Ambulance service still dominates agenda as groups prepare for Thursday night meeting.
BY CHUCK VANDENBERG
MONTROSE – Lee County Supervisors stumbled for close to two hours Tuesday through face shields and tech issues as the COVID-19 pandemic continues to wreak havoc on county operations.
At the board’s regular meeting held at the Lee County Conservation Center near Montrose, supervisors met for the first time in person in almost two months. Supervisor’s Rick Larkin, Matt Pflug, and Gary Folluo still called into the meeting via teleconference. Rich Harlow, Ron Fedler were at the center along with Lee County Auditor Denise Fraise and county staff.
Fedler asked the meeting be held in person this week to see if some of the problems with doing them via teleconference could be avoided, but the opposite turned out to be true.
Despite the technical snafus, the board did approve keeping county buildings closed for an additional two weeks until June 1.
Folluo said the county just wasn’t ready yet to open back up despite Iowa Governor Kim Reynolds relaxing even more restrictions around the state Wednesday.
“We haven’t received the 3,000 masks we ordered and the barriers aren’t up yet and we are still seeing COVID cases in Lee County,” Folluo said. “It would be inappropriate to open buildings right now.”
Larkin said the health care experts are saying there could be a second wave of the coronavirus and the county needs more time to see what is happening.
“People are saying their could be a second type of pandemic go through here later on, so we might want to be prepared and keep investigating it,” he said. “June 1 is a good date to review it again.”
The move passed unanimously. A good portion of the rest of the meeting was talking about the pending June 30 deadline for Lee County EMS Ambulance to continue providing service in the county.
Lee County EMS is asking for an additional $450,000 from the county, which would bring their total subsidy request annually to $950,000, up from a $500,000 request made in January.
American Medical Response is offering to provide the service for just $450,000, a figure several supervisors feel isn’t realistic. AMR also isn’t in network with Wellmark Blue Cross/Blue Shield which would impact costs to county employee and residents on that plan.
Supervisor Matt Pflug pushed AMR’s National Public Affairs Director Wes Harrell on the Wellmark issue asking him if AMR would sign a contract with Wellmark.
Harrell said AMR does accept Wellmark, but it’s not an in-network service and the company would look at that possibility once they are a ground-service provider.
“That’s to be determined and we are willing to work toward that in good faith,” Harrell said.
Harrell said local commentary from supervisors that the county was settling for AMR because of the cost was inappropriate. He said AMR is a global leader in emergency medical response, going so far as to call it the “Cadillac” of services. He said AMR provided an offer to the county that is on par with the current service it has.
“There was a comment made that sometimes you have to settle because of cost. We feel we are the premier service and we are the Cadillac. We transport 13 million patients a year,” Harrell said.
“We’re excited about the opportunity to potentially provide service to Lee County. But we don’t want Lee County to think they have to settle.”
Harrell said, like with any health care provider, the provider bills for insurance and then the remainder of the costs are billed to the individual. With regard to Medicaid, the reimbursement is set by the government and the providers cannot go after the individual for the rest of the bill. It is absorbed by the company.
Providers set rates based on those reimbursements and AMR’s rate sheet taken as a complete sheet shows rates close to double what Lee County EMS is currently charging.
A meeting has been set for Thursday at 5 p.m. at the Montrose Fire Station where supervisors again want to hear more on the three proposals and ask questions of each group.
Harrell said he didn’t know if anyone from AMR would be able to make the call, but he said the AMR proposal is pretty straight forward and he’s not sure how much more information he could provide.
The meeting will also give Keokuk and Fort Madison fire officials a chance to outline their service proposal. Those two entities are asking for $966,000 each from the county to help offset some start-up costs.
“I would appreciate if everybody who put in a proposal would be able to come on Thursday to make their case why they should be the one we pick,” Fedler said.
County Budget Director Cindy Renstrom said the only way the county could afford to put more money into any of the proposals would be to access the county’s reserves, which she didn’t recommend.
Folluo said if the county was going to up the amount of the subsidy, then he felt they should go back out for proposals.
“This is not something we put for bid as it wasn’t a construction project or improvement. We solicited bids from known providers that we thought would be feasible,” Fedler said.
Folluo said at least the county should allow the proposals to be tailored to the additional funding.
“If we come up with another 400,000, by rights shouldn’t we allow Keokuk and Fort Madison to tailor their plan to include $900,000 and do the same thing with AMR. Maybe they could provide additional ambulances to Lee County,” he said.
Pflug said he felt no decision should be made until after the Thursday night meeting.
“I think we need to ask questions on Thursday night. There are questions, critical funding questions, that we can ask then,” he said.
“There are still some questions I want to ask these people directly before I would make a decision. $450,000 isn’t going to cover ambulance service in Lee County. It’s going to be on the backs of somebody.”
Folluo said everyone needs to remember that Lee County EMS won’t provide service with a $500,00 subsidy.
In other action, the board approved new contract renewals with Wellmark for county employee health insurance with increases in copays for prescriptions and doctor visits. Co-insurance and deductibles will remain the same. The board also approved renewals of the county Wellness Program Contract with Health Solutions, and vision insurance for the next fiscal year.
The board also:
• approved removing golf carts from current ATV/UTV ordinance that sunsets at the end of the year.
• approve an updated pandemic policy to reflect new current symptoms of the coronavirus and COVID-19 illness.