The state last month gave the City of Warren a path to potentially no longer respond to emergency medical service calls outside of the city.

What the city’s next move is, though, is not yet clear.

Two letters were sent to municipal officials back in May — one from City Manager Nancy Freenock and another drafted by legal counsel — that would petition the state to no longer require the city to respond with its ambulance outside the city.

The response from the state Bureau of EMS was issued to legal counsel. It was provided to the Times Observer by the Department of Health.

At issue, fundamentally, is the increase in ambulance calls the city has fielded as a result of volunteers in the surrounding municipalities being unable to provide 24/7 coverage.

Council last month went into executive session and returned to take action on two items – both contracts with a law firm related to EMS issues. However, changes to the state’s opening meetings law – the Sunshine Act – require, among other things, not acting on items not on the agenda that spend money.

So council attempted to re-approve the items during Monday’s meeting.

The first action – hiring counsel to address an emergency medical services (EMS) personnel matter – was approved.

The second item would have hired that same law firm to draft a letter to the municipalities as a cover letter to a response received from the state on the city’s request to no longer respond outside the city limits.

The prior action would have allocated up to $2,500 to craft that letter.

On Monday, City Manager Nancy Freenock asked that the limit be raised. Councilman John Wortman, who made the motions, said he was concerned about writing a black check to which Mayor Maurice Cashman responded that not doing so would slow down the process.

Cashman explained that the $2,500 was to send the letter to the municipalities with the state’s letter.

The bureau, in its response, concluded that it isn’t the appropriate entity to field such a request, deferring to the plan administrator for the county’s collaborative EMS response plan that was approved in 2016.

“(T)he City of Warren, by voluntarily participating in the Warren County Collaborative EMS Response Plan, hereafter referred to as ‘the plan,’ took on additional responsibilities pertaining to EMS responses within the County of Warren outside of the city limits.”

The state acknowledges that the “demand for EMS” has increased “and the operational paradigm in Warren County has changed” but assert that “those factors alone do not relieve the City of Warren of carrying out responsibilities that it previously agreed to.”

They assert that “the City of Warren’s participation in the plan created an expectation of an available licensed service to other municipalities within Warren County.”

“The Bureau,” the letter concludes, “continues to hope for a local solution amongst the relevant community partners to ensure the health and safety of all residents of Warren County.

“(T)he City of Warren has a path to its request without formal regulatory relief from the Department.”

“They already have the (state’s) letter,” Cashman said on Monday of the county’s other municipalities. “Maybe we should table this and ask what the next step is going to be and what it’s going to cost.”

Wortman stressed the importance of the city’s obligation to respond to the state’s letter.

“We’re going to be opening negotiations,” Councilman Gregory Fraser said. “What’s that going to cost?”

He suggested council should get more information before proofreading.

“Right now we have a changed circumstance,” he said, explaining that the city needs more information from counsel “to say ‘This is the direction we think we should go'” and what it might cost.

He moved to table action on the motion.

Discussion then shifted to the broader challenge of finding solutions to EMS challenges.

“I don’t think the $2,500 is going to do it this time around,” Cashman said apparently of finding a long-term solution on the EMS question.“This is a long term deal…. (You) gotta trust your manager to manage this” with an “overview given to council from time to time.”

“Negotiations (with multiple municipalities) are not going to happen within a month,” Fraser said. “(It is) going to take quite a bit of time, a year or more before we get any kind of conclusions to negotiations.”

Cashman said the next step would be determining “where you’re going to go and what you want to (see) be accomplished. That’s a longer discussion. Council has to be involved in that discussion. (It is) going to be very complicated going down this road.”

What exactly is the road Cashman discussed?

“That’s what we have to define,” he told the Times Observer after the meeting.

Fraser said council may wish to have the law firm develop “what our opening negotiations position is. There’s a lot of options is what I’m saying. I think we need more information from the law firm (on) what they think the most prudent next step is. Then we decide how we want to move forward.”

The motion to table passed 6-1.