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Medic One proposes percentage-based cost sharing to avoid $270,000 deficit

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A chart of percentage-based costs for each of the six districts served by Lewis County Medic One, as proposed by the Medic One Board of Directors on Feb. 4. Officials with each district are expected to discuss the proposed figures during the Feb. 17 meeting of the board to be held at Cowlitz-Lewis Fire District 20 headquarters.

Lewis County Medic One's Board of Directors has proposed what they feel is a fair solution to the agency's potential solvency problems, and expect to hear feedback from contract districts during their next meeting Feb. 17.

Discussing during a special meeting of the board held Feb. 4, officials proposed a system by which all six districts serviced by Medic One (Lewis County Fire Districts 2, in Toledo, 15, in Winlock, and Cowlitz-Lewis Fire District 20, in Vader and Ryderwood, who own the agency; as well as Lewis County Fire Districts 1, in Onalaska, 3 in Mossyrock, and 8, in Salkum, who contract for services) would support the agency based on the parentage of paramedic transports within their districts rather than attempt to hash out more specific rate structures and revenue policies.

Members of the board, made of commissioners from Districts 2, 15 and 20, said this would allow each district to determine how they would fund their portion of financial responsibility for Medic One, rather than insist on specific rates per transport or specific amounts of patient revenue or portions of levied taxes.

This proposed solution has come after five months of negotiations after it was reported by Medic One Operations Chief Grant Wiltbank in October that the agency would be experiencing a roughly $95,000 deficit this year. Wiltbank said this potential shortfall was due in large part to decreased call volume experienced since the middle of last year, as well as a decrease in per-patient revenue by roughly 20 percent.

Circumstances were further compounded after Lewis County Fire District 5, in Napavine, approved a contract with American Medical Response in December rather than continuing with Medic One, decreasing revenue for Medic One by around $200,000 per year.

Since that time, multiple proposals have been put forward to reduce expenditures, including part-time coverage for contract districts to keep their costs generally the same, but such districts have insisted they will not accept less than current levels of 24/7 coverage.

If the board's current proposal is accepted, it would support a system of seven paramedics covering all districts 24/7 at an estimated cost of around $820,000 for 2015, leaving a $270,000 deficit without a change in current revenue practices.

The new system would spread this deficit, as well as all other costs, across all six districts according to how frequently Medic One transports a patient from their area. According to last year's response levels, District 2 would be responsible for 19.71 percent of costs, while District 15 would be responsible for 28.49 percent, District 20 would be responsible for 9.06 percent, District 1 would be responsible for 16.12 percent, District 3 would be responsible for 4.46 percent, and District 8 would be responsible for 22.16 percent.

Districts 2, 15 and 20 would continue to contribute all patient revenue to Medic One and would pay for any remaining costs for their portion out of their fire district budgets. Districts 1, 3 and 8 would be allowed to determine, according to their own needs, how they would pay for their portions, and would instead be billed based on their percentage of overall costs rather than a fixed fee per transport, as they are currently billed.

Aside from no longer billing per transport, the proposed system would treat all Medic One responses as an advanced life support call rather than allow less-serious calls to be downgraded to basic life support, at least for the purposes of billing. Board members said this is because, even if a call is downgraded, it still costs Medic One the same amount to dispatch a paramedic. Medic One Business Manager Diane Wallace added, under the proposed system, she would expect to begin billing each district monthly rather than quarterly, stating Medic One has too little funding left in their reserves to go multiple months between payments.

Initially, representatives on the board said they would be in support of such a system, at least as it relates having clearer terms for the contract districts. However, Commissioner Terry Williams, of District 20, said the new system would mean around $17,000 more in expenses for his district, whose total operating budget is around $90,000 for the year, and said he would need to speak with his fellow commissioners to determine where such funding could potentially come from.

Officials from Districts 1, 3 and 8 are expected to share their views of the proposal during the next meeting of the Medic One Board of Directors (scheduled for 7 p.m. Feb. 17 at District 20 headquarters), after having met with their respective Boards of Commissioners this week.

While contract districts had previously insisted they would not continue negotiating solutions with Medic One until Wiltbank's position was eliminated (detailed in a letter to the board dated Jan. 15), the board has yet to either lay off Wiltbank or respond officially to the letter, and board members said they are uncertain if this will impact the potential for the proposal to succeed at their next meeting.

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