County may provide more ambulance funds


LEE COUNTY – Despite some released funds on an IRS lien, Lee County Supervisors may look at providing more funding to Lee County Emergency Medical Services this week.

According to Lee County Supervisor Gary Folluo, the countywide ambulance service provider had about $18,000 released by the IRS on Monday against a lien, but $8,000 of it went to taxes and liability insurance, leaving about $10,000 to cover existing payroll.

On Friday supervisors funneled close to $36,000 to help cover payroll expenses in March.

Lee County Attorney Ross Braden said the county’s assistance to the ambulance service is discretionary according to a contract between the two entities.

“Upon the request of the EMS service and the condition and precedent that they’re operating at loss, which we did verify, they can come to the county and ask for help, but it is discretionary,” Braden said Tuesday morning.

The parties involved including the mayors from Fort Madison and Keokuk, their respective fire chiefs, county officials, Lee County Ambulance representatives and others have had three conference calls since Friday to look at options of keeping ambulance service viable in the county.

Friday was a call to approve the supplemental funding assistance, and Saturday’s call focused on what the options for providing ambulance services in the future looked like.

Monday’s call, according to the Folluo, was focused on funding going forward and what progress is being made at the state and federal level to uncover more funding options.

“The agent for the state with the IRS released the lien and some money did start coming into the ambulance service. However, there was $18,000 that came in and $4,000 went out to taxes and another $4,000 went out to the liability insurance,” Folluo said.

He said the county should expect another report on Wednesday as to revenues that have come in. He said it’s everyone’s hope that the service can get closer to having enough money for the next round of payroll.

Folluo said in the event the service didn’t have enough money, supervisors may have to get together again this week.

“We may have to have another meeting like we did last week, if there is another gap with their payroll,” he said.

On Saturday, Fort Madison Mayor Matt Mohrfeld said he wasn’t optimistic that the ambulance service would sign another contract with the county, so talks centered on determining what a future ambulance service might look like.

Supervisor Matt Pflug asked Folluo, who’s been on all the conference calls, if the Lee County EMS has given any indication as to whether it will enter into another contract with the county.

“As of right now, I don’t believe so,” Folluo said.

Folluo said there has been one private entity with a ground ambulance license that has shown some interest in providing services, and more investigation on that will take place.

He said the county was also looking for input from citizens and interested parties on cost-savings measures and other options for the continued service.

“I want to put out there that if you have information or would like to discuss things with the supervisors regarding the ambulance service you can reach me at 319-795-1348,” Folluo said.

In Iowa, ambulance services are not considered essential services and therefore are not publicly funded. However, a bill was to be presented in this year’s legislative session, but it was scheduled on the day the legislature was sent home due to the coronavirus outbreak and no movement has been made with the proposal.

Bill Young, the director of Lee County EMS has said the reimbursement rates from Medicaid and Medicare are putting the company in a bind because of the high number of Medicaid recipients in Lee County. He told supervisors in January, that the company wrote off more than a half a million in Medicaid services alone in 2019.

Board Chair Ron Fedler said the county saw some of this coming, but not to this extent.

“We saw some of this coming earlier this year, but we didn’t realize it would be this kind of financial trouble,” he said.

“We’re all doing a good job trying to solve this situation and I think Gary and the rest of the board will be doing whatever we can. There are options out there to keep it private or go non-profit.”

The county budgeted an additional $50,000 in the 2020-21 fiscal year budget to help the service offset some of its losses, but the company is now facing critical shortfalls.

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