Ambulance costs soar for gov'ts

BERLIN TWP. — Officials overseeing rural areas in Erie County face significant and seemingly unsustainable cost increases to continue providing ambulance services for locals. Those expense estimates, coming from North Central EMS through Fisher-Titus, range anywhere from four times to eight times compared to what these cash-strapped governments contribute today. Right now, just in Erie County, North Central EMS provides ambulance services to: • Berlin Heights and Berlin Township; Berlin Township trustees cover the costs for these communities. • Milan and Milan Township; Milan Township trustees cover the costs for these communities. • Oxford Township, however, its contract with North Central EMS will expire on Dec. 31; Oxford Township trustees recently pursued a new option for ambulance services and expressed no desire to renew with North Central EMS. Leaders for the townships of Berlin and Milan recently informed their constituents of what steps they've taken and will take to address this issue. Why is this happening? This past summer, leaders of Fisher-Titus — which oversees North Central EMS, providing ambulance services to many rural communities, including in Oxford Township — noted the hospital can no longer sustain growing financial losses. North Central EMS has financially struggled for years, according to a letter sent out to government officials by Fisher-Titus. In 2018, the service posted a $2 million operating loss. Since then, leaders said they've taken steps to "rightsize" operations, reduce coverage areas and renegotiate subsidies from local governments. These measures cut annual losses significantly, down to $819,000 in 2024, but the system still operates at a deficit every year. "The financial reality is that EMS costs are outpacing the funding available from subsidies," Fisher-Titus stated in its outreach to local officials. "This model cannot continue without jeopardizing the stability of both EMS and other health care services." Fisher-Titus wanted township trustees and other local government officials involved with North Central EMS to decide whether forming a joint ambulance district could work. This, however, would require a levy for new money, resulting in people living in areas serviced by North Central EMS to pay more in property taxes. It's not known what a long-term solution for everyone involved might be. Individual jurisdictions, meanwhile, could branch out on their own and pursue different avenues. Most notably, Oxford Township pursued a partnership with Perkins fire to provide ambulance services. Pursuing a new option? Those representing the townships of Berlin and Milan, in short, don't know exactly what they're doing going forward. They all, however, stressed the importance of providing reliable ambulance services to community members but in a cost-effective manner. Here's how each government body responded to this developing situation: Berlin Township trustees with Mike Old responding: We have been working very hard to find the best solution to the North Central EMS ambulance situation here in Berlin Township. Back in August, we were notified of the problems North Central is dealing with. We realize that their financial issues cannot be sustained and appreciate the financial help that Fisher-Titus has provided on behalf of our citizens. I believe we are in Year 2 of a five-year contract and have just been notified that we will have to renegotiate the current contract at an estimated increase of over five times the yearly amount that we currently pay for services. This is a very complicated process to learn the ins and outs of how an ambulance service works as well as learn what other options are available. There are some issues that come with running an ambulance service in rural areas. Response times and how billing money is collected are challenging. A special thanks to the Erie County Township Association who has put together a number of meetings to research the problem, look for possible solutions and to explore the best options for our local townships moving forward. We have gathered a lot of information and are still working toward the best solution. At this point, we don't have a lot of specific cost numbers to work with. First we have to see what options are out there and would those options have any interest in expanding their operations to include Berlin Township. We have reached out to explore some of these possibilities. They also have to consider how to get the right finances as well as maintain the proper level of service to their people before taking on additional business. Everything indicates that all options will come with a significant increase in cost. The biggest impact we have had in the township at this point is planning for the future. We have started the process to purchase a new fire truck. We are looking at over a $1 million investment as well as a multiple-year wait time. We likely will have to put this on hold until we get the ambulance situation figured out. Our fire station is almost 25 years old and will need a new roof as well as other building improvements sometime in the next few years. We have been putting money aside to pay for these projects. Small townships don't have a large budget to work with, and we have to find the best path that works for us. As we move forward in this process, we are very concerned with how this will impact our citizens financially. Keep in mind that we recently have all seen a big increase in property taxes. We don't want to speculate on things until we have some more solid cost numbers to work with. We are fortunate to have some good people around Erie County helping all of our townships work through this challenge. We will continue to look at any option available and try to figure out what is the best move for Berlin Township. Editor's note: Berlin Township is scheduled to spend $33,800 in ambulance services in 2026, a 3% increase from 2025. But North Central EMS, through Fisher-Titus, indicated the cost could increase by 437%, equating to about $181,500 a year. Milan Township trustees with Greg Cumston responding: Many Erie County political subdivisions have been meeting multiple times a month to discuss options for emergency medical services. Representatives from Milan Township have actively engaged in all of these meetings. We have heard presentations from Fisher-Titus and North Central EMS representatives as well as a presentation from Firelands Ambulance Service. We have also reached out to and received valuable information from surrounding full-time departments. Milan Township agreed with the other Erie County subdivisions that we are not interested in creating an EMS district with the current subdivisions serviced by North Central EMS. The Milan Township board of trustees is diligently processing all of the information presented, including the possibility of having our current five-year contract broken by the provider and possible rate increases of 396% to 792% for emergency medical service for Milan Township residents. While no decision has been made, we will continue to work with surrounding subdivisions to ensure our residents are adequately protected. Editor's note: Milan Township is scheduled to spend about $47,400 in ambulance services in 2026, a 3% increase from 2025. But North Central EMS, through Fisher-Titus, indicated the cost could increase by as much as 396%, equating to about $235,000.