JOHNSTOWN — The Johnstown Area Volunteer Ambulance Corps. has announced it will be shutting down March 16, making it the second ambulance service in Fulton County to close over the past two months.
Fulton County EMS Coordinator Steven Santa Maria said he was alerted to the shutdown by JAVAC President Duane Abbott and by the New York State Department of Health. He said the service, which has served the Johnstown area since 1971, is set to cease operations at 8 p.m. on March 16.
JAVAC had been part of the Emergency EMS Response Plan put into place when the Ambulance Service of Fulton County abruptly announced it was shutting down Feb. 8. The ASFC was the largest ambulance service in Fulton County, employing about 60 people and operating about four ambulances.
JAVAC is smaller. As part of the emergency plan it briefly deployed two ambulance rigs but normally operated only one.
“We’re losing one ambulance that was responding to two calls or less per day, on average, so it’s not as catastrophic as it was when the Ambulance Service of Fulton County decided to cease operations,” Santa Maria said. “We feel the couple of calls per day they were running can be absorbed with the current resources that we have.”
The Greater Amsterdam Volunteer Ambulance Corps. (GAVAC) has carried the majority of the load for the territory formerly served by ASFC. GAVAC has been granted a temporary state certificate of need to have “first call” responsibility for ASFC’s territory, which included Gloversville and some of the western parts of Fulton County. GAVAC has been deploying five ambulances in Fulton County since ASFC closed, and has applied for a permanent certificate of need to operate throughout the entire county.
Shortly after the emergency response plan to cover ASFC’s territory was put into place, GAVAC and JAVAC began clashing over which agency had the legal authority to get the “first call” responsibility for the lucrative inter-facility transfer calls at Nathan Littauer Hospital. JAVAC had a “non-binding” agreement with Nathan Littauer Hospital to take the calls, and GAVAC questioned whether JAVAC had the legal authority to take them at all.
Santa Maria told the state Department of Health in an email written Feb. 14 that officials from both GAVAC and JAVAC had told him they might not be able to continue operations in Fulton County without the revenue from the hospital transfer calls.
The disputed territory was referred to the Adirondack-Appalachian Regional Medical Services Council for a ruling clarifying the boundaries of JAVAC’s territory. The council had not yet ruled as of Wednesday.
“It’s almost a moot point now,” Santa Maria said.
A news release from JAVAC’s president Abbott posted on the Fulton County Area News Facebook page Wednesday thanked the service’s employees and volunteers.
“We have made every effort possible to find the means to continue serving the community, but with the [loss] of our call volume, we can not afford to remain open,” Abbott said.
An employee answering the phone at JAVAC Wednesday said he was not aware of the impending shut down, before someone else at the location could be heard screaming, “Hang up!”
ASFC had sited insufficient reimburse from Medicaid as one of the reasons it ran out of money in February. The agency has been looking for a $200,000 cash infusion or a partner to help it resume operations.
GAVAC Executive Director Thomas Pasquarelli did not respond to an email seeking comment for this story. Pasquarelli has said GAVAC may partner with ASFC and acquire its ambulances and equipment.
JAVAC had shown signs of fiscal strain in recent years, failing to meet deadlines to reimburse the city of Johnstown for gasoline costs. The Johnstown Fire Department has also started its own ambulance service, which now has the “first call” responsibility in the city of Johnstown.
Pasquarelli in February also issued an order to GAVAC’s employees that they could no longer work for JAVAC during their off hours because the two agencies were now in direct competition.
Daniel Schuttig, a labor relations representative for the United Public Service Employees Union, said some of his members worked for ASFC and for JAVAC. He said the shutdown of JAVAC will mean Fulton County will be more reliant on GAVAC.
“Fulton County is crazy for putting all of its eggs into GAVAC’s basket. I don’t think many of these nonprofits are going to be able to survive into the future,” he said.
Santa Maria said ambulance agencies throughout New York state are coming under increasing fiscal strain.
“I think Fulton County is just reflective of what’s going on statewide,” he said. “This comes back to things like reimbursement rates hurting the finances of these agencies.”
On Tuesday the United New York Ambulance Network and the Healthcare Association of New York State participated in a rally outside the state Capitol from 10 a.m. until noon to raise awareness about the elimination of Medicaid Crossover and Supplemental funding in Gov. Andrew Cuomo’s executive budget proposal.
Cuomo’s budget proposal would:
• Eliminate Medicaid payments for Medicare Part B co-insurance. Medicare Part B patients are currently responsible for a 20-percent insurance co-pay. Where a Medicare patient is also eligible for Medicaid, Medicaid pays this 20 percent on behalf of the patient in what is known as a “crossover” payment.
Cuomo’s proposed budget eliminates crossover payments, meaning providers already operating below cost will lose out on a further 20 percent.
• Eliminate the Medicaid Supplemental Funds for ambulance providers. A 2017 study by the state Bureau of Emergency Management Services recommended a $31 million increase during the next five years in money set aside to pay ambulance services for transports that qualified for Medicaid Supplemental Fund payments.
Providers have been receiving Medicaid Supplemental Funds annually as “catch-up” payments, based on the number of Medicaid-qualified calls reported by a provider the prior year.
The governor’s proposed budget eliminates this catch-up, a move that would cost ambulance providers another $6 million annually.
Santa Maria said the cuts will only make it harder for ambulance services to remain in operation.