ITHACA, N.Y. — Tompkins County legislators voted to cover the start-up costs and one half of the estimated first-year costs of the Rapid Medical Response project on Tuesday at their last meeting of 2023 while they await grant approval from the state.
Negotiations with officials in all nine municipalities to determine terms to cover the remaining half of the estimated first-year cost, an amount totaling $699,794, will begin next year. County Administrator Lisa Holmes will represent the county in these talks and will report back the results.
For now, the county will use $232,000 the legislature put in the contingency fund to cover one half of the estimated first-year costs it agreed to contribute initially — along with $54,000 the body unanimously voted to contribute as part of the 2024 budget.
Funding to cover the remainder of what the county agreed to contribute will be awarded through the New York State Local Government Efficiency grant and the state’s Countywide Shared Services Initiative funding “sometime within” 2024, according to the legislation.
“Because of the importance of these emergency services, the Tompkins County Legislature wishes to launch [the program] without waiting to receive a grant decision,” the legislation reads.
Last month, legislators voted to create a memorandum of understanding (MOU) to formally initiate negotiations to come to an agreement on how much municipalities are able and willing to contribute to support the program during its first operational year and into the future. The terms negotiated will be outlined in this MOU.
The amended legislation passed on Tuesday includes language in the MOU that recognizes municipalities had already passed their budgets by the time legislators in committee approved it.
The Rapid Medical Response program was created by county staff at the Department of Emergency Response (DoER) earlier this year, and includes three SUVs stationed around the county during the day, staffed by nine fully-trained EMTs. The goal is to support existing emergency services in responding to dispatch calls faster and more efficiently.
The vehicles won’t be used to transport patients, since they aren’t ambulances. But they will be outfitted with medical supplies so responders can initiate treatments if necessary before transport arrives. They’re meant to move faster than the four existing services are able, to get to the scene of an emergency before a transport service does.
Officials throughout the county have supported the program, acknowledging its necessity, particularly in rural areas where longer response times were recorded. But over the last two months, legislators and local officials have disagreed on how much the county should contribute to make it happen.
Staff at the DoER devised five cost-sharing plans, with all but one including some contribution from the municipalities. But officials in rural communities have been adamant about their inability to do so, even in small amounts, citing dwindling budgets and ever-rising tax levies.
Rich John, who represents Ithaca, has held firm in his belief that because taxpayers in more rural locations in the county would benefit more from the service than their urban counterparts, a sentiment which a number of officials have disagreed with, they should share some of the cost.
John proposed adding language at the meeting on Dec. 19 to emphasize fairness, he said.
“Certainly there are benefits that are county-wide, ” he said. “And with half of the cost being in the county budget already, everybody is going to pay something towards this. The question is, how do we pay for the rest? And how do we fairly divide that cost?”
He also wanted to give Holmes, the county’s administrator, a clear direction as she begins negotiations. But legislators Veronica Pillar, Mike Sigler and Anne Koreman said they wouldn’t support the legislation as a whole if the amendment was included.
The amendment was removed from the legislation.
In past negotiations, the three have maintained the opinion that implementing a cost sharing system to fund a county-controlled program like this one is, in the words of Sigler, “a slippery slope.”
“That’s not how the county works,” Sigler said this week. “I think if we go down this road, start to look at what’s good for the county and allocate according to which resident is getting the most benefit […] That’s not really a path I wanted to go down.”