New EMS Chief Jerry Martin wants San Juan Islanders to know that he is working hard to create a workable budget that ensures high quality care and “no out-of-pocket expenses” for residents of Public Hospital District 1.

At a town hall meeting at the Mullis Senior Center on Tuesday, April 12, Martin outlined the 2016/2017 budget he has in the works and why he hopes the public will pass a $.50 per $1,000 of assessed property value levy come August.

“Fifty cents per $1,000 is that magic number,” said Martin. “It will keep us afloat and keep it so that there are no out-of-pocket expenses for you folks.”

No “out-of-pocket expenses” means that district 1 residents (San Juan, Brown, Pearl, Henry, Spieden, Stuart and Johns Islands) are covered under a zero-based billing clause created by the early founders of the San Juan Island emergency medical services. This ensures that there are no response, patient care or ground transportation fees for under or uninsured residents. Insurance is billed first, but co-pays and/or remaining amounts are not billed to islanders, and Martin would like to keep it that way. Opponents wonder if this is reasonable due to the current state of the EMS budget.

One of the financial problems EMS faces is how to bill for Medicare and Medicaid. For a typical resident patient transport, via ambulance, on island, EMS will bill approximately $1,500. If the patient has insurance through Medicare or Medicaid, EMS is able to collect around $160-$250 from these insurance policies. The remaining $1,250-$1,340 is deemed “non-collectable” due to the zero-billing clause for residents. Because higher numbers of islanders are using Medicare over the past few years, baby boomers are getting to Medicare age, the amount EMS is able to collect is dwindling.

During the Town Hall meeting, residents suggested that EMS send a voluntary payment bill to island patients, explaining the payment process and offering them a choice to pay some of the “non-collectable” portion of the cost for their care. Part of Martin’s plan to create a financially responsible and sustainable budget is to move forward with only the necessary amount of staff. In 2015 EMS supported 15 employees, not including volunteer EMTs, but Martin believes he will be able to provide the same high level of service residents are accustomed to with just nine employees plus a less than part time chief flight nurse. Part of the reason this works is not only the high experience and training level of these employees, including five paramedics, but because the number of calls EMS responds to every year may decrease as more people are using the emergency room at Peace Health Island Hospital.

Though Martin is making cuts in the 2016/2017 budget, he is adamant that San Juan Island EMS continue to provide the exceptional care they’re known for. Their cardiac arrest unit last year was rated higher than King County, who has consistently been at the top in that area.

With more than double the percentage of residents 65 years and older compared to most communities, 35 percent on San Juan Island versus 14 percent of the general population, the need for first class cardiac arrest services is vital to many islanders.

Local Mark Forlenza noted the importance of EMS when he spoke at the opening of the town hall meeting. Forlenza, a cardiac arrest survivor, believes he would not be here today were it not for the efforts of his CPR-trained wife and San Juan Island EMS paramedics and EMTs.

“I am alive due to the efforts of our EMS team,” said Forlenza. “The levy is a small price to pay.”