By: Jeremy D. Wells
Carter County Times
The Carter County Ambulance Board met in regular session on Monday, with director Rick Loperfido providing the board with additional information on his recent meeting with representatives of St. Claire Regional Medical Center, the Rowan County ambulance service, and the Rowan County judge executive.
Loperfido said that he, board chair John Brooks, and Carter County Judge Executive Mike Malone attended the meeting, along with ambulance service representatives and judge executives from “five or six counties” who are experiencing the same issue with St. Claire.
Despite an extended meeting, Loperfido said, they left with “no conclusion reached during the meeting, other than to continue to do what we have been doing to assist our county residents return home when we have units available, and a truck at the hospital dropping off a patient.”
He said he did have a suggestion for the hospital, however, funding a dedicated transport with the Rowan County ambulance service.
He said he learned that St. Claire can be fined up to $8,000 a day for keeping patients who have been granted a medical release, which should give them incentive to help fund those types of transports. Especially, he said, since they are experiencing this issue with ambulance services from several surrounding counties.
He said he’d researched the number of “haul backs” by searching for calls originating in Rowan County and found that – so far this year – they’ve hauled back 42 individuals. That’s compared to 46 individuals total for 2021.
When you multiply that by the number of counties impacted, especially for some of the smaller districts who have as few as two trucks, it could be cheaper for the hospital to fund a dedicated transport truck than to deal with the fines.
“Many of these counties are in the same situation we are,” Loperfido said, explaining that like Carter County they were funded by a special 911 district tax and could themselves be fined up to $10,000 if they were on a transport call and unable to respond to a 911 emergency.
“This service is about 911 calls,” he said. If they were unavailable because of a transport, “the service could be really hurt.”
Finance director Valerie Nolan also asked to speak, addressing the contention that insurance will pay the ambulance service for transports.
Besides the fact that the calls don’t originate inside Carter County, she said, the service already has a significant problem with insurance refusing charges. So far this fiscal year, she said, they’ve incurred nearly $125,000 in write-offs for runs that insurance refused to cover. If they continue at the current level, she said, the service will have provided more than half a million dollars in unpaid service.
She also noted that if St. Claire wanted to extend good faith, they could offer to guarantee any transport runs that were refused by insurance. That, she said, would still be cheaper than an $8,000 fine.
She also said it was a problem unique to St. Claire.
“KDMC doesn’t call us like that,” she said.
In old business Loperfido told the board they are still waiting on a computer board for their O2 system, and continuing to have their oxygen tanks filled externally.
In new business Loperfido noted that the Kentucky Ambulance Providers Association will be increasing their dues from $325 to $500 in the next year.
Part of the reason for that, he said, was extensive spending on work towards new legislation that increases the amount paid through the Medicare reimbursement formula by 8.7% in 2023.
Nolan said the most exciting part of this is that “as goes Medicare, so goes the industry.”
While it isn’t guaranteed, she said, it increases the likelihood that some insurance payouts will increase to match the Medicare standard.
In other action Loperfido gave an update on vehicles, including one truck out of commission after hitting a deer and another with engine failure. Because of that, he said, they’ve brought Carter-1 back online for use, should they experience any significant delays to repairs.
Loperfido and Brooks also discussed the terms of an equipment loan discussed through Commercial Bank of Grayson. The loan would cover $610,000 for the purchase of seven new LifePac heart monitors, seven new patient stretchers, and seven Lucas’s heart compression devices, financed over seven years.
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