Ambulance department sees drop in revenues

     While typically not an issue, the Monticello City Council heard from CJ Johnson, ambulance director, regarding a drop in revenue for the Monticello Ambulance Service, affecting FY 2017 budget amendments.

     During the May 15 council meeting, a public hearing was held and the council approved proposed budget amendments.

     City Administrator Doug Herman noted that the expenses for FY 2017 will be reduced by $20,000, with revenues reduced by $1.6 million. The biggest pieces of the revenues are the city’s bonding proceeds, which drop by $1.3 million, and projected revenue from the ambulance department.

     Herman said that the city received the bonding proceeds before the end of the fiscal year, requiring an amendment.

     Ambulance revenues are projected to drop from $425,000 to $275,000, which Herman noted as being “significant.” He prefaced the discussion by saying the drop in revenues is in no way related to the way the department is being run.

     “It’s more a factor of Medicaid/Medicare reimbursements, collections in general, and call volume,” said Herman. “And we can’t control that.”

     Johnson explained to the council that the department has both billable and non-billable calls. Though, he did offer that already within the current fiscal year, the ambulance has had more billable calls than they did last, with a month and a half remaining in the fiscal year.

     Medicare reimbursement, which is down, makes up about 54 percent of the department’s total reimbursements. Medicaid makes up about 25 percent of those billable calls.

     “The government wants to get people to stop using ambulances that don’t need to use one,” Johnson explained of the decrease in reimbursements for basic calls. However, he said some of those people have no other option.

     “What Medicare and Medicaid say we get for a reimbursement, that’s what we get,” he said. “We have no say in that.”

     Johnson cited less transfers from Jones Regional Medical Center in Anamosa to Cedar Rapids or Iowa City due to improved facilities, services, and specialists coming to JRMC; patients no longer need to be transferred on.

     Council member Tom Yeoman asked, then, how the ambulance department could reduce expenses. Johnson said, “When people call, we have to respond.”

     “It’s going to get worse,” Johnson said of the overall situation, “before it gets better.”

     Herman said county townships provide funding for fire and cemeteries, but not for ambulance services. He said that lack of funding is something that should be addressed with the state legislators.

     Council member Brian Wolken asked, worse case scenario, what would happen if the ambulance continues to lose money.

     “The city is not required to have ambulance coverage,” said Johnson. Herman added that the closest service in Anamosa or Manchester would be called.

     The ambulance department also pays 8 percent of what they collect in fees to a private service to handle billing. Yeoman asked if that was still worth the cost. Johnson said Anamosa is now switching to a service due to the hassle of handling billing in-house.

     “It’s so specialized and there are so many changes that paying the 8 percent is worth it,” said Herman.

In other city business:

     • The council heard from Will Gingrich about allowing chicken ownership within city limits. The council will consider the proposal during a meeting in June.

     • The council approved voluntary annexations for The Sign Shop, Koob Automotive & Towing, the city shop, and the Monticello Machine Shop.

     • The council approved plans and specs for a new 10 T-hangar at the Monticello airport. Bids are due on May 31 at 10 a.m.

     • The council approved plans and specs for the Main Street resurfacing project. They also awarded the project to the lowest bidder, Eastern Iowa Excavating & Concrete, Cascade, for $493,503.54. The engineer’s estimate on the project was $720,939.40. All four bids came in under the estimate.

     Sidewalk work is likely to start before the fair, with the asphalt work on the roadway to begin after the fair.

     The project also includes changing Main Street from a four- to a three-lane street. Herman said the traffic control signals would also have to be changed.

     • The council approved issuing city credit cards with a $2,500 limit to the following departments: city clerk, city administrator (who will not be getting a card at this time), police, ambulance, library, and parks and rec.