Matt Hinton.

June 28, 2006.

HAND DELIVERED.

Re: Ambulance Interlocal Agreement.

Gentlemen:.

The City of Vicksburg has provided all of Warren County with Ambulance and Rescue services for at least the past eight (8) years at great costs to the City of Vicksburg taxpayers who are also taxpayers to Warren County.

During these past eight (8) years, we have tried to come to some resolution that will equitably spread the costs of the services over those who use them.

The total estimated budget for emergency services, excluding fire suppression, is $3,210,507 for fiscal year 2007. The estimated amount the City will collect is $1,311,000.00 which is based on the rate of current collections. This leaves a loss of $1,899,507.00.

The City provides not only ALS services to the County, but also BLS,.

Rescue services (jaws of life), Dive Team Services and Haz-mat services to the County. All of these services to persons outside the city are life-saving services. These responses outside of the City limits constitute 35% of all emergency responses.

The City has available for all county residents various types of ambulance responses and we have attempted to define them as follows:.

ALS responses are occasions where the ambulance is dispatched by E-911 and where the patient is visibly injured, treated with an IV or some other invasive procedure is performed by the ambulance crew and transported to the ER. These calls outside of the City limits for FY05 represent 41% percent of the calls to the county.

BLS responses are where the ambulance may or may not be dispatched by E-911 and the patient is treated and/or transported to the appropriate facility. These are occasions where there may not be obvious signs of injury, but the patient needs to be seen by a physician and checked out in the ER. For example, someone is in a car wreck and they appear to be alright, but are Warren County Board of Supervisors transported to the ER upon request or to make sure they are not injured.

These also include the non-emergency/medical necessity tranpsort responses, for example if the person cannot walk, sit or stand and needs to be transported from nursing homes to doctor’s offices or hospital or from a home to the doctor’s office. With the exception of these calls that originate at River Region, very few of this type of call originate or terminate outside of the city limits. These calls outside of the City limits for FY05 represent 61% percent of calls to the county.

The non-transport calls are calls where E-911 has dispatched an ambulance, but a patient is not transported to the ER. For example, if someone with asthma needs oxygen, the ambulance will respond and treat the patient, but there is no requirement to take them to the hospital. These calls outside of the city limits for FY05 represent 11 percent of calls to the County.

The public service calls are where E-911 dispatch an ambulance for non-emergency services, such as if someone has fallen and no one there can get the person off of the ground. Usually, there is not a reason to transport the patient once they have been assisted. Usually, these calls are answered by the volunteers, but if they do not respond, the Vicksburg Ambulance Service will respond. This category represents less than ten (10) calls.

We propose that the City and County equitably divide the loss, $1,899,507.00, that the city taxpayers incur by having such emergency response professionals and state of the art equipment available for response throughout Warren County. Thirty-five (35%) percent of the loss is $664,827.00. When that figure is divided by the number of responses and patient care reports outside of the City, 2,205 last year, the cost per response/patient is $301.51. We propose that the City and County enter into an Interlocal Agreement whereby the City provides its ALS, BLS, Rescue Services, Dive Team Services and Haz-Mat services for $300.00 per response for rescue, dive team and haz-mat services and $300.00 per patient care report for ALS and BLS ambulance response/patient care report for these emergency services outside of the city limits.

Additionally, as part of this equitable cost sharing, we suggest that the funds to share in this cost would not come from the County’s general fund, of which city tax payers pay 65%, but come from those persons who reside outside of the city limits or from some other funding source so that city tax payers are not paying twice for the same services.

We propose that the County pay the estimated $664,827.00 at the beginning of the fiscal year and then within ninety (90) days of the end of the fiscal year, we will prepare a final report, have an accounting with the fire department numbers, and issue a credit or debit accordingly.

We appreciate your willingness to consider these matters and look forward to their resolution.

Sincerely,.

___________________________.

Laurence E. Leyens, Mayor.

____________________________.

Sidney H. Beauman, Jr., Alderman.

_____________________________.

Michael A. Mayfield, Sr., Alderman.

cc: Separate copy to each Supervisor