Kingston has ridden a 10-year wave of upward economic momentum that not even COVID could stop. One could be forgiven for assuming these halcyon days would continue forever. But the city’s rise may now be hitting some rough waters as illustrated by the newly proposed 2025 budget increases. The new City of Kingston 2025 budget comes with an 8.9 percent increase in the property tax levy — a huge increase in comparison to prior years. Given the size of the increase, on top of other recent actions by city government such as those against property owners and project labor agreements, Kingston isn’t exactly ringing “open for business.”

Given the biggest source of what’s driving budget and tax increases — emergency medical services — it’s likely we are in for more increases in the years to come unless cost-effective solutions are found. Buckle up as the city transitions from merely encouraging healthy lifestyles into entering the healthcare business.

Under Mayor Noble’s administration, Kingston has been awarded an extraordinary number and dollar amount in grants for a range of projects. Many are representative of the mayor’s focus on the environment and healthy living. These goals are sometimes promoted as longer-term investments in our community’s health — encouraging the eating of kale and riding bikes as opposed to ice cream and video games will naturally lead to healthier outcomes. Examples of investments include adding more bike lanes, parks, “complete streets,” food and exercise programs, and a renovated Dietz Stadium, where many Kingstonians get their exercise. These are all intended to inspire healthier choices and provide environmentally friendlier conditions for Kingston residents. But even these healthy lifestyle investments, including the city’s new urban forest ranger, can’t hold back what’s happening in the emergency care industry.

Hollywood legend Bette Davis poetically said “old age ain't no place for sissies.” If by “sissies” we mean those faint of heart and delicate in physique, from my experience so far, I agree — getting old can be rough. And if you are older and live in Kingston, Ulster and the Hudson Valley, you’re in growing company as research from groups like Pattern for Progress show our region is continuing to “grey out.” As we get older, our healthcare needs increase. Even the healthiest amongst us may need to call upon emergency medical services and engage with our healthcare system.

Many of our local municipalities are facing a two-fold challenge that is going to require someone — I’m talking to you, local taxpayer — to suck up the costs to solve this crisis. Between the rising costs in EMS-related care and falling volunteerism rates for such services, we are at a crossroads. This is a challenge being faced by towns across the nation, but in New York State and Kingston, the higher proportion of older citizens adds additional pressure to the challenge.

At the beginning of 2024, Kingston changed over to how emergency medical services are provided within the city. Because of rising costs from the private company that had been providing services, Kingston changed to an entirely city government-run system through the Kingston Fire Department. Today, the KFD is now responsible for ambulance services within city’s borders. Early this year the mayor reassured the public that there would be little if any impact on taxpayers because a to-be-selected insurance billing provider would help to offset the costs, and the KFD would handle any overtime and staffing needs. But now the real cost of the change is starting to become clearer.

Based on the city budget proposed last week, the mayor now says that of the 8.9 percent increase representing $1,586,288 in new tax revenue, almost $900,000 of it will be for funding city-operated EMS services. That figure roughly aligns (on the high side) with what the private contractor had originally proposed for a dedicated city ambulatory service — $1 million. But we can assume this coming year’s budget still does not fully represent the full costs that will be associated with the switchover, including staffing, overtime, new equipment, vehicles and facilities. None of this includes the huge costs coming down the road for helping the Kingston Fire Department also take care of the many other services it provides with its currently outdated facilities.

In November, the Common Council is set to vote on spending $1.25 million on a 13,000-square-foot building at 18-30 East O’Reilly Street to serve as a new Central Fire Station. We have been given no idea what the cost will be to develop the property for use as the KFD envisions, nor do we have any idea how much it will cost to renovate the KFD’s 115-year-old main building. We are most likely talking many millions of dollars, paid for possibly through a combination of funding sources. But long term, there will be an increase in operating costs, paid for by city taxpayers. We can fully expect these projects to be expensive, especially if the city approves a current Project Labor Agreements proposal that’ll result in more union members working building contracts.

As mentioned earlier, Kingston is not alone in having to address the growing challenges of ensuring responsive emergency medical services. Because of dwindling volunteers and increasing response times to emergencies, the Town of Hurley is currently considering setting up its own townwide ambulance district for approximately $450,000 per year, not including initial setup costs for equipment, vehicles, etc. Other towns are looking at doing the same. With all these towns following similar paths, it begs the question: Can any of this be coordinated at a wider level, such as the county, to find synergies and cost efficiencies?

While there is talk of establishing shared-service agreements between towns, it’s unclear if the county wants to facilitate or even engage in this growing health and economic problem. Perhaps this is something the new county health commissioner, Eve Walter, can take a look at. I understand she has expertise in healthcare administration, and her last job included working at a company whose mission is to improve personal, community, and public health through innovative collaboration. This might be a useful skillset needed at a time of growing local healthcare crises. As they say, timing is everything.