Church Hill EMS is licensed to run calls in Sullivan County and has been for years, but it primarily responded to “Code 80,” or non-emergency transport calls, sometimes called convalescent calls, Venable said.
“First and foremost, the emergency responses, and I think maybe Church Hill had been covering responses in the Kingsport portion of Hawkins County, our EMS will certainly respond there without hesitation, and we are fully capable of doing that,” Venable told the Times-News. “We are prepared for a 911 call today .. anywhere we get one in the county, we can handle it. Church Hill EMS was not involved in 911 calls and that type of emergency in Sullivan County to my knowledge. If they were, we certainly can cover anything they were doing. The other things is convalescent calls ... people who need to get to the doctor and need ambulance services for whatever reason to those appointments ... we’re preparing right now to be able to cover all that. I think we are staffed up now to where we won’t miss a beat. But we’re reviewing where we’re at, and we are prepared to hire additional people and put on additional equipment.”
Although an arm of county government, Sullivan County EMS has long been expected to pay for its operations through non-taxpayer-generated revenue. In other words, it is expected to keep its expenses within whatever revenue is generated through patient charges. But that revenue, as elsewhere across the nation, has dropped in recent years due to changes in Medicare and other guidelines for federal reimbursements.
As a result, the Sullivan County Commission did redirect some funding to the county’s EMS last year to provide cash flow during periods when payments were not keeping up with billing.
Sullivan County EMS billing is handled through a third-party contractor — as is a professional collection service to go after unpaid bills after a certain time.
And last year the Sullivan County Commission approved designating $349,000 of general fund revenue (basically one penny on the county’s property tax rate) to provide capital outlay to Sullivan County EMS. That figure is repeated in the budget just approved for this year.
Sullivan County’s budget for the fiscal year that began July 1 and runs through June 30 of next year estimates Sullivan County EMS (listed as “ambulance service” in county budget documents) will have total revenues of about $5.34 million, with $5.3 million coming from patient charges. On the spending side of the balance sheet, the current budget estimates Sullivan County EMS will have expenditures of just over $5.23 million. Neither the estimated revenue or the estimated expenditures include the $349,000 for capital outlay, which is listed separately under the general fund.
“Our main objective is to answer emergency calls. Somebody had a great idea, maybe, 20 or 30 years ago, that we could subsidize that as much as possible and keep it off the taxpayer by being involved in the business you could actually make a profit on — and that’s the convalescent calls. We are at a lower level than we were in the past (on convalescent calls).”
Venable said there are two reasons Sullivan County will prepare to fill any void in convalescent calls due to the demise of Church Hill EMS.
“Number one: public service,” Venable said. “That’s part of it. But number two is if we can determine that that’s a profitable business that will keep our tax rates lower and subsidize emergency service. Now, we’re going to do the emergency service whether it is profitable or not. That emergency response is our main priority. But the convalescent will subsidize that and keep that (EMS) off the tax rate. Quite honestly, with the way the government and insurance companies are paying for those convalescent type services now, it doesn’t appear that profitable. This is happening from Memphis to Mountain City. Medicare, Medicaid and insurance reimbursements are going down. We are trying to find a niche and find out at what level it will become profitable.”