Supervisors balk at panel recommendation for ambulance service

3-2 votes sends county back to look at proposals, while July 1 deadline looms


LEE COUNTY – Lee County Supervisors voted 3-2 in a special Saturday meeting to table a recommendation from a panel to hire a Dallas-based ambulance service.

With just over seven weeks left in the county’s current contract with Lee County EMS, the special meeting was called by Supervisor Chairman Ron Fedler after a panel voted 6-2 with an abstention to use American Medical Response out of Dallas, Texas on Friday.

Lee County EMS Ambulance declined to sign a new contract with the county when funds began to dry up in February, after indicating in January the company would need $500,000 in 2020-21. That figure at the time was $70,000 more than the 2019-20 contract.

When Lee County EMS balked at another contract, the county informally went out for proposals. Lee County EMS then submitted a new proposal asking for $950,000 in the next budget year beginning July 1, to continue the service. The county got three other proposals including two from Fort Madison and Keokuk Fire Departments, which would function jointly, and a proposal from AMR for $450,000 for the next fiscal year.

The panel interviewed AMR reps on Friday morning about their service and how they could offer such a low rate.

On Saturday, with at one time 50 people on the call, Supervisor Matt Pflug moved to table the issue after an employee of Lee County EMS said AMR didn’t have contracts with Wellmark Blue Cross/Blue Shield, which is the county’s health insurance company.

The move doesn’t have a timetable, but discussion will continue as part of Tuesday’s regular Board of Supervisor’s meeting, which will tentatively be held at the County Conservation Center with a 10-person limit. It will also be teleconferenced, however that login information was not available as of Sunday morning.

Fedler asked that County Auditor Denise Fraise reach out to all three entities submitting proposals to have a joint meeting to answer pending questions. That meeting could be held at the Montrose Fire Station at a date to be determined.

Nick Dooley, a paramedic with Lee County EMS, told the Supervisors during the public comment section that he didn’t believe that AMR had a contract with Wellmark.

Pflug asked Supervisors’ Gary Folluo and Rick Larkin if that question had been posed to AMR during the interview Friday morning.

Dr. Phillip Caropreso said he would follow up with Floyd County officials, where he believes AMR doesn’t accept Wellmark coverage.

“This is a very important piece we need to know. Even as a taxpayer myself I’d like to know that. That has the potential to be a huge bill. And I think that’s why possibly their price is so low at $450,000. If that question really wasn’t answered it needs to be answered.”

Folluo said he never heard AMR reps say they wouldn’t accept Wellmark.

“They did not say they don’t accept it. They said sometimes insurance companies negotiate rates and there’s are higher than the national rates,” Folluo said.

Rick Larkin said the county is running out of time and the committee made a recommendation.

“I think those on the committee would rather go with a local type company, but we just can’t go with a $500,000 increase on the ambulance service and we have to make that decision. The committee did approve it and that’s why were having the meeting today and were under a timeline,” Larkin said.

Fort Madison Fire Chief Joey Herren pleaded with the board to get the financial reps from the county, Fort Madison and Keokuk in a room to look at options and explain the city’s proposal better.

The joint proposal from the fire departments was for $960,000 per year, per city. Fort Madison’s proposal also indicated a $1 million loan would be taken out internally to help offset start up costs. He said that amount would just be to purchase three ambulance rigs and the supplies and equipment that go with them..

“Our numbers were high, but neither of us was in the ambulance business and had no equipment. Get the financial people from the three parties together and look at this and what it takes to get this off the ground,” Herren said.

“I know that number scared everyone, but over the long-term that number goes down, It’s just the upfront cost and that cost is always scary and eventually it balances out. We never got to present it to anyone, we just turned it in.”

Larkin said the saving would have to be immediate because the county doesn’t have that kind of money.

“That’s why we sit down, our financial person has some ideas. If you let us present our case, there’s somethings public providers can do that private can’t. We need to be able to present this case to you,” Herren said.

Fedler then called for a vote to table the issue with Pflug and Harlow voting no, wanting more information on the Wellmark issue. Folluo and Larkin, who both sit on the recommending committee voted against tabling the move, and Fedler broke the tie voting to table.

Several Lee County EMS staffers were on the call, but no comments were made by the ownership of the company. Nor were any comments made by reps from AMR.

Lee County EMS ownership reps were on some of the committee meeting calls, but no comments were filed.

1 thought on “Supervisors balk at panel recommendation for ambulance service

  1. (Submitted by Melissa Steffen Hobbs, Montrose Iowa)

    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 increase our 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 taxes be increased ? 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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