Ambulance service debates leave us saying – “WHAAAT?!”

If you haven’t been paying attention to the recent scramble for the county to find an ambulance provider, you’re missing out.

We’re all suffering from cabin fever, and this is better than anything Netflix can offer. It’s better than working up a new brownie recipe or redoing your bathroom.

And… it’s an imperative, emotional issue that has the ability to impact every single life in Lee County.

So for those of you binge watching Ozark, or whatever, here it is in a nutshell. We’ll try to be brief.

Lee County EMS is in financial trouble and they wanna double what they had last year in a subsidy from the county. The county says WHAAT?? we don’t have that kind of money, let’s see if Fort Madison and Keokuk can help.

The cities jump in and feverishly race around trying to see what a shared program looks like, in the meantime, some committee has evolved that offered up the service to anyone as long as they can get a proposal in by April 30.

In comes ambulance super-power American Medical Response undercutting Lee County EMS by about $450,000. The cities come in and they want $1.8 million combined and Fort Madison’s gonna take out a loan for $1 million to buy rigs and equipment.

The county says WHAAAT??! No way. The committee’s gonna bring AMR in for some questions, they had the most professional proposal and the best price, said Dr. Phillip Caropreso. After the committee interview of AMR, the committee’s split on AMR’s intentions, but votes 6-2 ‘reluctantly’ basically because there’s no time left. Caropreso, who advocated first for Lee County EMS, then did an about-face to support AMR based on its proposal, said WHAAAAT???! About-face.

Lee County Board chair Ron Fedler calls a special meeting on Saturday and more than 50 people get on the call. The conversation was lively but scattered with everyone getting on the call, there were kids running in the background, people were baking, talking working, typing. It… was….awesome.

There never has been a better time to see how the sausage is made. But it is being made.

Several questions popped up about AMR’s contract status with Wellmark Blue Cross/Blue Shield which is the county’s health insurance provider, and one of the most recognizable in the state. A Lee County EMS employee said the Dallas-based AMR doesn’t have a contract with Wellmark, so tremendously high private billing would ensue. That question has yet to be put directly to AMR. WHAAAT?

Matt Pflug said “WHAAAT?” why didn’t we ask that question. Why wasn’t Pflug on the committee call. Quorum was out as it was posted as an open meeting. Anyone could have been on that call. Supervisor Rich Harlow also wanted clarification on the insurance contract and also didn’t appear to be on the calls. In Zoom meetings some of those dialing in only list as a Caller No. so it’s difficult to see who was really listening in.

During the committee vote Friday afternoon, it was all Lee County Sheriff Stacy Weber could do to not go all Yosemite Sam on the committee when he said. “On July 1, somebody better be running an ambulance.”

His department is the front line in the county. He needs to know.

Seven weeks.

As a stark reality….that’s less time than we’ve been dealing with this pandemic.

Several counties and cities in Iowa have separated from AMR after alleged price hikes and contract demands.

A document received from Charles City dated May 2019 illustrates some of the changes AMR demanded of that city, including eliminating payments made by AMR to the city and Floyd County for ambulance driver staffing, use of dispatch services, and fire station rental. AMR rebuilt the proposed contract to have the city donate those services and facilities “in-kind”. The contract rewrite also required a $50,000 annual payment to AMR from Charles City.

That information was included in an agenda summary, which indicated the city was short $54,225 in AMR requests, so the company would only agree to a one-year deal.

A copy of that contract shows, for example, a Basic Level Support-non emergency charge of $1,101.04, which was the same rate they charged in the 2018 contract. An employee of Lee County EMS provided Pen City Current with a rate sheet that showed their charge as $372 base rate charge plus $13/loaded mile. AMR charged $28.11 per mile.

However, a rate sheet released by the county shows BLS Non-emegency charges under AMR’s proposal for Lee County at $700 with a $22/mile charge.

