Letter to the Editor: As a pediatrician in our community and the President of the Medical Staff at McDonough District Hospital (MDH), I want to provide important context regarding the current situation with Lifeguard Ambulance Service and emergency medical services (EMS) in McDonough County.
First, it is important to recognize that Lifeguard Ambulance Service provides high-quality care to our community. This discussion is not about the quality of care being delivered, it is about how that care is sustainably funded.
For decades, MDH has stepped in to ensure ambulance service for our community, first by directly operating the service after becoming one of the first hospitals in Illinois to do so in 1970, and more recently by financially supporting Lifeguard. While this reflects a long-standing commitment to our community, it is not how EMS is typically structured and is no longer sustainable in today’s healthcare environment.
For many years, MDH has provided significant financial support to help sustain the local ambulance service. This support was never a legal obligation of the hospital, but rather a voluntary commitment to help ensure that our community had access to timely emergency care. Unfortunately, like many rural hospitals across Illinois, MDH now faces increasing financial pressures and can no longer continue subsidizing ambulance operations at the level required to sustain the current model.
Illinois law recognizes ambulance service as an essential public service. It gives counties the authority to provide EMS, contract with providers, and levy taxes to support these services. While the law does not mandate that counties operate ambulance services directly, it clearly places responsibility for ensuring EMS availability within the county sphere, not on hospitals.
Historically, McDonough County acknowledged this need and, in 1970, committed to ensuring ambulance service for residents, with MDH operating the service on the county’s behalf. At that time, the county also committed to providing ambulances to the hospital on a regular basis, presumably to reduce the hospital’s costs. To my knowledge, MDH did not receive ambulances from the county and instead has borne the financial responsibility for ambulance service.
In surrounding counties, ambulance service is supported through a combination of county systems, fire departments, or publicly funded models, and NOT through the local hospital. While the structure varies, the consistent theme is that EMS is treated as a public responsibility with local government involvement and financial support. Reliance on a hospital to serve as the primary financial backstop is not the typical model and is increasingly unsustainable.
Emergency medical services are essential everywhere. Ensuring they remain available and well-funded will require a shared, long-term commitment to our community’s health and safety.
Mary Kathleen Lockard, MD Medical Group of Macomb, LLC President of the Medical Staff of McDonough District Hospital
