By Sue Moore
South County Emergency Medical Services (EMS) has earned a certification so far achieved by just a couple of hundred of the several thousand of this country’s ambulance services: It’s been certified in best practices and procedures by the national Commission on Accreditation of Ambulance Services.
Besides the quick response and turnaround times the South County EMS service provides, it uses the most up-to-date vehicles and the latest equipment to help save a life. The CAAS report commended this small agency for its exceptional service but noted that quality comes at a cost; the community will need to decide how it wants to support the vital service. While not yet on life support, one day last year it had only $39 in the bank to make payroll, Louis Cox, one of the CAAS inspectors, noted.
The main reason the service is in financial straits is because it doesn’t get fully reimbursed for the cost of each run. If a patient is served by Medicaid, the standard payment from the government is $125 but the actual cost is about $700. Medicare payment is $330, no matter the cost incurred. For years, private insurance helped to pick up the difference because it paid in full. The Affordable Care Act has brought an increase in Medicaid runs and aging residents using Medicare. Thus, the local EMS ends up writing off nearly half of its billings, according to Wes Schmitt, the EMS board president.
To offset this dilemma, South County EMS went into debt to purchase two new ambulances and started to work with Borgess and Bronson Hospitals to provide medical transfer services which could be an additional revenue stream. They have competition for this service from Life and Pride ambulance companies.
Another source of revenue has come from memberships from families and individuals. At $50 a year, it resembles a life insurance policy. If a member gets sick and calls 911 for an ambulance and the total bill comes to over $1,000 but their private insurance will only settle for $750 payment, the difference does not have to be paid by the individual. Memberships from healthy people is a big advantage in helping to defray the costs. The reality is that one never knows when an ambulance will be needed.
South Kalamazoo County has had its own ambulance service since the funeral homes were legislated out of picking people up back in the 1960s. Vicksburg was served by volunteers until the late 1980s when the state began to require trained emergency technicians be employed and on duty 24/7. That’s when Schoolcraft and Vicksburg volunteers got together and set up the South County EMS, bought a building behind Bronson Vicksburg hospital and started staffing the service with full time paid personnel.
A long-time volunteer, Nancy Decker, tells the story of trying to not accept payment for her services. The state law required the service to reject her offer. Ever since, the required training for certification of EMS providers and paramedics has increased each year.
The Kalamazoo County Medical Authority headed by Dr. Bill Fales oversees all the ambulance services operating in the county. At Fales’ urging, all three local EMS services applied for certification by CAAS and were approved. It was a rigorous process requiring time and attention to every possible detail of the medical procedures.
“South County EMS provides exceptional service for such a small agency,” the inspector wrote. “They met all 60 criteria, receiving a three which meant ‘exceeds expectations.’ This is one heck of a management team,” they told Schmitt. There were no deficiencies in the 125-page report. There were some suggestions that the board will take action on, Schmitt said.