Council Reviews Budget Expenditures/Income Potential for Ambulance Services

The Lamar City Council, City Treasurer Kristin McCrea and City Administrator John Sutherland discussed Ballot Issue 1A, the .025 percent county sales tax which is on this year’s November 6th general election, during their October 22nd meeting. The discussion stemmed from other economic issues as well as the council’s vote to support the Adoption of Proposition 110 in the approaching election.  As was reported earlier, the Proposition will allow for a statewide sales tax of .067 which will develop funding for general road improvements throughout Colorado, including rural areas such as Prowers County.  The County Commissioners also expressed their support of the passage of the proposition, suggesting that it could mean as much as $2 million per year for municipal road improvements.  The breakdown on finances indicates that around $780 million could be generated in the first year of the tax which could then be leveraged into $6 billion in bonding throughout the state to pay for the road projects.

The council discussion also focused on Ballot Issue 1A and how the passage of that tax would be applied to the cost of operating the ambulance service for Prowers County. City Treasurer, Kristin McCrea explained that the estimated city’s portion of $240,000 generated per year would be used to offset the money the city and council takes from their general funds to cover the operation of the ambulance service each year.

Some basic facts and figures show that ambulance runs have increased in the past five years. There were 967 in 2010, 933 in 2013 and 976 in 2014, but from that point the number of calls has jumped. 2015 showed there were 1,174, 1,284 in 2016 and so far, there have been 935 through this past September.  Fire Chief Jeremy Burkhart said at an earlier meeting, he expected to have almost 1,263 runs before the end of the year.  It costs $850 for a basic ambulance run, plus mileage at $18 per mile.  McCrea explained that the ambulance service is also under contract for specific events with one vehicle and two employees to cover a football game for example, and that amounts to a $90 fee per event for the city.  Twenty-four percent of ambulance calls are in Prowers County, the balance, 76% are from within the city limits.

The city does not always recoup that expense and has to write off costs with the contractual write off from Medicare at approximately 46% while the write off for Medicaid is from 86% to 94%. The monies taken from the General Fund for the past several years is: $80,329.22 for 2015, $137,620 for 2016 and $233,508.41 for 2017.  This is a cumulative figure with increases from one year to the next and not generated individually.  None of these amounts have been recovered, so the loss has carried forward year-over-year and has now accumulated to $296,117.26 and is expected to continue growing.

The city’s ambulance patients repay the city for services at 44% for Medicare, 42% for Medicaid (with only 14-18% of that repaid), Private Insurance is 10%, Worker’s Compensation at 1% and Private Pay at 3%.

The actual annual revenue, according to McCrea, is near $200,000 for salaries and expenses as the ambulance service makes use of grants to help offset some equipment costs. She said the city has made adjustments in the way in which overtime is paid, altering the work schedule to measure hours on a four week period and fire and ambulance runs are kept on separate accounts. The city paid $40,000 in overtime in 2015, but so far, in 2018, has kept that to about $8,000.  “We’ve also recouped some fees through the new EMS billing services we started using which has helped the cash flow.  They are timely in sending out their bills and they are also very consistent in their collection efforts,” she explained.

This year’s city budget for 2019 has included the $240,000 generated through the passage of the ballot and was done only to help implement the new budget figures. The city would receive $240,000 in funding while the Holly Fire and Ambulance District would receive $80,000 and a reserve account to be administered by a three person board for ambulance needs in the county would receive $80,000 a year per the estimated revenue generated by 1A. The board would consist of membership from the city, the county and from Holly.

By Russ Baldwin