LEE COUNTY – A consulting firm contracted by Lee County to look at the county’s ambulance service may have triggered a substantial increase in ambulance rates.
At Monday’s regular Lee County Board of Supervisors' meeting, Lee County Ambulance Director Mark Long presented some proposed changes to the current rate structure that would be effective July 1, 2025. Some of those rates are more than double.
Long said the proposed new rate structure comes from a recommendation from Fitch & Associates, an EMS consulting firm the county hired for $33,000 to review operations. The consultation was proposed by former Lee County Auditor Denise Fraise, who now sits on the board of supervisors.
The new proposal also charges $115 for a lift assist, which is a call where the patient simply needs assistance getting off the floor or out of a chair where emergency crews would provide assistance moving the patient and then leaving.
Long said he had mixed feelings about that charge. He said he’s spoken with supervisors Garry Seyb and Tom Schulz.
“I don’t love the idea of billing for it, but it’s the environment we’re in. I talked with Garry and Tom about it and they thought we probably should be doing it,” Long said.
But Long said the county ambulance is also looking at creating a hardship waiver that it currently doesn’t have that would allow patients to apply for hardship to have the bill waived under certain financial circumstances.
“Here’s the struggle with that one. We would not want anyone not to call and sit on the ground for five, six, seven, ten hours because they thought they might be billed,” Seyb said.
Fort Madison Fire Department Lt. Chad Hannum was present at the meeting and said he could see patients requesting only the fire department respond. There would be no charge at this point for the fire department to provide lift assistance. Hannum said most of the volunteer fire departments will provide lift assistance as well, but then Seyb said it comes down to how fast a volunteer crew could get there.
“Within our community, the taxpayers are already paying for it. There absolutely is an expense being incurred, I agree,” Hannum said
Seyb said when an ambulance is dedicated to a call, they aren’t available to anything else. “They are duty bound to respond to that call until the call is completed,” Seyb said.
“We have four ambulances in the entire county and, when one is dedicated, and there is a car accident, they’re not available until they complete that lift assist.”
Hannum said Burlington only sends an engine on lift assists and no ambulance unless the firefighters determine an ambulance is needed.
Hannum, who will take over as Fort Madison Fire Chief in May, said the way to get around the cost of the lift assist is to simply have LeeComm dispatch send out fire for the assists and not an ambulance. Then the firefighters can determine if an ambulance is required.
Many of the proposed rate increases are more than 100% of current rates. For example, the current rate is $387 for a BLS (Basic Life Support) non-emergency call. The new proposed rate is $800. That amounts to a difference of $413, or a 107% increase.
Advanced Life Support (ALS) emergency calls are currently billed at $735 per call and that is proposed to be increased to $1,500 for an increase of $765 or 104%.
Other proposed changes include a charge for a dedicated responder on stand-by at $100 per hour, as well as flight crew transfers where the ambulance service would transport flight crews and that rate would be $250 per transfer.
Mileage would go from $21/mile to $22.87 per mile. There would be no changes to charges for supplies used on calls at this time.
Supervisor Ginger Knisley said she would prefer a hardship form that isn’t based solely on income. She said there are other factors that impact families’ ability to pay, including number of family members.
“You could have a family that’s at 300% of poverty that’s pretty normal and didn’t experience generational poverty, and another family that makes the same, but they have a disabled child and other factors,” she said.
“I’m not a fan of strictly going by income guidelines. I’d like there to be a few other factors looked at.”
Supervisor Chairman Tom Schulz said it would be tough to evaluate that subjectively.
Long said the approval of hardships would rest with Lee County Ambulance personnel.
Long said the new structures are just proposals at this point and have not been approved by anyone.
“These are recommendations from Fitch after they came in and did their consulting,” he said. “We are greatly increasing what we are billing, but we would have this method on the side to help people."
He said the people who will be most impacted will be private pay customers. Medicare and Medicaid do not allow balance billing or pursuing patients for what Medicare and Medicaid don’t pay.
He said many people locally would likely qualify for hardships considering the low-income demographic of the county.
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