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Northampton Commissioners discuss ambulance fees

JACKSON – Northampton County EMS Director Paul Nowell presented several requests from his department at the Board of Commissioners meeting here on May 3. One was tabled for discussion at a future meeting, while the other two were easily approved.

The first of those requests was a proposal to establish an ambulance franchise fee for non-emergency ambulance services operating within the county. Nowell explained there are currently four providers in Northampton County that transport non-emergency patients.

“The fee would not affect any emergency ambulance provider such as Gaston or Eastside,” he added about the two volunteer rescue squads in Northampton County.

Northampton County adopted their Ambulance Franchise Ordinance in 1994 to regulate ambulance services within the county. One section of the ordinance allows the Board of Commissioners to make amendments, such as the proposed addition of the franchise fee.

Nowell said adding the proposed fee would help the county offset administrative costs associated with the maintenance of the franchise. That includes medical oversight from the county and ensuring compliance with the North Carolina Office of EMS.

“We just thought that the county ought to recover some of the money that we’re spending out for these other providers. They’re for-profit entities,” he noted. “We’re not getting reimbursed.”

The proposed fee would be an annual rate of $2,000.

Commissioner Joyce Buffaloe asked for a breakdown of the annual cost to the county. Nowell didn’t have the specific numbers, but he did note it costs $8,700 to compensate the medical director who oversees all the EMTs.

Commissioner Kelvin Edwards asked if any surrounding counties charged a fee to their franchises.

“I’m not sure of any surrounding county that has a franchise ordinance fee,” Nowell admitted, but added that he knew other North Carolina counties such as Pitt and Guilford had one.

Board Chair Charles Tyner asked if Nowell had discussed this proposal with the franchises currently operating in the county. He cited concerns that a fee might discourage the ambulance businesses from providing service in Northampton.

Nowell reported he had not talked with the four for-profit ambulance services yet, but he also said he believed the other providers would continue to provide service even if one of them decided to leave.

Edwards agreed with Tyner’s suggestion to talk with the local ambulance franchises first in the interest of total transparency. He motioned to table the matter to make a decision at a future meeting.

Commissioner Nicole Boone seconded, and the board voted unanimously in favor.

The remainder of Nowell’s presentation centered on rate adjustments for the ambulance fee schedule and the ambulance standby rates.

Nowell explained the last time the ambulance fee schedule was adjusted was in 2019 with directions from the Board to review the rates every two years.

“This is just a small adjustment to keep up with inflation,” Nowell said.

The commissioners approved the changes unanimously with Boone motioning to approve and Commissioner Geneva Faulkner providing the second.

Following that approval, Nowell shared a proposal to increase standby rates for county ambulance services. Those rates were first established eight years ago and haven’t been adjusted for inflation since. He also noted that the rates don’t distinguish between Basic Life Support (EMT) and Advanced Life Support (paramedic) even though a paramedic ambulance is more costly to staff.

The proposal would change the current hourly rate of $75 for non-profit entities to $85 per hour and $250 per hour for nonprofit paramedic service. For-profit entities would see their standby rates change from $150 per hour to $200.

Faulkner motioned to approve the new standby rates, and Edwards seconded. Like the previous vote, it also passed unanimously.