Four out of five counties in the state have at least one “ambulance desert”, defined when more than 25 minutes of travel time is required for an ambulance to make a run.

Those who reside within the KenTenn EMS service area who have chosen not to pay the monthly fee, according to documents signed at the service area city halls, opt out because of a number of reasons. Among those reasons are that they do not believe they will need the service, they believe they have insurance that will cover the cost of an ambulance response/transport, or that they can not afford the fee, and know it is not mandatory.

While there may be options to ponder and consider, the statistics and financial data of record for the ambulance service supports evidence that under current circumstances, revenue sources and expenses, the KenTenn EMS will not be able to support operations and provide services currently provided.

Alternative measures for identifying additional revenue sources, such as increased individual and business monthly fee payment and/or municipal supplements, in addition to consideration of decreasing the number of ambulances within the fleet as well as staffing, will be necessary, for operations to continue in any capacity.

Concerns have been raised as to whether an increase in per month fees would deter some from continuing to pay for the service.

Other concerns have been voiced regarding each municipality’s already “tight” budgets being able to support an increase in the amount each provides as a supplement.

Cutting staff, or the number of hours now worked by staff, could raise concerns as to whether staff members will seek other options for employment.

Cutting the number of ambulances on the road, would result in longer wait times for ambulances to arrive.

Residents, businesses and municipalities will need to determine what actions must be taken, if the KenTenn EMS is going to be able to continue current operations.

Residents and businesses who do not pay the fees currently, should consider starting now.

Those who now pay monthly or annual fees, and can pay more, should consider paying more, for service.

Municipalities should determine what amount, if any, can be used from their budgets to supplement the service.

The KenTenn EMS should closely examine all possible expenses involved in the operation, and make necessary cuts.

In the event stakeholders are unable, or unwilling to take a different approach in each of those aspects, everyone must accept the level of service having been provided in the past by KenTenn EMS will not be able to continue, and that could mean a reduction in staffing, equipment or base locations, possibly all three.

Those with questions about KenTenn EMS, or those interested in joining the effort to maintain the level of service now provided, may call 270-208-1000, or visit online, www.ktems.org.

(Editor’s Note: Following months of urging local area residents and municipalities to come to the aid of the KenTenn EMS, and with the absence of emotional pleading or lists of reasons why the ambulance service is essential to the community, The Current requested, and was provided with the financial information listed within this article. This piece is factually based, and statistically recorded, however editorial liberty was also exercised in the concluding paragraphs.)