Highland Area EMS Information Sheet
This information sheet has been prepared in cooperation with the Trustees of the respective fire protection districts and officials from the City of Highland.
Effective May 1, 2024, Highland EMS will no longer be serving St. Jacob Fire Protection District, Marine Fire Protection District, Highland-Pierron Fire Protection District and Grantfork Fire Protection District. Those districts will be served by the Alhambra-Hamel Ambulance Service with a truck being stationed within the borders of the Highland-Pierron Fire Protection District.
Highland EMS will be going to 1 full-time staffed ambulance from the current 2 ambulances, and will be solely focused on emergency response for Highland citizens.
The Special Service Area that serves St. Rose Fire Protection District has a contract with Highland EMS through December 31, 2024, but has requested the option to join with an alternate service provider if it makes economic and operational sense for the district.
The Districts and the City of Highland understand that citizens will have questions and will be concerned about the change in this service. The Districts and the City are committed to providing our citizens with immediate and quality care when there is a need for emergency medical services. We the Trustees of the Fire Protection Districts and elected officials of the City of Highland are all residents as well, so when we make changes to the services, we are making changes for our families as well. We are committed to doing everything we possibly can to meet the standards of service our residents have come to expect while taking into account the economic realities impacting our EMS services.
The questions and answers below are intended to help explain why these operational changes are happening.
For Specific questions regarding your district, please contact the respective districts at the information below:
- Highland-Pierron FPD: 618-654-1161
- Marine FPD: 618-887-4221
- Jacob FPD: 618-644-5751
- Grantfork FPD: 618-654-9836
- Rose/SSA 5: 618-526-4221
- City of Highland: 618-654-9891
How is the service currently organized?
Currently the City of Highland owns the EMS service and provides EMS service to the 5 fire protection districts through contracts for service. This has been the arrangement for many years with the 5 districts: St. Jacob, Marine, Highland-Pierron, Grantfork and St. Rose. Each year the City would send contracts to the districts with requested levy amounts to fund the EMS service. The Fire Protection Districts would levy the funds and then would make annual payments to the City for the service.
The City of Highland also has its own tax levy for EMS services which is capped by state statute at .25%.
What is happening with the service?
As we saw with our neighbors in Pocahontas, federal policy decisions regarding Medicare and Medicaid reimbursements have made it very difficult for EMS services to cash flow. Highland is no different. The City has subsidized the EMS service for several years exhausting the reserves of the EMS department. This is not an issue unique to Highland, rather this is a nationwide issue that has caused many government funded EMS services to consolidate, reduce services or contract the service out to private entities. These are always difficult decisions that are rarely made voluntarily, most often the governmental agencies are forced into those decisions because of financial difficulty.
EMS services in Illinois have additionally been impacted with increased operating costs due to inflation for equipment and apparatus and the increases in minimum wage which have significantly impacted starting wages for these positions.
How is EMS funded?
Highland EMS is operated as a hybrid government fund and enterprise. That means it is supported both from property taxes and from fees for services. Highland EMS specifically has traditionally been funded with about half of the necessary operating cash coming from property taxes collected from the City of Highland and the Fire Protection Districts; and about half of the operating cash coming from fees for services for the calls they respond to. In this business model, if the operating expenses exceed the revenue from property taxes or fees for services, the City of Highland is responsible for covering the operating loss.
How does EMS raise revenue to fund the service?
There are two options for increasing revenue to meet increased operating costs; raise taxes and/or raise fees.
The City of Highland has been at or very near the statutory maximum for our EMS tax levy for several years, so the only growth in the City controlled property tax revenue is in EAV growth across the city.
The City has also instituted rate increases the last several years, however, due to Medicaid and Medicare rules, the amount paid to the service for calls with Medicaid or Medicare patients remains flat regardless of what is charged. Medicare and Medicaid pay about 55% of the estimated cost of providing the service. This means that when we raise rates, we increase the amount we lose (and eventually write off) in providing service to Medicare and Medicaid patients. For Highland EMS between 60-70% of our calls are to Medicare and Medicaid patients, so we lose money on 60-70% of the calls we respond to. So raising rates, does not equate to a dollar for dollar increase due to the flat rates paid by Medicare and Medicaid.
This leaves raising the property tax levy’s for the fire protection districts.
The City of Highland has contracts with the fire protection districts through April 30, 2024.
In May of 2023, the City sent contracts to the districts for a 3 year term beginning May 1, 2024. The contract asked the districts to increase their tax levy over the 3 years to a levy amount equal to what the City of Highland has levied on their citizens for the EMS service. The increases would have been stepped up to .20% in year 1, .225% in year 2, and .25% in year 3. This would have required for some districts a tripling of their tax levy for EMS over those 3 years. The Fire Protection Districts collectively decided to seek lower costs through alternative providers for their EMS services.
St. Rose Fire Protection District is covered by a Special Service Area that is controlled by the Clinton County Board. The Special Service Area did increase their tax levy this year and requested a contract with the City of Highland extending their service until December 31, 2024, however they requested the option to early out if they decide to join in with the other 4 fire protection districts in their service if it makes economic and operational sense.
Why is Highland going to one ambulance?
Due to the loss of the property tax and fees for services revenue from the Fire Protection Districts, on May 1, 2024, the City of Highland will be going to 1 full-time ambulance to cover the emergency needs of the City of Highland residents. Based on past call volume, we expect the remaining ambulance to average 3 calls per day. The City is currently negotiating with the EMS union on issues related to emergency call in and special event staffing.
It is a priority of the City to maintain a government run EMS service for as long as possible to ensure the best service possible to our citizens.
Does this impact fire services?
No. These changes only impact EMS services within the current Highland EMS service area. This does not impact any of the fire services or the mutual aid responses between the agencies for fire service.
These operational changes are being made as each taxing body tries to obtain the best services possible for their citizens at the lowest possible cost. These business decisions do not impact the longstanding relationships between the departments.
Will current employees lose their jobs?
Yes. Highland EMS is currently authorized 16 full-time EMS personnel to serve the city and the surrounding districts. Due to staff attrition, we currently are staffed at 13. On May 1, 2024 due to loss of district revenue and call volume, Highland will likely go down to 8 full-time personnel. The City is currently negotiating these details with the union, but the union has been made aware of our intention to go to 8. The City has requested of the Fire Protection Districts in their negotiations with their alternate provider, request preference for our employees who will be laid off on May 1. The City is actively working to make sure all our employees who wish to remain EMT’s have that opportunity without interruption.
Is this a long term solution to the EMS funding issue?
No. Without changes at the federal level to the current funding for EMS reimbursements from Medicare and Medicaid, all EMS services will continue to see operational costs outpace revenue growth. These changes, while they may see short-term gains for the respective departments, will only delay future difficult decisions for the services and their government bodies. The City of Highland has lobbied our federal elected officials on this issue and encourage others to do so as well.
Another possible solution could be a consolidated ambulance district. This was made possible through recent legislation sponsored by Rep. Charlie Meier that allows for the creation of ambulance protection districts to serve multiple communities through a voter approved referendum process.
