State auditor’s report shows minor deficiencies in Lee County Ambulance financial reporting
BY CHUCK VANDENBERG
FORT MADISON – City officials will consider a move Tuesday that could provide facilities for a future potential ambulance service.
With Lee County EMS Ambulance operating on a week-to-week basis under heavy financial pressure, Fort Madison and Keokuk Fire Departments are scrambling to submit a proposal to county officials to provide services in the county, as an option to losing the service.
At Tuesday’s Fort Madison City Council meeting council members will vote on a first reading of an ordinance to rezone property owned by Bobby and Jessica Holtkamp at 2324 Avenue J, and city owned property at 2332 Avenue J, from residential to B-4 Highway Business District.
The move is an effort to identify a temporary location to house ambulance services and staff for the city.
According to a report prepared for the council by City Building Director Doug Krogmeier, ambulance employees would be housed in a single-story home owned by the Holtkamps at 2324 Avenue J. Bobby Holtkamp has indicated he wants to build a large garage/warehouse behind the home that could house the fire department and ambulance equipment. The warehouse is being planned large enough to temporarily house the fire department’s rescue boat and hazmat equipment as well.
The report also indicates that the city eventually wants to build a new fire station and that construction could include space for any ambulance services, should that come to fruition. If and when that would happen, Holtkamp would use the warehouse for his Holtkamp’s Floors, Decor & Furniture business.
Fort Madison Fire Chief Joey Herren said right now this is all just leg work in the event that the city’s take over the ambulance service. He, and Keokuk Fire Chief Gabe Rose, are working on a proposal that would provide advanced services to the county. The two cities would each cover half the county, including their respective cities.
“They have hospital to hospital transfers that would be involved so we would have to have advanced services,” Herren said.
The city would pay a monthly rent or lease to Holtkamp for the space until a new fire station could be constructed.
The city parking lot at 2332 Avenue J is already considered commercial property in the city’s comprehensive plan, so the rezoning of the both properties would be compliant with that plan.
“The fire chief’s plan to use this building for ambulance service should be temporary, because a new station is needed,” the report indicated.
“In view of this, while working with Bobby Holtkamp, who would prefer to build a larger warehouse than just what is needed for the ambulance, staff determined that the more appropriate request would be to rezone the property.”
County supervisors are still accepting proposals for a county ambulance service contract that would begin July 1. The board currently has accepted two proposals – one from Lee County Ambulance, and another from an undisclosed provider. City officials from Keokuk and Fort Madison are looking at the possibility of providing the service under their licenses.
The upcoming county budget includes $500,000 in supplemental funding for Lee County Ambulance for the 2020-21 contract, but ownership there has indicated they wouldn’t be signing that contract renewal, but instead submitted a new proposal. The details of that proposal have not been released.
Lee County Supervisor Gary Folluo told supervisors at a recent meeting, that the county may be looking at needing to double that number per his conversations with Lee County Ambulance officials.
The ambulance service had several issues pointed out in Lee County’s State Auditor’s report issued on April 10 for the 2018-2019 fiscal year.
Among those issues was a deficiency in segregation of duties and deficiencies in financial reporting.
According to the auditor’s report LCEMS’ “financial reporting did not include patient billing receivable of $327,377, accounts payable of $17,430 and an additional $35,277 of salaries payable at December 31, 2018. A listing of accounts payable of $17,430 and salaries of $35,277 were not prepared at December 31, 2017.”
The report indicated that adjustments were made to properly record those amounts at a later date.
The report also showed Lee County Ambulance had not reconciled billings, collections and delinquent accounts in a test month causing an error of $66,143 in reported billings for December 2018. The service reported billings of $327,377 compared to the auditor’s calculated receivable balance of $261,234.
Other issues pointed out in the State Auditor’s report included Lee County Ambulance not having formal credit card policies for staff, no formal policy for capitalized assets, and other deficiencies in internal controls.