photo by: Chris Conde

Lawrence City Hall is pictured in September 2018.

Lawrence city leaders will soon discuss an outside study of the city’s agreement with Douglas County to jointly fund and provide emergency medical services, the results of which call for the county to increase how much money it provides toward the service.

As part of its meeting Tuesday, the Lawrence City Commission will receive a report regarding the EMS study, which was recently completed by The Public Policy and Management Center at Wichita State University. Currently, the city pays about three-quarters of the cost for the service and the county pays the remainder.

The funding agreement originated in 1996, when the city and county agreed to consolidate the countywide EMS with the City of Lawrence Fire Department, resulting in the current Lawrence-Douglas County Fire Medical department. Though the agreement has been in place for 25 years, the funding allocations have not changed significantly in that time. Some of the funding agreements between the city and the county go back more than 50 years, and in 2017, former City Manager Tom Markus suggested reviewing the numerous agreements with the goal of ensuring the funding breakdowns were equitable, as the Journal-World previously reported.

A detailed review of the EMS began more recently. In June 2020, under current City Manager Craig Owens, the city, county and the International Association of Firefighters Local 1596 issued a request for proposals seeking assistance from a consultant to review the current agreement and service delivery model, and ultimately selected the PPMC at Wichita State University, according to a city staff memo to the commission.

The study included a review of the current EMS system and agreement, as well as various other considerations. Those included a review of the legal responsibilities under Kansas law, best practices for managing and funding EMS, and the development of a new funding methodology and master agreement for the provision of EMS services.

The current agreement covers how EMS is provided and funded within unincorporated Douglas County and the cities of Lawrence, Baldwin, Eudora and Lecompton, according to the memo. The review found that how the department was funded seems to have been arrived at in a somewhat arbitrary manner.

The memo states that it appears the agreement that the city would pay about 75% and the county about 25% was not based on the cost of service, but rather on how much each local government had been paying for the service at the time of the consolidation. The agreement also does not address the costs of providing overhead services such as human resources, legal, risk management, facility maintenance or IT support.

Apart from the expenses of the consolidated department, the agreement has other funding elements, according to the report from the PPMC. That includes that Douglas County pays for 100% of the station staff at the Eudora station, the coroner scene investigation, new ambulances, and 100% of EMS-only expenses, such as personnel, supplies and contractual expenses. Douglas County then receives 100% of the medical billing.

The report states that while both the city and county have “made this funding formula work,” both local governments noted several challenges with the formula being based on historic funding of separate departments from 25 years ago, instead of the actual costs of a merged department today. The report states in part that the new funding formula should be based on service delivery data, incorporate logic that is easy to understand, and consider equity among jurisdictions.

During a recent joint meeting of the city and county commissions, City Manager Craig Owens and County Administrator Sarah Plinsky said they have been going over the approximately 25 active agreements between the two governments, and said they would soon be ready to start bringing forward some of those agreements for review. The EMS agreement will be the first such agreement, and after the report is presented to the City Commission, it will be presented to the County Commission on Wednesday. As part of the meeting Tuesday, the City Commission will provide recommendations based on the report and request a final draft of the agreement to be completed.

The City Commission will convene virtually for its regular meeting at 5:45 p.m. Tuesday with limited staff in place at City Hall, 6 E. Sixth St. The city has asked that residents participate in the meeting virtually if they are able to do so. A link to register for the Zoom meeting and directions to submit written public comment are included in the agenda that is available on the city’s website, lawrenceks.org.