Montana Public Radio

Budget Problems Put Glacier County EMS At Risk Of Closure

Feb 18, 2020

Imagine calling 911 for an ambulance and the dispatcher tells you there isn’t one available. That could soon be the case for many Glacier County residents. The county says its emergency medical services are close to folding amid the local government’s long standing financial woes.

Glacier County Chief Financial Officer Chancy Kittson is showing off the county’s still new looking four-year-old EMS facility that provides emergency transport coverage over 3,000 square miles.

“Glacier County is a huge service area. So you have from here; it must be close to 60 miles to the Canadian border, to Babb.” Kittson says.

At its peak in 2018, Kittson says the county had up to 30 paid EMS staff and the county spent about $2.1 million on department operations. But over the last two years the department has dwindled to about 11 paid employees and some volunteers.

"We’re potentially 30 days away from drastically reducing services to a 100 percent volunteer service just because of the cash flow challenges that the county is having."

The county’s financial woes are a long, complicated story we’ll get into later, but in short, if its emergency transport system keeps running in the red, the program could shut down in April at the latest.

Acting EMS Manager Tauna Evens says that could mean many of the 50 monthly calls her staff receive on average could go unanswered.

"It is very difficult right now especially. Do we go find other jobs? We just don’t know. Right now, we’re just going day to day just to see what happens."

Evens says it’s unlikely the rural county of roughly 14,000 people could find enough volunteers to provide the service when funding runs dry.

"I think everyone is very concerned about what's going to happen. If there’s an emergency, are we going to be jumping in the back of a pickup and being hauled to the hospital? There is no clear answers at this point what people will be able to do."

According to the Montana Department of Public Health and Human Services, EMS programs across the state are already strained when it comes to replacing older volunteers and even finding candidates for paid positions. The department’s Shari Graham says if Glacier County's program folds, it would exacerbate that situation on the Rocky Mountain Front.

"They would have to have EMS come from outlying communities, which would not only be a delay in service for the Cut Bank area, but that would also mean that it would be taxing on those surrounding communities and pulling their volunteer staff out to cover the Cut Bank community."

Neighboring Pondera County’s EMS program says it would respond to calls in Glacier County if staff are available, but that’s not always the case. Pondera County’s EMS manager says even if it has the capacity to lend help, emergency transport arrival times could range from half an hour at best to two hours.

Toole County says an agreement would have to be hammered out before its staff out of Shelby could respond to calls in Glacier and response times could be lengthy

Dr. Hank Clay who sits on Glacier County’s Health Board is concerned about what this will mean for locals' access to emergency health care. The health board recently sent a letter to county commissioners pleading for them to find a way to keep the EMS program going.

Clay, who works at Northern Rockies Medical Center out of Cut Bank, says the hospital requests about three patient transfers daily. He says even now, staff sometimes can’t find a ground EMS provider to transfer patients to Great Falls or Kalispell, where more advanced medical services are located. Medevac services can also be unavailable at times.

"And we’re stuck with a patient that we really have no business taking care of; and that’s a problem," Clay says. "Hope they come to some solutions quickly because without EMS we’re gonna really put citizens in this county in jeopardy. Lives are going to be lost because of it."

County Commission Chair Michael DeRosier is very aware of the concern.

"The community is starting to notice that and plead with us, 'don't let that happen.' But we've gone to the community and we asked the community if we, if they wanted to fund it."

DeRosier is referring to ballot measures voters shot down early last year asking them to raise taxes to pay off most of the EMS department’s debt. But DeRosier says the department's budget issues don't solely rest on a lack of funding.

"You know, they always had a tendency to overspend and we were a little lax in monitoring that."

DeRosier says between building a new EMS facility and covering budget shortfalls, the department accounts for over half of the county’s $5 million in debt.

DeRosier says part of that problem stemmed from the department falling behind on billing dating back to 2014, namely $1.8 million worth of hospital transfers out of the Indian Health Service’s Browning facility. IHS disputes that figure and now the county is taking the agency to court in an attempt to get the money

In the meantime, the county has stopped providing IHS with transfers, which paid for much of the county’s EMS program in the past.

Glacier County CFO Chancy Kittson says the legal dispute over IHS billing could make or break the local government's ability to provide EMS.

"Without a doubt, this building and this program is one of the items that is 90 percent responsible for the financial position of the county," Kittson says.

The state has frozen roughly $1.3 million in funding for the county because of discrepancies in its cash reporting. The county says it’s close to getting the funding unfrozen. Kittson says that, and a payout from IHS, would boost the county’s plan to resolve its debt in the next five years.

But even if that happens, it might not be the end of its saga of financial troubles. The state Department of Justice is in the midst of investigating how the county wound up in so much debt. And while there’s no timeline for that investigation, it’s findings could be another twist in Glacier County’s story.