LEE COUNTY – A panel born out of a contract to subsidize the Lee County EMS Ambulance Inc. operations met for the first time Thursday to look at plans to take over the service in a year.
The committee, approved by the Lee County Board of Supervisors, was formed as part of a contract inked last month between the county and the ambulance service to provide $900,000 of county funds to offset operating shortfalls.
The committee is chaired by Jim Steffen, an EMS coordinator and training director for Southeastern Community College and a 30-year paramedic. Dr. Dr. Philip Caropreso, a Keokuk physician serves as vice chair.
The board includes other members of Keokuk, Fort Madison and Lee County first responder services including both city fire chiefs, representatives from the county, both Keokuk and Fort Madison hospitals, and LeeComm.
Lee County Auditor Denise Fraise sits on the board and said the focus of the group is to make sure the ambulance service is staying afloat and make a plan to move forward with services after this fiscal year.
Fort Madison Fire Chief Joey Herren said the group has 12 months to get a plan in place for continuation of services at the end of this fiscal year June 30, 2021.
Fraise said in reality, the board has about five months because if the county is going to take over the service on July 1, 2021, it has to be included in the county budget, and that is put together by year’s end for approval in the spring.
The group will be meeting bi-weekly and will review Lee County EMS financials monthly and quarterly per the contract. Fraise said the financials will not be discussed in open session because Lee County EMS Ambulance is a private company.
“We are in charge of making sure they are staying a float. They will be sending us financials every month,” Fraise said.
Steffen said someone should talk with ambulance service to see what their comfort level is with those discussions.
“If this group looks at the next step, those financials are going to be pretty critical as a prediction of revenue. My suggestion would be to talk to them and see what they’re comfortable with,” Steffen said.
The group talked at length about the value of the property and getting appraisals done, which are in the works. They also discussed budget numbers that have been provided by Lee County EMS, as well as a preliminary budget prepared by Lee County staff.
Steffen said some of the leg work on the potential budgeting and revenue projections could be simplified if the county were able to get numbers out of Jefferson and Washington counties, who recently went through transitions similar to Lee County.
Steffen said Washington is in the process of taking the service public, and Jefferson was taking steps in that direction, but hadn’t signed any contracts yet.
There’s no point in the committee doing a lot of work that’s already been done. Jefferson County just went through this and did a cost differential of a public vs. private service. A lot of those recommendations would apply here,” Steffen said.
He said in reviewing the Lee County EMS budget, maintenance and equipment costs seemed very low
“Their repair line item is a low number. Don’t know where that comes from but it has to be low,” Steffen said.
“There is no way that they are running six ambulances for that much. I have 15 years of experience running maintenance and there is no way they are running repairs at that rate. Triple maybe, quadruple perhaps.”
He also said the budget doesn’t include any capital outlay, but does have some depreciation of equipment.
“There would be a substantial capital expense in this,” he said.
Steffen asked Supervisor Rick Larkin, who is also on the board, if all things were equal in the numbers, would the board of supervisors prefer a public or private service.
Larkin said with all the county went through in the past year with the ambulance service, the board’s direction has been to take it public so there weren’t ongoing contract and revenue issues.
Fort Madison Community Hospital’s Amanda Burgess said it was her hope that the county would take over the service to open up grant opportunities for advanced equipment purchases.
Steffen said Lee County did increase their charges for this year, but they were previously very low compared to state averages.
“1/3 to 1/2 low… something like that.”
The group decided to meet again on July 23 with data from other counties to review as well as a getting a set of bylaws together for committee approval.
Caropreso said he would like to see an outline of steps of action the committee is trying to accomplish in general terms.
Steffen said he was going to reach out to the state Ground Emergency Medical Transport contact at the Iowa Department of Human Services about potentials there for additional reimbursements of Medicaid patient charges.
The additional funding is from federal sources to public operators of ambulance services, but Herren said the service would need two years of run history before any additional funding may be available.