EMS service slightly behind budget

Turnaround

Even before I got on this board, I was hearing horror stories about Lee County EMS. You have done a 180-degree turnaround. That’s a reflection of leadership, staffing, and support. It’s a different culture and that’s a good thing.”

Tom Schulz, Lee County Supervisor

LEE COUNTY – A report from Lee County EMS director Mark Long shows that calls are down slightly for the year with numbers reported through Sept. 30.
Long gave an update to Lee County Supervisors at Monday’s regular meeting and said the county ambulance service will be looking at close to 5,000 calls for service in 2023.
But Long said he does have a few minor concerns around payroll.
“We’ve had a few incidents with part-time staff. Some have retired and we’re having to use full-time employees to cover those spots, so that’s hurting us a little,” Long said.
“And our maintenance costs are up. We’ve had to replace three ambulance engines, two this year.”
He said the Ford engines are having trouble with lifters and one of the ambulances was under warranty, but it took six months to get the engine replaced. The two others were done in-house and took a week.
“That’s a double-edged sword,” said Jason Dinwiddie, the ambulance department’s second in command. “When it takes that long to get them back.”
Long said the department is 25% of the way through the fiscal year, but is at 28% of budget with regard to expenses. He said the department is just at 19% of projected revenue with 25% of the year complete.
He said there are about 65 accounts that have yet to be billed and that’s due to the service’s billing company providing documentation to Iowa Department of Health and Human Services for additional reimbursement under the Ground Emergency Medical Transport program.
That program provides additional funding to publicly-run ambulance services based on Medicaid calls.
The Ground Emergency Medical Transportation (GEMT) Program is a voluntary program that allows publicly-owned or operated emergency ground ambulance transportation providers to receive supplemental payments that cover the difference between a provider’s actual costs per GEMT transport and the Medicaid base payment, mileage, and other sources of reimbursement.
Providers receive cost-based, supplemental payments on a prospective basis for emergency ground ambulance transportation of Medicaid Fee-for-Service (FFS) and Medicaid managed care (MCO) members under Title XIX of the federal Social Security Act (SSA) and the Affordable Care Act (ACA) only.
“There are about 60 accounts that are waiting on that billing to come in,” Long said. “So I think we’ll turn that around sooner than later.”
He thanked the citizens of Lee County for approving the .75/$1,000 EMS levy that has helped keep the service functioning.
Long also said the ambulance service has helped in eight counties that border Lee County with mutual aid calls, however he said Lee County has only requested mutual aid one time all year.
Supervisor Matt Pflug asked what impact will be seen when and if Insight opens a rural emergency hospital in Keokuk.
Long said he believes the call count won’t be affected that much because the hospital will be a trauma hospital where patients are stabilized and then transported out.
“They’re going to transport those patients out pretty quickly so we’re still going to see a lot of calls,” Long said. “Our Keokuk ambulance calls will be quicker because we can take them to that facility, but we’ll be called back to transport them. They won’t have their own ambulances like the Fort Madison facility has.”
Supervisor Tom Schulz said the service has done a complete turnaround since they took over in 2021.
“Even before I got on this board, I was hearing horror stories about Lee County EMS. You have done a 180-degree turnaround. That’s a reflection of leadership, staffing, and support. It’s a different culture and that’s a good thing.”
Long said a lot of the credit goes to the staff for hanging in there while change took place.
“These aren’t the best living conditions for the staff, but they know things are happening and they’ve stepped up and done a great job."
Long said the majority of comments he's hearing are around the new Tahoe that supervisors are driving around in.
"People are questioning that vehicle because it can't transport," Long said. "But I tell them it is fully equipped with medical equipment and it allows us to react quicker."
Supervisor Chairman Garry Seyb said the idea isn't new to Lee County.
"This is a service model that's being used around the country and it works," Seyb said. "I've gotten calls on this, too, and people need to understand that it makes us a better service and gives supervisors flexibility to react to major traumas and still keep ambulances in service."