Lee County EMS director shoulders blame for financial woes

Ambulance director says company is willing to stay on for 12 months, but needs $900K from county


LEE COUNTY – The head of Lee County’s current ambulance service said the company is willing to go another 12 months, but said the county needs to come up with another option for 2022.

Bill Young, the director for Lee County EMS Ambulance, Inc, told Pen City Current Monday the current proposal submitted to the county for $900,000 in subsidies would have to be met, but the county should look at making the service a governmental entity.

He said the service just can’t continue to function with reimbursements the way they are, and with private providers being left out of legislation for gap funding.


“We just don’t see that working out financially,” Young said Monday.

“We went up to $900,000 and even that would be a break-even point. With reimbursements, and the way we feel things would change, the best thing is that it will have to be some kind of government entity. That way other things would open for them.”

Young took total blame for the ambulance services financial woes on himself.

“First of all I want to start out saying that the way things have gone the last couple of months was my part,” he said.

“I have learned a lot and grown a lot from this experience and I regret that we had to ask the county for extra funds. But it was a provision in our contract that allowed us to do that. So that’s what we did.

“We’ve been honored to provide service to the county for the past 25 years and we’re willing to continue over the next 12 months until the county can come up with the best alternative.”

If that alternative does become a county-, or even city-run ambulance service, it could hinge on a bill hung up in the Iowa Legislature due to the dismissal for the coronavirus.

That bill, House Study Bill 631, would give county boards the right to assess a tax to cover the shortfall in revenues that Young says is not only plaguing Lee County, but the nation’s ambulance services.

“My biggest hope is that the state follows through and the legislation is passed to make EMS an essential service,” he said. “If that happens the county would be able to tax and levy for that service and that would generate some income to cover shortfalls.”

According to Iowa Gov. Kim Reynolds, legislators are planning to return to the state capital on June 1.

Another Medicaid reimbursement that is not available to private services is the Ground Emergency Medical Transportation program, which provides federal funding through state Departments of Human Services. That reimbursement requires a couple years of billing history to set rate structures, but it something else the county could plan on.

Fort Madison Fire Chief Joey Herren said that program is part of how he thinks the cities can offer ambulance services with comparable subsidies to Lee County EMS in the future.

Herren and Keokuk Fire Chief Gabe Rose will be presenting a proposal to the Lee County Board of Supervisors on Tuesday, along with Lee County EMS staff.

Young said the investor group of Lee County EMS, which includes three family members and fifth investor, has cut the service as deep as it can, and rate increases could be taken in addition to the county’s $900,000 if approved for one more year. He said those are things that would need to be hashed out with the county board.

“It’s something we could work on together. We would have to be able to sit at the table and discuss things and maybe try to find other cuts, but, we’ve pretty much cut every where we can cut,” he said.

“We have to be able to provide a service that people expect and that comes with a cost.”

Young said Lee County EMS did find itself in trouble with the IRS and was facing liens.

“I will just say that was true, and those are things that I’m not proud of. I didn’t ask for help when I needed to ask for help in this position and I put other people here in a bad spot. I realize that and apologize for that. I screwed up and I wanna move forward and get it fixed so the county has a reliable ambulance service going forward,” he said.

Young said EMS service is his passion and if allowed he would like to continue to be a part of the service going forward.

“I’m willing to stay on as long as anyone will allow me to. This is my passion and EMS is where I feel I belong,” he said.

“I feel bad because of what I did, but I can’t keep living on that and I want to look to the future. If asked to do that, by all means I would be willing to do that.”

Young said Washington County is currently moving toward a county-run ambulance service and he said he believes Henry County’s hospital-based EMS service could move in that direction as well.

Young said he wasn’t surprised when American Medical Response pulled their offer to provide service Wednesday.

“People are saying it was things the board said, but my from my standpoint (their proposal) didn’t have the right demographics and numbers of Lee County and our payor mix,,” Young said. “They did their homework, but I question that, knowing the numbers we have here – it would have been a tough sell.”

The investor group was eerily quiet during public committee and board of supervisors meetings over the past three weeks, declining to make any comments during the meetings, nor responding to requests for interviews.

“We were never trying to hide anything. We just were trying to get ourselves together,” he said.

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