EMS and SKCFA in Discussions Over Finances

Standing in front of the building that houses the South County EMS ambulances are left to right: Wes Schmitt, president of the South County EMS board; Vicki White, administrator EMS board; Lea Bailey, paramedic; Chris Koeneke, emergency medical technician.

By Sue Moore

When you feel the clutch of a heart attack or perhaps a stroke coming on, what do you do?

What you should do is call 911 to get medical attention as quickly as possible. Does it matter who comes to your aid? No. Just that they get to you quickly and let you live a while longer.

How quickly aid will come to residents in the Vicksburg, Schoolcraft, Scotts, Climax and Fulton areas is about to be an issue.

Those 911 calls for the last two decades have been answered by South County Emergency Medical Services (SCEMS), a nonprofit organization. It is run by a local board of directors and staffed by local area licensed emergency medical technicians (EMT) and paramedics.

In the rest of Kalamazoo County, those services are supplied by three for-profit companies: Life, Life-Care and Pride ambulance services. They and South County EMS are the only providers licensed to operate in this area.

Wes Schmitt, president of the SCEMS board (disclaimer: Schmitt is also secretary and treasurer of the South County News), appeared at the South Kalamazoo County Fire Authority meeting in May to reveal the precarious financial position of his EMS operation. He outlined the need for financial support to continue going forward, saying that it couldn’t continue to operate for much longer under the contract it has with the fire authority.

Authority chair Jason Gatlin referred the matter to his board’s financial committee which will meet and review the request. He did not indicate if there would be a quick decision.

“All of our revenue is received from reimbursements from Medicaid, Medicare or private insurance. A small amount of revenue comes from memberships and grants,” Schmitt told the authority board. “The South County Emergency Services Board feels our current operation best serves our local citizenry. It is our intention to pursue every avenue possible for financing our operations. One of these avenues is financing from the SKC Fire Authority.”

“We feel this upcoming fire authority decision is so important that we are going to begin a public notification of our current status, so that each citizen can provide elected officials with input as to what they feel will best serve them and what cost are they willing to incur,” Schmitt said.

He said that all ambulance services have been impacted by the Affordable Care Act. It has significantly increased the number of Medicaid clients in Michigan. Also, increased life expectancy has expanded the number of Medicare clients.

But repayment of actual costs has not kept up with the reimbursement received for billed services. For South County, the write-off of non-collectible debt in 2016 has increased from 20 percent a few years ago to over 45 percent. To offset these losses, SCEMS contracts for paramedics with Pride Care, and pays its EMT’s at the low end of the local industry average to keep benefit costs under control, Schmitt said.

The saving grace in April, 2016 was a patient transfer program the ambulance service began with Borgess Hospital. This helped because the insurance companies’ payment helps to offset the costs of the 911 calls.

But that changed on April 1, 2017, when Borgess switched to Pride Care to provide all transfers. Schmitt said he was taken aback and did everything in his power to reverse that decision. He was successful; South County will resume participation with Borgess beginning in July 2017. But the lag in billing income is significant; it won’t be realized for another 90 days. In the meantime, Schmitt and the South County board say they need support from the Fire Authority.

He went on to list the outstanding obligations of the EMS board. The ambulance debt is approximately $130,000 with the two vehicles easily worth that amount, he said. This debt is held by Arbor Credit Union. Debt on the building housing the ambulances behind the hospital is approximately $205,000. While the building is appraised at approximately $350,000, the building’s usefulness is limited. This debt is held by Kalamazoo County State Bank.

The financial future is up to the Fire Authority board, comprised of one representative from the townships of Wakeshma, Brady, Schoolcraft and Prairie Ronde and the villages of Vicksburg and Schoolcraft.

These entities have choices too, according to Randy Smith, Brady Township supervisor. They could choose to contract with the other ambulance services in the county.

Or the Fire Authority could rescue SCEMS through a contract for services, Schmitt said.

But the communities would want to know if response times would be the same or worse, Smith insisted. They would want to know if their costs be the same or more. “We need to find all of that out before we can move forward. We can’t just give them money, that would be illegal. SCEMS needs cash now. Government doesn’t do cash now,” Smith said.

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