Wlaf1450TOP PHOTO: Campbell County EMS is shown here at the scene of a wreck last month.
JACKSBORO, TN (WLAF) – Although the county commission failed by one vote to approve a rate increase for the county’s ambulance service at its Jan. 19 meeting, the issue is far from settled.
EMS Director Bruce Perkins said Saturday he will bring the proposal back before the commission in February, hoping that at least one of three commissioners who missed the January zoom meeting will provide a crucial eighth vote for a majority.
In a detailed written summary of EMS revenues and costs prepared by Finance Director Jeff Marlow, Marlow summarized his review by writing “It appears that the county commission should give serious consideration to increasing the current rates for EMS services.”
Marlow pointed out that a number of factors played into the ambulance service’s revenue shortfall, but that the decrease in federal and state Medicare and TennCare reimbursement rates played a major role. That is a predictable problem, Marlow pointed out, writing, “It’s no secret in the EMS community that Medicare is in exit mode when it comes to paying for emergency services. It’s not a matter of if, but when.”
Charting the fiscal history of the ambulance service since it became a department of the county in 2002, Marlow showed that until 2016, patient charges covered well over 95 percent of all EMS costs. In that year, Medicare rule changes resulted in a decline of over $250,000 in revenue, with that amount having to be made up from property tax revenue.
From that point on, other factors including a decline in transport of dialysis and other non-emergency patients, competition for non-emergency transport from the private service VitalCare Medical Transportation and a first-responder program adopted by the City of LaFollette have all contributed to decreasing runs and patient charges while costs continue to go up. In the current fiscal year, county property tax revenue will make up over one-third of the $2.8 million EMS budget.
To halt the increased reliance on tax dollars and enable the ambulance service to finally add additional EMTs needed to improve emergency response times, Perkins asked the commission to approve rate increases based on the average rates charged by other area EMS services. A comparison of rates charged for emergency and non emergency transport, mileage and supplies showed that Campbell County charged the lowest rates among the four other services that responded to requests for rate data.
Perkins requested approval to charge the average of the rates charged by Anderson, Grainger, Monroe and Hamblen counties, all of which were significantly higher than Campbell County, which has not approved a rate increase since May 2008.
However, at the January meeting, several commissioners debated the need, with Commissioner Scott Stanfield expressing concern about how much of the increased rates would be covered by insurance and how much from patients’ pockets. A vote was finally held with Stanfield, Ralph Davis, Lisa Lester, Whit Goins and Zach Marlow all voting “no.” Sue Nance, Scott Kitts, Johnny Bruce, Robert Higginbotham, Charles Baird, Rusty Orick and Mike Douglas all voted “yes” on the motion but with three members not present, the commission fell one vote short of the necessary majority.
“I have to bring this request back and hope for that additional vote,” Bruce stated. “We can either operate by increasing patient charges or by increasing the cost to taxpayers. Not having a county ambulance service is not an option, people’s lives are at stake.” (WLAF NEWS PUBLISHED – 02/01/2021-6AM)