Ambulance district lacking funds

Article first ran on June 5, 2018

Disturbing news arose from the special called Fiscal Court caucus meeting on Tuesday, May 29, as representatives of the Ambulance District Board, Dale Beighle and Gina Adams, and Ambulance Director Phillip Hart were present to report that the ambulance district did not have the necessary funds to make their June bond payment of $50,000 for the new headquarters and keep the district in the black. They were requesting that the Fiscal Court use LGEA funds to help them make the payment.
    The district has a $1.5 million budget for 2017-18  and $800,000 goes to payroll. According to Hart, the cost to staff two ambulances 24 hours a day, 7 days a week for 365 days is $705,000. That covers a total of 24 staff members. According to Hart, that is twelve full time employees who receive benefits as well as wages and twelve part time employees who do not receive benefits.
    Expenses have increased as the run totals have increased at a substantial rate. They have experienced 300-400 more runs in 2017 over 2016 as more runs are being called to dispatch. They are required to respond to a call whether an ambulance is truly needed or not.
    In addition, collection of fees not reimbursed by insurance is in question. While figures presently were not available at the meeting, Hart did indicated that several years ago, they collected at a rate of only 60 percent and presently do not “hard bill” the patients but rather a third party tries to collect.
    Medicaid and Medicare patients are also a problem. No matter the cost of the run, Medicaid and Medicare as a rule only reimburse 20-25 percent of the cost of a run. As a result, many of the runs for patients using these federal government plans created a financial deficit for ambulance districts.
    Hart indicated there were 42 times Air Evac was used  in 2017 with an average reimbursement cost of $224.
    He also indicated that their rates for ambulance runs are very similar to those charges of other neighboring agencies.
    Magistrate Gary Veirs pointed out that the LGEA is “an excellent resource for funds but it is an unpredictable income and should not be relied on to cover a fixed expense.” Continued discussion revealed that last year, the Fiscal Court did not receive LGEA funds.
    Beighle pointed out that government regulations from higher up is making it more costly. Each comes with an unfunded mandate and two or three could add $20,000-30,000 to a cost of a new ambulance. And with one ambulance having over 200,000 miles and the other approaching that mark, they will very soon be in need of a new ambulance.
    Veirs agreed, “Unfunded mandates are breaking local government’s backs.”
    Adams pointed out that with the drug issue and use of NARCAN is having unattended financial effects on the budget. “Most times NARCAN is used, there is nothing back on the cost from anyone,” she said.
    Beighle pointed out that the district will have to use billing revenue to meet payroll until November, but the June payment is what they do not have the funds to cover.
    Magistrate Rick Mineer encouraged the study of collection of billable fees.
    “If the collection rate is 60 percent and we can get that to 80 percent, it may solve the funding issue. If not, either those who use the services are going to have to pay more or you have to raise taxes.”
    Hart pointed out that in the budget, “Half of the revenue is from taxes and half of the revenue is from those using it.”
    The district had to dip into their reserves in 2015-16 to the tune of $400,000 for unexpected expenses. It was good that they had the funds at that time to handle an overrun but it has not helped the budget since then.
    Since the meeting was a caucus meeting, no action could be taken. Judge David Fields will continue to look at the issue and the Fiscal Court would revisit the issue at the June 12 regular scheduled meeting. Each member of the Fiscal Court agreed that ambulance services have to be provided to the county.
    In other action, Pendleton County Animal Control Officer John Bloomfield was present to ask the court to consider moving their second employee to a full time status. Presently, her limited hours as a part time basis is leaving the department in staffing constraint situation with the increase activity and calls that the department is receiving.
    Earlier in the evening, the Fiscal Court held a special called meeting to address two issues. With Cincinnati Bell dropping 911 services to all districts, Emergency Management Director Mike Moore had been working with NKY counties as well as Gallatin County and the NKY Airport to seek out a solution to their problems. Indigital has stepped up to provide the services.
    The one-time cost for equipment would be $83,393 with a monthly cost of $1,022. But, Pendleton would hopefully be a recipient of a KY 911 Board grant of $79,223 which would leave the county with only a $4,169 portion of the one-time costs.
    In addition, Indigital would be providing a MEVO at no cost which is generally an $85 per month costs and Network costs would be waived which is generally a $950 per month costs.
    The board approved entering into the contract with Indigital.
    The board also approved an Memo of Agreement with KEM for Michele Hamilton’s salary.
    The meeting was adjourned.