AMR, which is listed under the Better Business Bureau as Rural Metro, Mission Care of IL, AMR, Amb O Cab, Ambulance Service Co. Medevac Mid-America Inc, and Reed Ambulance, is not accredited by the BBB. A statement on the BBB website reads: “BBB files indicate that this business has a pattern of complaints concerning billing or collection issues, and customer service issues.”

However, the committee did get a recommendation on AMR from the Macomb Fire Chief for the service it provides in McDonough County, which Folluo referenced on Saturday.

Not all great news for AMR. Add in that they don’t think they can get up and running by July 1, and the county’s in a real pickle.

But we have to ask. Where the heck is Lee County EMS? The staff is passionate and vocal in support of their employer, but no one from the Young family has commented publicly during the process.

Pen City Current has reached out on multiple occasions, and through multiple channels, to discuss the issue with leadership there, but no response. Joey Herren represents the cities on these calls, and AMR has addressed committee concerns publicly.

The Lee County EMS staffers beg the committee to consider their moves carefully, and our Letters to the Editor plead for the county to consider loyalty to those here locally who provide this service.

It’s a point very well taken, but where’s the company leadership? If $950,000 gets it done, why is there no advocacy going on in the public?

The best answer here, if Lee County EMS wants out, is to extend the service up to a year in an agreement with the county for a reasonable charge. Then either consider a referendum vote of the county to charge for a service, give the cities a chance to explain their proposal, and/or allow legislators to further consider ambulance service as essential under the law, which would trigger assessments to pay for it.

If Lee County EMS wants to stay in – come out, come out wherever you are.

In all seriousness, these are serious people trying to protect the people of Lee County and it’s been a siege for all of them. And although we have to smile and laugh especially in these trying times, it is time to get serious.

We have very smart, dedicated and passionate people taking care of us here in Lee County. Lee County EMS was wonderful in taking care of our daughter prior to her death in February. Local police and deputies did welfare checks in a matter of minutes on her when we were out of town.

These people are the VERY BEST we have and they need to make this priority No. 1. We can solve it, but people have to be in the room and it has to happen now. And that just cannot be Beside the Point.

Chuck Vandenberg is editor and co-founder of Pen City Current and can be reached by email at

4 thoughts on “Ambulance service debates leave us saying – “WHAAAT?!”

  1. If you go with the out of town company and after a year they want to change the contract to something that’s untenable, you cannot go back to Lee County EMS, they will most likely be dissolved so then, you’re STUCK with the out of town company and must sign their unworkable contract.

    Move carefully but…fast! WHAAAA???

  2. The city fire departments would be the best long term stable solution… Sure they want four or five times as much money as other providers, but apparently the local politicians and taxpayers don’t care as having two large ancient courthouses and double services and ongoing costs to maintain two county seats proves.

  3. Will the new ambulance hire all employees of the current Lee County EMS? I do not believe any privatization of emergency services benefits is appropriate for Lee County EMS. The effects of doing so have not been shown to streamline and reduce costs for Iowa Medicaid coverage. Some may argue that this comparison is similar to comparing apples to oranges. Upon review you will see that argument is not valid as Medicaid and EMS both provide essential services to our county.

    How long does the initial contract remain in effect? Perhaps after the first contract is due for approval the Texas company will raise their rates dramatically? I know providers who offer a “teaser rate” to make them seem like a bargain. In reality after the initial period, providers double the initial rate.

    By the time that happens, our local EMS provider would have liquidated their equipment. Moreover, the people working there have found other employment. Their specialized skills gone. How much higher would unemployment rates be in the interim. Also- how many counties in Iowa have privatized similar EMS services.

    As unpopular as this question may be…couldn’t a special levy be added? I believe people all over the US tout “BUY LOCAL”. It’s become a mantra for people who understand that supporting local businesses is the right decision to make.

    Citizens of Lee County please rise up and demand we continue to receive crucial services from our local Lee County EMS.

    Thank you-

    Melissa Steffen Hobbs
    Montrose, Iowa

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