Concerns about emergency medical service coverage in rural regions of Summit County have been smoldering for some time, and ignited within the North Summit Fire District last year, intensifying the need for officials to examine the issue.

The County Courthouse opted to hire SafeTech Solutions, a consulting firm that specializes in EMS, and began an assessment in August. The data, which was collected through phone and in-person interviews as well as public meetings and reviews of reports, was then evaluated and used to compile several potential system design models. 

The draft plan presented to the Council of Governments on Monday was a good start, said Park City Fire District Chief Bob Zanetti, who requested changes to the way Summit County’s EMS system operates last May; but there were several burning questions that he hoped would be addressed before the final version is presented next month.

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The goal of the study was to find a long-term, sustainable, reliable and viable EMS system for Summit County that ensures equitable access from the West Side to the East Side, SafeTech Solutions owner Aarron Reinert said during the presentation. He offered four potential models for how EMS could operate in Summit County ranging from a plan to keep what’s already in place to hiring and a quickly-dismissed option to hire a third-party provider.

However, the assessment only focused on the costs of emergency medical services and did not consider a combination system with a fire department, which is the most common model, according to Zanetti and North Summit Fire District Chief Ben Nielson. The failure to factor in a fire-based EMS system led to a more than $10 million expense estimate, while both fire chiefs said they could run a more efficient operation for less money.

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Summit County’s existing EMS system is estimated to generate around $2.9 million in revenue from patient transports this year, with the majority of that coming from within Park City Fire District boundaries. The County Courthouse also provides a $1.8 million subsidy for Park City Fire to provide EMS services in eastern Summit County. SafeTech Solutions estimated the current gap between revenue and true expenses is $5.6 million.

The calculations for the $10 million “true expense” for the EMS system were based on salary costs for advanced emergency medical technicians and paramedics, ambulance operating expenses, administrative costs and more.

The assessment determined that Model 1, which consisted of creating one county-wide EMS system operated by a single provider that is funded and governed by an official body. The plan is essentially what is already in place.

It called for seven staffed advanced life support ambulances in Park City as well as Coalville and Kamas with an estimated expense of $10 million with the potential to earn more than $2 million in revenue, totaling a $7 million deficit. The figure was expected to be near $8 million by 2033.

Some proposals suggested creating either two or three EMS systems that operate independently or as a collaboration. The assessment estimated these options would result in a $12 million expense with a similar return, resulting in a loss of more than $9 million. 

These models were more expensive because they required additional ambulances. However, administrative costs were lower if districts shared some personnel, which is the largest expense. In all cases, the loss presented did not include the subsidy provided by Summit County. A fourth option to contract out the services was mentioned, but ultimately eliminated.

SafeTech Solutions warned against creating multiple EMS systems as it could create long-term challenges. They speculated the systems in North Summit and South Summit could fail, specifically under the second and third models that would create independent districts, in part because of unnecessary competition.

The consulting firm also estimated run volume would have to increase by 600% on the East Side to sustain the self-sufficient departments. There were around 4,500 EMS runs in the Park City area in 2022 compared to less than 450 in North Summit and under 500 in South Summit the same year. The transport rate, or what can be billed, is around 54% across the county, according to the assessment.

However, Nielson affirmed that his crew is up to the task. 

The fire chief indicated there are too many complaints to keep EMS operations running the way they have been. The study determined stakeholders are concerned about response times, brownouts, transparency and accountability, particularly on the East Side.

“North Summit is up and running. We are ready to do it, and we can do it at the same level as Park City. They’re not alone anymore,” he said. “We need to start to consider that Park City Fire isn’t the only option.”

The fire chief indicated there are several factors the assessment didn’t consider that led to inflated costs, though he, Zanetti – and the study – agree that EMS is generally underfunded in Summit County.

One of the biggest questions that remained for elected officials and first responders after the presentation is how the county plans to pay for the needed changes. One possible suggestion was to develop a user cost based on property tax assessments that would be applied uniformly across the county to ensure everyone is paying their fair share.

Zanetti has long raised concerns about an unbalanced financial structure and has advocated for Park City Fire to be compensated fairly. He echoed Nielson’s message that the North Summit Fire District is ready to serve the East Side, but Zanetti said the West Side fire department will continue delivering quality gap-free services countywide until they’re no longer needed.

“We’re in the service-delivery business. We’ll never lose sight of that,” Zanetti said.

SafeTech Solutions anticipated it could be difficult to create efficiencies in any future EMS system because of past issues, historical development and differing expectations. The fire chiefs said they felt the assessment was a good starting point, but are looking forward to collaborating with county officials on the issue further as there’s still a lot to be decided.

The feedback provided over the next few weeks will be incorporated into the final EMS plan that is slated to be presented in May.