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Sullivan County EMS seeks another cash transfusion

J. H. Osborne • Feb 14, 2016 at 12:00 PM

BLOUNTVILLE — The Sullivan County Commission will be asked Tuesday to approve $350,000 in funding for the Sullivan County Emergency Medical Service to try to keep the nonprofit agency solvent the rest of this budget year.

The money would come from the county’s general fund “surplus.”

The EMS continues to experience declining revenues, Director Gary Mayes told members of the county’s Budget Committee during a called meeting Thursday.

The committee agreed to draft a resolution for the full commission’s consideration Tuesday.

Sullivan County Accounts and Budgets Director Larry Bailey said Thursday that his office had multiple unpaid bills it needed to pay for the service, which responds to 9-1-1 calls countywide.

Bailey said that as he spoke — during the hastily called Budget Committee meeting, in a backroom of the historic Sullivan County Courthouse after a monthly work session of the full Sullivan County Commission — roughly $30,000 in unpaid bills owed by the EMS lay on a desk in his office.

Back in October, Mayes and Bailey came to the Budget Committee with a similar situation.

At that time, Bailey said the unpaid bills tallied around $60,000 — and coupled with his office’s having just made payroll for EMS employees for the most recent pay period, the service was left about $79,000 in the red.

The answer back in October was the immediate transfer of about $300,000 from the EMS’ capital funding account to cover its operational costs.

The Budget Committee approved that transfer.

Commissioner Mark Vance, however, voted “no.” Vance said that money was only added to the EMS budget when this year’s budget was approved in August to pay for much-needed ambulances.

That money was added to the EMS budget with one cent of the county’s property tax rate. That one cent is the only portion of the tax rate that goes to the EMS, which has for years been expected to pay for its own operation through its revenue.

But Mayes said revenue has been on a steady decline in recent years due to changes in reimbursement guidelines by Medicare and by a shift toward more and more patients being “self-pay” because of much higher deductibles.

Mayes said the problem is not unique to Sullivan County EMS, but is pervasive among ambulance services — both public and private — across not only Northeast Tennessee, but nationwide.

While the EMS would ideally like to have 65 days worth of “cash on hand,” it now operates with only about four days worth of cash on hand, Mayes said in October.

On Thursday, Bailey said the EMS’ balance on hand was about $200,000 — but the next two-week payroll will take a majority of it.

Bailey said last year EMS revenue averaged $372,000 per month, and for January the total was $309,000.

Mayes has said Sullivan County EMS runs 21,000 calls per year and Medicare has been refusing to pay about 400 per quarter, or 1,200 per year, based on the ALS/BLS coding.

As he did in October, Vance again questioned Mayes on the EMS’ use of a third-party, Paducah, Kentucky-based company to do all the agency’s billing for the past four years.

Vance said the EMS is spending about $200,000 per year on that company, and he thinks it would be better to go back to doing the billing “in-house.”

Mayes said that absolutely would cost the EMS more money than paying the company in Paducah, which provides everything — computers, software, personnel, postage — to provide billing.

The Sullivan County Commission is scheduled to meet at 9 a.m. Tuesday on the second floor of the historic Sullivan County Courthouse.

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