Legislature Hears Rapid Medical Response Pilot Program Presentation and Holds Shared Service Public Hearing
The Tompkins County Legislature is considering a proposal to create an Emergency Medical Services (EMS) rapid response program to address critical gaps in the local emergency response system. The Tompkins County Department of Emergency Response developed a proposal following calls from local municipal officials and an examination of data on existing emergency response times and staffing at local agencies.
Tompkins County Director of Emergency Response Michael Stitley and EMS Coordinator Joe Milliman detailed the proposed two-year pilot program. Milliman outlined the issue; volunteer first responders are increasingly hard to recruit, and low staffing levels leave the agencies that rely on volunteers with less resources to respond to every call for service. Some calls for Emergency Medical Services (EMS) are going unanswered in Tompkins County and response times are longer on average for those calls that do receive a response. Currently, EMS providers are decentralized across Tompkins County, with different agencies and municipalities offering different levels of service and staffing in different geographic locations.
The proposed countywide rapid EMS response program would offer three response units placed in locations around the County allowing for a quick response (for example, one may be in Lansing, augmenting existing resources). The units would not use traditional ambulances or transport individuals for medical attention, but would offer rapid, on-site support to address an immediate issue or support someone while they await additional resources. Director Mike Stitley shared that this program would supplement the existing system, and is not designed to replace existing services offered by local municipalities. Stitley added that this new program could be dispatched to any type of call, even those regarding lower-level concerns. The program’s goal is a high level of customer service, helping ensure that when someone calls 911, they can expect someone to arrive from an emergency response unit.
The estimated cost to start the program is just shy of $700,000. The investment would support three units of full and part-time staff members, each with a vehicle and EMS equipment.
A subcommittee of the Tompkins County Council of Government, a body comprised of officials from each local municipality, identified and studied the need for enhanced Emergency Medical Services. The resulting conversations led to this proposal and the opportunity for a New York State Countywide Shared Services grant which the County is in the process of applying for, and a public hearing on the program held immediately in advance of the October 3 Legislature meeting. Part of the Department of Emergency Response’s presentation focused on potential cost sharing options for local municipalities who would use the service.
Legislature Chairwoman Shawna Black (D-Ithaca) remarked on the progress that the Department of Emergency Response and Milliman in his EMS Coordinator role have made over the past year. The coordinator position was newly budgeted for in 2023 and Milliman was lauded for hitting the ground running.
Legislator Dan Klein (D-Danby) added that this has been an ongoing issue faced by local governments everywhere and that many people locally have spent “time trying to crack the code,” adding that he’s excited that there’s something on the table to consider that could “make a dent in this problem.”
The program will be considered as part of the County’s 2024 Budget considerations.
Legislature Receives Presentation from Moody’s Analytics Regarding Bond Rating
Representatives from Moody’s Analytics and Fiscal Advisors and Marketing Inc. joined the meeting to discuss the methodology used to issue a bond rating for Tompkins County. Tompkins County has an Aa1 credit rating.
As a municipal government Tompkins County can issue bonds. The credit rating issued by Moody’s helps to determine the interest rate associated with those County-issued bonds. Bonds are a loan; the entity that purchases a bond from Tompkins County loans the County money to complete a project and the County then repays that loan with interest. A good credit rating for Tompkins County means that the bonds it issues are more attractive to buyers and less expensive for the County to pay off.
The Legislature invited the Moody’s representatives to present on the topic as it is considering the County’s fund balance as budgeting decisions are made. Several Legislators have expressed interest in gaining a deeper knowledge of how the County’s fund balance impacts its credit rating and how to best set policies to use the fund balance and set aside funding reserves.
Susanne Siebel from Moody’s presented the methodology to assign bond ratings to Cities and Counties. All U.S. municipalities use the same methodology, assessing the local economy, institutional control over finances, financial performance, and leveraging debt and liabilities in relation to revenues. The presentation compared the County against other New York and U.S. counties, showing that Tompkins outperformed its peers in several categories. Ultimately, the County’s ability to repay its debts is calculated under the credit rating; an Aa1 credit rating is the highest among area counties rated by Moody’s.
Deborah Dawson (D-Lansing) inquired about the importance of fund balance in maintaining the County’s credit rating. The County’s fund balance is currently broken out into unallocated fund balance and fund balance allocated for specific capital reserve and other program areas. Siebel clarified that if something is in the County’s audited financial report, it is used in the credit rating. If a financial metric (such as fund balance) is not restricted it is included in the “available fund balance.” If it is listed as restricted, it is not ignored in the credit rating process, but it is not a core component of a rating. The County’s non restricted fund balance is an important metric in determining its ability to pay back its debts and achieve a high credit rating.
This brought into question whether the County’s reserve funds are considered “restricted” by Moody’s, which is dependent on how it is outlined in the audited financials. Legislator Randy Brown (R-Newfield) asked that County staff who report on finances use the same terminology as the audited financials so that there can be consistency in future reports.
Among Other Business
October was declared “United in Kindness Month,” with a proclamation outlining the ill effects of bullying on young people and the local efforts undertaken by the Tompkins County Bullying Prevention Task Force. Brandi Remington, a representative from TST BOCES thanked the Legislature and spoke on behalf of the Task Force, inviting the community to a series of events.
Chris Sponn was confirmed by a unanimous vote of the Legislature (13-0, Legislator Travis Brooks (D-Ithaca) excused) as Director of Workforce Development following a search process and unanimous approval by the Workforce Development Board.