Prop EMS Would Fund Hawk Point-Area Base, New Ambulances and Lifesaving Equipment With No Tax Rate Increase
LINCOLN COUNTY, Mo. — A new ambulance base near Hawk Point, an eighth ambulance and replacement of aging lifesaving equipment are at the center of Proposition EMS, a $20 million bond proposal facing Lincoln County voters Tuesday.
Lincoln County Ambulance District Chief Administrator Ray Antonacci sat down with Lincoln CountyWatch on Sunday, Nov. 2, to explain what the proposal would fund, how the district plans to issue the bonds and why a vote against the proposition would not eliminate the existing tax rate.
“One of the hardest places to get to in this district is the Hawk Point area out west where 47 turns south,” Antonacci said.
If approved, Proposition EMS would allow the district to purchase property and construct Base 7 near Hawk Point or elsewhere in western Lincoln County. The district’s goal would be to position the base where crews could reach more residents in that area within five to 10 minutes.
The new base would also bring an eighth ambulance into the district.
Proposition EMS would authorize the district to issue as much as $20 million in general obligation bonds, but Antonacci said the district would not borrow the full amount at once.
The first bond issuance would likely be between $7.5 million and $8 million. Additional bonds would be sold later as existing debt is paid down and property assessments create enough room to borrow without increasing the district’s current debt-service tax rate.
“We are only going to sell enough bonds that will keep your repayment in the eight-cent area,” Antonacci said.
The current rate is approximately eight cents per $100 of assessed valuation. Because residential property in Missouri is assessed at 19% of market value, the annual cost on a home valued at $200,000 is approximately $30.40.
That rate is already being collected to repay the $11.5 million bond issue approved by voters in 2020. Antonacci stressed that voting against Proposition EMS would not remove it.
“A no vote will not get rid of the eight cents per $100,” Antonacci said.
The existing bonds are expected to remain in repayment for approximately another 15 years. If Proposition EMS passes, each new bond issuance would begin its own 20-year repayment period. The district intends to control the timing and size of those issuances to keep the rate near its current level.
Voter approval would allow the district to borrow the money through municipal bonds. It would not provide the district with an immediate $20 million payment.
The money could only be spent on long-term capital needs, including property, buildings, ambulances, medical equipment, communications systems and safety gear. It could not be used for employee salaries, benefits or routine disposable supplies.
“These capital bonds that we issue do not go toward salaries or benefits,” Antonacci said.
The official ballot language authorizes the money for district facilities, land, ambulances, other vehicles and medical, communications and lifesaving equipment.
A major part of the district’s 10-year plan is replacing one ambulance each year.
New ambulances now cost approximately $400,000. In some cases, the district can save about $75,000 by moving an existing ambulance box onto a new chassis, but that process can only be repeated a limited number of times before changes in technology and construction require a complete replacement.
Antonacci said ambulances can accumulate between 150,000 and 200,000 miles within about four years. Transmission failures around that mileage can cost between $13,000 and $15,000 to repair.
The district would also replace cardiac monitors and defibrillators purchased in 2016. Those units originally cost approximately $30,000 each. Their replacements now cost about $60,000 each.
As the monitors age, warranties expire and replacement parts become harder to obtain. Antonacci said the district will eventually have to replace them regardless of the election’s outcome.
The 2020 bonds funded new ambulances, equipment and two additional bases.
The first new location was constructed in Moscow Mills, where increasing call volume had created a growing need for coverage in southern Lincoln County. Antonacci said the base has reduced response times along Highway 61, Highway C and surrounding subdivisions.
A second location, Base 6, is now under construction near highways 47 and W in the Winfield area. It is expected to open in March 2027.
That project was delayed while the district and the Missouri Department of Transportation worked through concerns about placing two driveways along Highway 47. The design was ultimately changed to use one larger driveway.
Antonacci said the ambulance and crew assigned to Base 6 are already available and will move into the building when construction is complete.
Proposition EMS would continue that expansion by adding Base 7 toward Hawk Point. Bond money could pay for the property, building and ambulance, while the salaries of the additional paramedics would come from the district’s operating revenue.
The district currently operates seven ambulances and requires at least six to remain staffed. If staffing drops below that minimum, employees can be ordered to remain at work or report for mandatory overtime.
In addition to the new base and ambulances, the proposal would fund improvements at existing locations. Antonacci said the Elsberry and Winfield bases need renovations, while aging driveways and other infrastructure also require repairs.
The district receives operating revenue through sales taxes, property taxes and ambulance billing. Antonacci said those sources cover daily operations, employee compensation and benefits but leave little room for multimillion-dollar bases, $400,000 ambulances and other major purchases.
Patient billing does not recover the full cost of every response.
Antonacci estimated that the district transports approximately half of the patients its crews evaluate. The district can bill for those transports, but Medicare and Medicaid may reimburse about $350 on a bill approaching $1,000.
Crews still provide medical assessments, medication and other care to patients who are not transported, but the district generally cannot bill for those encounters.
“If you’re in dire need of an ambulance, I don’t want you to be afraid of a bill when you call,” Antonacci said.
A “yes” vote authorizes the ambulance district to issue up to $20 million in additional bonds for the proposed capital plan.
A “no” vote denies that new borrowing authority but does not eliminate the existing eight-cent debt-service rate or end repayment of the 2020 bonds.
“I can’t tell you how to vote in my position as chief,” Antonacci said. “I can just tell you what the facts are.”
Proposition EMS will appear on ballots for registered voters residing within the Lincoln County Ambulance District on Tuesday, Nov. 3. Official election information and sample ballots are available through the Lincoln County Clerk.
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Sources: Lincoln CountyWatch interview with Lincoln County Ambulance District Chief Administrator Ray Antonacci, Lincoln County Ambulance District, official election notice and Lincoln County Clerk election information.
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