“We don’t think they understand our plight,” Mark Lauer said of the cost of running an ambulance service.

The members of Karns City Regional Ambulance Service gathered Tuesday evening, Oct. 18, to discuss the struggles of maintaining its part-time service and potential solutions.

Board member Kandi Nassy said several representatives met Oct. 11 in Grove City to brainstorm solutions for funding and staffing shortages faced by EMS services. She and Lauer, president of the service, relayed the information to their small team.

“The representatives were questioning why there weren’t enough volunteers,” Lauer said. “They continued to lean to it being a local municipal government issue and said they want to work with (them) on that.”

Karns City Regional Ambulance Service has operated for three years, said Michael Turner, a member of the service. For funding, they survive on a subscription service and the flat fees allowed for ambulance services by Medicare and Medicaid.

“Medicare sets the standard for reimbursement for the billing companies. We haven’t seen an increase in decades. They passed a law to increase that reimbursement flat fee by $100,” he said.

Medicaid’s former reimbursement was $400, with the new law increasing the amount of $500 going toward departments.

Turner added that unlike hospitals, which bill patients for every service like an IV or heart monitor, ambulance services charge flat fees.

“A patient refusing treatment is only $60 or $80,” he said as an example.

For private insurance companies, hospitals send the check to patients for the ambulance ride, which is supposed to end up in the ambulance services’ accounts. Turner said that when patients cash the check for themselves, ambulance services have to take them to court — and pay out of pocket for court fees, too.

Lauer said that between bills, rent, equipment and payroll, the cost to run Karns City’s service is $30,000 a month.

“We have to be able to maintain a part time service. If people want coverage 24 hours a day, that’s up to the municipalities who services cover. We don’t think they understand our plight,” he said. “We’re primary coverage for 13 municipalities.”

Lauer said state representatives mentioned at the hearing that municipal authorities are allowed to charge a half-mill tax for EMS services. (A mill is one-tenth of a penny.) Donegal Township voted at last month’s meeting to set up a tax for Karns City next year. Lauer said the service plans to ask the other municipalities in its coverage area for a similar tax.

Donegal Township residents pay a 2.5-mill fire tax as well, according to officials.

The service is often called upon to cover emergency calls for other municipalities, sometimes outside county lines, Lauer said.

“(Residents here) donate to have the ambulance service, and we need to be here for them,” he said.

“The big services are struggling, too,” Turner said. “Every resource is being pulled in every direction.”

When the meeting ended, Nassy said she planned to do research and speak with municipal officials about the possibility of using American Rescue Plan Act funds for the struggling EMS services.

Lauer said Butler County isn’t the only one in dire straits in terms of staffing and funding.

“I don’t mean to just say to throw money at it, but if (services) can’t bring wages up and the cost of EMS training down, no one will want to work it,” he said. “For the county to be protecting its residents, there has to be a change. Police departments don’t have to sell raffle tickets to buy bullets. Why do we have to sell tickets to operate?”