By Donna Thompson
The Times Telegraph
HERKIMER, N.Y. — Lack of funds, an aging fleet, a challenging geographic area to cover and a major growth in call volume are among the challenges the Mohawk Valley Ambulance Corps and other rural ambulance services face.
And if they are not addressed they could have a major impact on emergency transport services in rural areas.
MOVAC sponsored a symposium, “Need an Ambulance? Brewing Crisis in Rural Pre-Hospital Care,” Thursday evening at Herkimer College to lay out the ambulance service’s situation and discuss possible solutions. Local government officials joined MOVAC officers and members for the event.
MOVAC Board President Greg Eisenhut said the board’s goals are to keep the lights on and respond to ambulance calls in a timely and professional manner, but without sufficient funds this is difficult to do.
He said MOVAC will be asking municipalities in its service area to consider contributing $3 per resident for ambulance service. That amount would defray the cost of one or two new ambulances.
MOVAC would also consider another model, such as a part-county ambulance district, although this would likely be a more expensive alternative.
Municipalities pay for fire protection, Eisenhut pointed out, and there are grants available for fire departments. There are few if any grants available to ambulance services and most local municipalities that do not have their own ambulance service pay nothing.
State Assemblyman Brian Miller was on hand for the meeting and reported he had followed through on a $6,200 state grant that his predecessor, Claudia Tenney, had negotiated for MOVAC and the check would be forthcoming. He also commented that the problems MOVAC are having are ones he is hearing elsewhere in his district as well.
Having a crew on 24 hours a day, seven days a week costs about $350,000 a year, according to Eisenhut. To break even that ambulance must handle 1,000 calls, but transporting a patient to Bassett Hospital in Cooperstown could take close to three hours and traveling 80 miles to Albany Medical Center, four hours.
Workers’ compensation costs for ambulance workers are astronomical, Eisenhut said. MOVAC expects to pay $140,000 this year.
In the meantime, MOVAC is unable to pay its 47 employees a competitive salary. Without overtime, the annual salary for a basic emergency medical technician is $23,920 with the highest of the four levels, paramedic, receiving an annual salary of $33,280.
“It’s hardly the type of gross wages to make a career, even in Central New York,” said Eisenhut.
MOVAC is unable to provide its employees with health insurance and out-of-pocket expenses for training are often more than $7,000. The board is considering a raise and is offering up to a 3 percent match on a simple individual retirement account.
Even with the raise, the salary would fall below the salary offered by other agencies, according to Deputy Chief Adrian “Rick” Irizarry.
One reason for the shortfall in funds is that MOVAC does not receive anywhere near the amount it costs to run the service from insurance companies or patients. In January, for example, Priority, MOVAC’s billing service, reported that the service had gross costs of $527,132, with $417,804.92 in write-offs, for net receipts of $109,372.08.
Insurance contractual allowances write off more than 20 percent in many cases and lags in payments sometimes approach 9 months to a year, according to Eisenhut. Medicaid reimbursements are sometimes only 10 cents on the dollar and Medicare rates are less than 50 percent of the rate charged.
MOVAC receives no reimbursement if a patient refuses transport and responding with a fly car is not viewed as an ambulance response. One reason cited for the increase in call volume is the number of drug overdose calls. Once revived, many of those patients refuse further treatment, according to Irizarry.
MOVAC’s fleet includes five Type 1 ambulances and two Type 3 ambulances along with the fly car. Repair costs have been mounting on the aging vehicles. The two newest vehicles are Type 3 ambulances that have not performed well, Eisenhut said. At least one new Type 1 ambulance is needed.
Questions were raised about response times and whether MOVAC could refuse calls outside of its certificate of need area. Responses are slower if an ambulance is not available, Irizarry said. With the mutual aid agreements it has in place, the service cannot simply refuse a call.
Eisenhut said he is open to suggestions and wants to see the conversation continue.
Copyright 2018 The Times Telegraph