Friday, February 22, 2013

Tax Exempt Entity Taxes EMS

 AFD on scene Mullins Center

Just as "party houses" should not disrupt the tranquility of a neighborhood so taxpayers have to deal with the mitigation mess, neither should UMass allow the Mullins Center to host concerts that swamp our emergency medical services. 

Take last night for instance:  AFD and four other surrounding towns had to provide ambulance transport for 19 patrons of the Tiesto concert directly from the Mullins Center to Cooley Dickinson Hospital and two more from UMPD jail to CDH.

Yes, none of them were UMass students. But the Mullins Center is owned by the UMass Building Authority, sits on UMass land, cost taxpayers $50 million to build (with six digit annual operation losses), and pays no property taxes to either Hadley or Amherst.

Back in 2000 the Hadley assessor tried to partially tax the facility arguing that Ogden Entertainment was a private company and rock concerts had nothing to do with higher education. 

The Appelate Tax Board found against the town of Hadley saying Ogden was an independent contractor "merely providing contractual management services". Since certain type of concerts -- techno for one -- seem to produce a high number of ETOH (alcohol overdose) calls, Mullins Center does pay for one ambulance to stage on site.

But after the last fiasco, also a Thursday night,  Chief Nelson talked them into contracting for two ambulance crews on standby.  Last night required five. 

Dancing Peeps. Dehydration and alcohol make for a lousy mix.

When mere entertainment taxes our vital services so heavily, it's time to get serious about solutions:  Maybe the Mullins Center needs to start dancing to a different beat.

UMass will be so proud


Anonymous said...

Thanks for the hotties pics, LK! More! More!

Anonymous said...

Larry- My understanding is the taxpayers don't spend a cent for the EMT services. The promoter pays for the service and the person being transported (or their insurance) pays for the ride to the hospital.

Larry Kelley said...

No, the promoter paid for two ambulances out of five that were required.

And I'm far more concerned about a critical resource being tied up on baby sitting calls, hence not available for other life threatening emergencies.

Anonymous said...

OK, sure Larry, like you ever gave a rat's ass about anybody else. You just need an arguement or a grievence just to make you feel alive. Please Larry, it's getting deep in here.

Dr. Ed said...

Larry, there are FIVE different "costs" for an ambulance. These are the "fixed" costs -- to have it -- and not paid for by those using it:

Cost #1: To create it. This is to buy the truck, equip it, train & license the crew, etc. This largely is a fixed cost and while a *big* expense for a small town with a volunteer ambulance crew that gets maybe a dozen runs a year, it remains the same regardless of how many runs the ambulance makes. (E.G. -- the EMT training/licensing for one person costs the same if the specific individual makes one run a year or a thousand.)

Look at it this way -- to have the car in your driveway has fixed costs regardless of if you drive it 10 miles a year or 100,000. You have to buy it, pay the excise tax, register it and such -- this does not include the per/mile cost of gas, parts and such, and it actually becomes (percentwise) less relative to the miles you drive.

Cost #2: Opportunity Cost -- the nice thing about having FF/EMT positions is that you have greater staffing flexibility and more manpower for what you need if neither F or A is being used -- but the flip side is that using one eliminates the other capacity.

If AFD goes with 2-man ambulance and 3-man fire truck, every three ambulances takes two fire trucks off the road. This requires more guys on shift and/or mutual aid so as to have the fire truck able to respond if needed.

Query: Has there ever been a consideration of a "personnel-only" mutual aid protocol and in training other FDs (e.g. Hadley, Hamp, Westfield) on Amherst's equipment?

Every FD has a "headcount" of at least three times what it needs to use every piece of equipment concurrently -- it takes about 4.3 actual human beings to staff just one position 24/7 and the majority of any department is usually off duty at any given time.

Mutual aid usually requires both crew and fire truck because the requesting department has committed both somewhere else. Amherst is unique in that there are available fire trucks, just not a crew available to run them. Not a problem if the other departments don't have their own fires -- big problem if they do.

Hence is there any way that Amherst can request "just guys" -- essentially calling in the off-duty personnel of *other* FDs to help Amherst?

Larry Kelley said...

That's an easy one: No.

Dr. Ed said...

Part 2 -- Ambulance use costs:

1: Availability. The more ambulances you want, the more crews you have to have on shift -- and I believe this is what people are talking about relative to the "two ambulances" that the Mullins Center has to hire for events like this.

This is a fixed per/unit cost and stays the same if there are runs or not.

2: Per run costs. Fuel, supplies, wear & tear on the equipment, etc. Diesel fuel is not cheap and I imagine that a run to BayState costs more in fuel alone than one might think.

These costs are billed to the person being transported -- and the thing that Larry keeps missing here is that while the AFD may bill everyone the same, what they actually *get* differs vastly depending on whom they are transporting and what the person has for insurance.

I believe that they get 100% from a UMass student (the student insurance at least used to pay this), probably 80% from most insurance companies, and maybe 50% from MassHealth/Medicaid if they are lucky.

The important thing to remember here is that -- in theory at least -- this charge pays for all the other costs as well.

Think of it as a for-profit cab company -- all the expenses are paid for by the per-ride charges.

Dr. Ed said...

Other thoughts:

First, I got 13 ETOH and 7 medical runs which adds up to 20, not 19, but what really jumped out at me was that three of the ETOH runs were of two patients.

Does AFD charge each person the full cost of the run? That means that the second person's payment is pure profit because it costs the same amount of money to transport two persons as one.

Second -- and what I found more disturbing than just the ETOH, was the seven (7) calls for more serious stuff including a head injury (Mullins Center) that required transport directly to Bay State.

The run to the UMPD jail that Larry referenced was for an "injured prisoner" -- not ETOH -- and that raises lots of questions.

Larry, above and beyond the kids getting drunk and needing to have their stomachs pumped out, there were seven serious injuries arguably attributable to this concert! This is above and beyond something like past events -- and I think some serious questions need to be asked about why so many people got hurt.

Anonymous said...

Ed, try to focus here.
The simple fact is that these events often tie up all available AFD ambulances and staff. Even without these events we constantly rely on mutual aid and our residents have to wait longer for what could be critical care. Doesnt matter who is paying what for the rides to CDH, our town is left vulnerable. It is time for our residents to wake up and demand more staffing.

Anonymous said...

i can see larry going through a lot of pictures of young girls with little clothing. thats an easy one

Anonymous said...

Ed- The conflict in "19 vs 20" patients, is that if a patient refuses care, (not transported to hospital) then that would be the discrep. So essentially there could be 20 amb "runs" but only 19 patients transported.

Dr. Ed said...

if a patient refuses care, (not transported to hospital) then that would be the discrep. So essentially there could be 20 amb "runs" but only 19 patients transported.

Is this run "billable" or does the AFD have to absorb it? If so, and if this happens with some frequency, what would otherwise be a self-funding enterprise quickly goes into the hole financially.

And on the larger issue, particularly of Mullins' Concerts, there are private ambulance companies, which I assume meet the same license/education/etc requirements that the AFD has to meet, and if the issue is the staffing and that the AFD isn't available to the town, why is the AFD being given the paid detail?

In other words, if the problem is that the AFD doesn't have enough people & ambulances, wouldn't it make more sense to bring in a PRIVATE ambulance company for Mullins events - to increase the total number of ambulances available?