April 11, 2017

MEMO TO:           Mayor Barber and Board of Commissioners

FROM:                  Frank A. Rush, Jr., Town Manager

SUBJECT:           Emergency Medical Services Contracts - (Summary & Suggested Motions)

The Board of Commissioners is scheduled to consider two new contracts between the Town and Emerald Isle EMS, Inc. at the April 11 meeting.  The Board of Commissioners will also appoint two individuals to serve on a newly constituted Board of Directors charged with the governance of Emerald Isle EMS, Inc. in the future.


Emerald Isle EMS, Inc. has provided emergency medical services for the residents and visitors of Emerald Isle for several decades, initially as a completely volunteer organization with no affiliation or formal relationship with the Town.  Since 2001, EI EMS, Inc. has operated as the authorized emergency medical services provider in Emerald Isle under formal contract to the Town. 

EI EMS, Inc. is a separate non-profit entity, with a fully-paid staff providing services at the Paramedic level of care, and is supplemented by volunteer emergency medical technicians.  EI EMS, Inc. is currently governed by a 5-member Board of Directors elected annually by the volunteer membership of EI EMS, Inc.  In an effort to promote clear communication between the Town and EI EMS, Inc., a separate Joint EMS Committee (consisting of 3 representatives from each) meets periodically to review the EMS budget and consider other issues. 

The Town’s current contract with EI EMS, Inc. was extended in July 2015, and expires on June 30, 2017.  The Town also provides financial administration services for EI EMS, Inc. under a separate contract, and that contract was also extended in July 2015 and expires on June 30, 2017.  The total FY 16-17 operating budget for EI EMS, Inc. is $560,000, with a total of $390,000 provided by the Town’s General Fund and $170,000 derived from service fees.  In addition, EI EMS, Inc. also receives donations and generates fundraising proceeds, and this amount varies each year depending on specific initiatives.  The Town owns the EMS station and leases it to EI EMS, Inc. at no cost, and EI EMS, Inc. owns all other assets used to provide emergency medical services (ambulances, defibrillators, etc.).

For the past decade, there has been discussion by the Joint EMS Committee about the eventual transition of EI EMS, Inc. to a department of the Town government (similar to the Police Department, Fire Department, etc.).  This transition has not occurred, primarily because service quality has remained high and due to concerns from by EI EMS, Inc. about losing autonomy.  Over the years, EI EMS, Inc. has fully evolved from a completely volunteer organization to a fully-paid staff, the annual budget has increased significantly, the complexity of emergency medical services has grown, and many of the core volunteers who built EI EMS, Inc. over the years have moved on and are no longer active.  As discussed previously, I believe there comes a certain point at which any organization utilizing that much public money and operating with a fully-paid staff should fall under the direction of a unit of local government and be more directly accountable to a group of elected officials, and I believe we are at or fast approaching that point.  The actions presented for Board consideration at the April 11 meeting recognize this reality, and represent another step toward the eventual transition of EI EMS, Inc. to a Town department.

Emergency Medical Services Contract with Emerald Isle EMS, Inc.

The attached contract incorporates several new provisions intended to increase EI EMS, Inc.’s accountability to the Town.  The new provisions provide for greater Town involvement in the governance of EI EMS, Inc., and also implement a better-defined management structure for EI EMS, Inc.  The new provisions are highlighted in RED in the attached contract. 

The Town’s current contract with EI EMS, Inc. expires on June 30, 2017, however, a new contract is presented that would take effect on April 15, 2017, prior to the expiration of the current contract.  The attached contract would expire on March 1, 2018, and purposely adjusts the expiration to a date in the “offseason” in order to provide for an easier transition for EI EMS, Inc. to become a Town department in the future without the pressure of higher call volumes during the summer months.  (All previous contracts included a June 30 expiration date.)  The attached contract notes that the Town and EI EMS, Inc. will work cooperatively and diligently toward the transition of EI EMS, Inc. to a department of the Town, and this transition could occur as early as March 1, 2018, or in March of a subsequent year, at the future discretion of the Board of Commissioners.

The attached contract incorporates a newly constituted Board of Directors charged with the governance of EI EMS, Inc.  As stipulated, EI EMS, Inc. would appoint 3 members of a 5-member Board of Directors, and the Town would appoint 2 members.  This 5-member Board of Directors would choose officers (including a Chair) from among its 5-members, and would then be responsible for the governance of EI EMS, Inc. beginning on April 15.  The EMS Board of Directors would be responsible for the selection of the EMS Chief and the establishment of policies pertaining to all other EMS employees. 

The attached contract also includes a provision stipulating that all EI EMS, Inc. assets will be transferred to the Town (or other new entity approved by the Town to provide emergency medical services) at such time that EI EMS, Inc. is no longer the authorized service provider in Emerald Isle.  This provision is important because all EI EMS, Inc. assets were originally funded by the residents and visitors of Emerald Isle through tax payments, service fees, donations, contributions, or fundraising activities, and it is prudent to insure that these assets benefit the people of Emerald Isle in perpetuity.

EI EMS, Inc. formally approved the new contract at its April 4 meeting, and appointed members Arlayne Calhoun, Angel Hamlin, and Rebecca Gaffney to the new Board of Directors.  If the Board approves the attached contract, I expect that the new Board of Directors will convene on or before April 15, begin its work, and select an EMS Chief (they are currently operating with an interim EMS Chief) in the coming weeks.  I also expect that the Joint EMS Committee will continue its discussions about the future transition of EI EMS, Inc. to a Town department in the coming months, and provide a recommendation to the Board of Commissioners in late 2017 or early 2018.  The Board of Commissioners would then consider whether to execute another 1-year extension of the attached contract or to proceed with the transition of EI EMS, Inc. to a Town department at that time.

Financial Administration Services Contract for EI EMS, Inc.

The attached contract is identical to the current contract (that expires on June 30), and would simply extend this contract to match the term of the emergency medical services contract.  The new contract would be effective April 15, 2017 and expire on March 1, 2018.

The Town has been providing financial administration services for EI EMS, Inc. since 2011, and Town staff handle all accounts payable, payroll, and related functions for EI EMS, Inc. in a manner similar to the overall Town organization.  The Board should note that all expenditure decisions and personnel decisions are made by the leadership of EI EMS, Inc., and the Town’s role is limited to administrative functions.

Appointments – New Emerald Isle EMS, Inc. Board of Directors – 2 Vacancies

As stipulated in the new contract, the Board of Commissioners should appoint two individuals to serve on the EI EMS, Inc. Board of Directors.  One appointment should be an individual with a medical background, and one appointment should be an individual with a business background.  Both individuals must reside in Emerald Isle, and one appointment will serve an initial 2-year term and one will serve an initial 1-year term (in order to implement staggered terms initially).  All future appointments would serve a 2-year term.

I look forward to discussing these issues with the Board at the April 11 meeting.