County may move on ambulance service Tuesday


MONTROSE – County officials will hear for the first time, officially anyway, detailed proposals from two groups offering to provide ambulance services to the county starting in July.

At Tuesday’s regular board meeting of the Lee County Supervisors, Fort Madison Fire Chief Joey Herren and Keokuk Fire Chief Gabe Rose are scheduled to present a joint proposal under each city’s license to offer services to the county.

Following that proposal Lee County EMS Ambulance will give it’s first proposal to the board since asking for a bump in the county’s contribution back in January to an even $500,000.

The board also has an agenda item to consider approval of ambulance service beginning July 1.

The meeting will be held via teleconference beginning at 9 a.m. The public can access the meeting by dialing 1-872-240-3412 and using access code 156-009-109.

At a January meeting, Lee County EMS director Bill Young said the ambulance service would need another $79,000 in the next contract, which is in addition to the $421,000 subsidy the service was already getting.

Since that time the county put another $36,000 into the service’s payroll for a total of approximately $457,000 in the current year.

Shortly after the county gave the extra funds to the ambulance company, word got out that the service wouldn’t be extending their contract beyond June 30. The new contract is set to begin July 1.

After several conversations between the ambulance company and county officials, Lee County EMS’s investor group said they would need $900,000 according to a proposal submitted in April.

The group cited declining revenues, increasing costs, the coronavirus pandemic, and private and public insurance reimbursements, as reasons for the increased amount.

Supervisor Gary Folluo said at one point the request was closer to $1 million annually to continue the service.

The investment group, comprised mainly of the Young family, has not commented publicly on the ambulance crisis, or their current proposal. But Lee County EMS staffers have been very vocal about the county staying with a local provider.

Last year the company billed $2.4 million, but had to write off $1.1 million under bad debt, contractual write offs, non-billable transports, no estates, and collection fees. The revenue shortfalls led to issues with the IRS. The company also had a list of issues noted in the county’s 2019 state audit regarding deficient financial records.

When Lee County EMS hinted at not renewing a contract, the county reached out to Keokuk and Fort Madison to see if they could provide service or financial support to keep the service running.

Herren provided a joint proposal from Keokuk and Fort Madison fire departments to provide the service, but it would cost the county close to $2 million annually while the program got started.

The cities would each cover half the county, but without any ambulances, staff or equipment, the cities would need capital outlay from the county, in addition to at least one loan. Herren said the county’s contribution would likely go down as the services got up and running.

He said the ambulance services would be entitled to some public gap funding after two years, which could bring the cost down significantly.

The other twist will be whether legislators take up a bill aimed at classifying ambulance services as essential services, when they resume the session delayed by the coronavirus. If the governor were to sign such a bill, the county would be able to assess a tax countywide that would help cover the annual shortfalls of ambulance services.

Herren said the Keokuk and Fort Madison proposals are technically separate because they wouldn’t be able to operate under the same licensing because they are two separate entities. However, a 28E agreement similar to agreements already in place for aid calls between the departments would pull the two groups together.

On Wednesday, national ambulance provider American Medical Response pulled their proposal, which was for $450,000 annually, off the table after heavy public criticism and intense questioning from some county officials.

In other action at Tuesday’s meeting, the board will consider:

• resolutions amending the current fiscal year budget and appropriations
• appointing a weed commissioner
• approve a second reading of an amendment to an ordinance that would remove golf carts from the definition of an ATV/UTV.

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