Tompkins County votes for emergency medical service funding

Tompkins County Legislators voted to include a memorandum of understanding, or MOU, regarding the funding of a new emergency response program to the draft of the 2024 Countywide Shared Services Plan at a Public Safety Committee meeting earlier this month.

Chairperson Rich John proposed the legislature formally initiate conversations, in the form of the MOU, between the county administrator and the affected municipalities to discuss how to divide funding the recently created program.

He said creating the MOU would help ensure that once the new service, which is called the Rapid Medical Response (RMR) program, begins operating, various municipalities will not start to cut funding to their existing services.

“If we have no MOU, there won’t be any written commitment […] maybe informal ones,” he said. “But what I would really regret…is [if] the county starts funding this, and various towns reduce its services as a way to reduce budget money, we won’t end up with a net improvement in the overall system, which is what we’re trying to accomplish.”

The Department of Emergency (DoER) in the county created the RMR program earlier this year and was first presented it to the full legislature in October.

It consists of three outfitted vehicles staffed with EMTs that will be placed strategically around the county, particularly in rural areas, to help decrease alarmingly long response times recorded by the DoER from 2017 to 2021.

The data shows that residents in Tompkins County have to wait an average of 12 minutes and 48 seconds to receive medical attention after calling 911, while the national average is 4 minutes.

Response times increase significantly, according to the data, in municipalities farther away from the city and town of Ithaca.

The program is slated to become operational by 2024, but the question of who’s covering the bill, and which local governments are able to, remains unanswered.

The debate surrounding cost-sharing options between the county and the municipalities has been contentious, with select county legislators advocating that smaller towns contribute monetarily to a program they say impacts residents in these areas more so than urban taxpayers.

“It makes sense to me that we do have some sort of cost share that the residents of the county who are getting the principal benefit of this service helped to fund it in some measure, John said, “more than others in the community who aren’t seeing any benefit.”

But town officials like Robert Lynch, a councilperson in Enfield, have been adamant about their inability to financially contribute even slightly to the program.

“We, the rural towns, are flat broke,” Lynch said at the committee meeting earlier this month. “We can’t bankroll this. But you, Tompkins County, can.”

Committee member Anne Koreman said that none of the community officials in the places she represents, which include the towns of Ulysses, Enfield and Trumansburg, have been receptive to chipping in to maintain the program.

Other legislators said they have had conversations with various officials in a select number of municipalities that have shown interest in the possibility of contributing, like committee member Mike Sigler, who represents Lansing.

The creators of the program purposefully designed it with cost-savings at the forefront of their decision-making process. Still, emergency medical response systems are as expensive as they are important.

Estimated startup and operating costs for the first year totals $699,794 to cover the costs of personnel, three rapid response vehicles, equipment, materials and supplies. Subsequent annual operating costs of the program are estimated at $504,956.

To cover the first year of startup and operating costs, county officials have applied for funding through the NYS Local Government Efficiency grant and the NYS Countywide Shared Services Initiative funding.

County Administrator Lisa Holmes said in an interview that the grants will only cover the costs of one year of operation. After that, the county will need to consider cost sharing or other arrangements with municipalities to support ongoing operational expenses for year two and beyond.

In the 2024 budget, the legislature voted unanimously to contribute a one-time payment of $54,000 for equipment and other startup expenses and $232,000 for half of the first-year operating expenses.

An additional $232,000 was placed in the county’s contingency fund, one reserved for unexpected expenses, “awaiting a decision on sharing the program costs with other municipalities,” according to the proposed 2024 budget.

“The purpose of putting [the funds] in contingency was really to have negotiations with the other municipalities,” Rich said at the committee meeting earlier this month.

In Enfield, the town board filed a resolution in support of the county fully funding the service. Board members are expected to vote to approve the text, which explains that out of the five cost-sharing models representatives from the DoER included in the project, the four that require municipalities to contribute are “unfair.”

The 2024 Countywide Shared Services Plan draft will be brought to the full legislature at its next meeting on Dec. 5, at which time conversations between the county administrator and officials in the municipalities should have occurred. The Ithaca Voice