The commissioners discussed the issue at a May 21 work session. In keeping with board policy, they took no official action.
FirstHealth has offered to provide this service under a contract calling for a base rate of $254 for transport plus $5.75 per loaded mile. The contract would include a 3.5 percent cap on a rate increase.
When the board considered the contract at an April meeting, it deferred action after Commissioner David Cummings questioned the cost of such trips for the uninsured and the poor. He suggested that the board should study the matter further before awarding the contract.
Cummings told The Pilot that the base rate offered by FirstHealth is not unreasonable but said he was concerned that many people, especially those located longer distances from the hospital, would be unable to pay the transport rate on the loaded-mile basis.
At the work session, the board learned that the county’s Emergency Medical Services program could provide this service at an estimated annual loss of $74,000.
Statistics provided by Deputy County Manager Michael C. Griffin and EMS director Barry Britt show that it would cost an estimated $110,000 a year to operate such a program.
This cost was based on a 10-hour workday, five days a week, involving two employees with part-time assistance. Salaries and fringe benefits would total about $101,000.
Griffin and Britt figured on an average of 20 miles per trip and 20 trips a month, adding up to about 4,800 miles a year. At 85 cents a mile, the vehicle cost would amount to $4,000. The remaining $5,000 would cover such miscellaneous expenses as uniforms, contingencies and supplies.
Because these would not be emergency cases, the county EMS would use older vehicles for such transport and the schedule could be reduced to those hours when people would be most likely to have medical or hospital appointments. Such trips are not usually made on weekends or at night.
Based on a projected 60 percent collection rate, the agency could collect about $36,000, leaving the remaining $74,000 to come from the Advanced Life Support fund. The ALS program, which finances the county’s paramedic and ambulance service, is funded through a special 5-cent tax paid by all property owners.
Britt told the commissioners that FirstHealth has reported a substantial increase in such calls since Boles Ambulance Service, a private enterprise, discontinued this service earlier in the year.
Board Chairman Michael Holden said he has reservations about the county’s going into business in competition with the hospital. “I’m not sure it’s beneficial for the county,” he said.
If the county were to offer the service, it would absorb an estimated 40 percent of the cost because many people would not pay the fee.
Medicare pays about $109 for the average trip, and some private insurance covers non-emergency transport as well. But many Moore County people have no insurance and are more likely to be rural residents and/or low-income.
Non-emergency transport is service to people who need an ambulance to get to the hospital, clinic or doctor’s office but are too frail to travel in a regular vehicle. Most non-emergency trips are generated by nursing homes, and many are for specialized treatment such as dialysis.
The subject will be returned to the commissioners’ agenda at a future meeting.
