In Thursday's council meeting, Councilmen Moore, Jones Sr, and Yelverton took steps to ensure Demopolis and Marengo County may not have an ambulance service in the near future.* The Finance Committee had a proposed budget--one that included money for the Tombigbee EMS service currently operating out of BWWMH as subsidy.** The agreement was contingent on the City of Linden and Marengo County agreeing to similar contracts.* The City of Linden and Marengo County refused to agree.* The Demopolis Council, instead of revisiting BWWMH to see what else could be done, took a different route.
Councilmen Moore, Jones Sr, and Yelverton, and recently defeated mayor Williamson added in some last minute changes--changes that took the funds from TEMS and applied it elsewhere.* The members of the finance committee Collins and Cooley had NEVER SEEN the proposals until it was sitting on the table for a vote.* Without discussion, the three councilmen (who had apparently had a peak before the meeting) voted it through.* BWWMH was willing to negotiate ambulance coverage for Demopolis, but now the money has been budgeted elsewhere.
Who knows why they did this.* Williamson commented the prospect of the ambulance problem is now a problem of the "next administration".* It seems Williamson is so full of fail it's going to continue to the bitter end.* Nothing worse than an incompetent politician with borrowed power and no reason to keep constituents happy.
I hope the "next administration" can fix this mess.* Obviously Melvin and Thomas will still be around.* Hopefully a new majority can begin making good decisions for a change.
I can't see where TEMS / BWWMH needs a subsidy for the ambulance service. BWWMH currently reaps its share of funding from the one cent sales tax forced on the citizens of Marengo County a couple of years ago. Furthermore, the City of Demopolis committed its portion of the one cent sales tax to BWWMH. Subsidizing the ambulance service DOES NOT GUARANTEE an ambulance to be available for every call. I cna see why the City of Linden would not go for a subsidy. TEMS / BWWMH can't seem to keep an ambulance in Linden on a regular basis. I can see why the county wouldn't subsidize it. They had to shove the one cent sales tax on the citizens of the county in part to fund indigent care in the county. This should include ambulance service provided by TEMS / BWWMH. However, TEMS has been known to shirk its service to citizens in the south end of Marengo COunty to Clarke County based ambulance serivces Lifeline or Jackson Emergency Transport Services (JETS) because either TEMS has no ambulance available to catch the call, or its ambulance must respond out of Demopolis, thereby delaying prompt medical attention to the citizens in the south end of the county.
To make matters worse, rumblings in the grapevine say CEO / Administrator Mike Marshall is considering selling the ambulance service citing poor reimbursements from insurance for its services. The rumblings from the grapevine also say TEMS personnel are scrambling and scrapping to keep the hospital from selling the service, saying they believe they can make significant improvements which will in turn result in better reimbursements from CMS. Thing is, DCH has just sold its Fayette County Hospital Ambulance Service to NorthStar Paramedic Services out of Northport, citing falling revenues as a result of poor reimbursements from CMS (Medicare) resulting in $200,000/year losses for its ambulance service. Sounds like BWWMH / TEMS is facing the same crisis. I believe the Hospital Baord should take a good long look at this before selling out or shutting down the ambulance service in Marengo County. Maybe the Financial / Billing Department of the hospital needs some scrutiny to see if it is properly coding claims for the ambulance services it is billing CMS.
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I can't see where TEMS / BWWMH needs a subsidy for the ambulance service. BWWMH currently reaps its share of funding from the one cent sales tax forced on the citizens of Marengo County a couple of years ago. Furthermore, the City of Demopolis committed its portion of the one cent sales tax to BWWMH.
Indigent care doesn't stop at the ambulance. The hospital is giving over a million dollars a year in "charity" care. The ER stays packed with indigents who use them as a doctors office. The hospital doesn't have the luxury of turning away patients who don't pay their bills.
The Demopolis payment wasn't a yearly deal. The money from the county was around $250,000 if I recall correctly.
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According to the Demopolis Times article, the money was withdrawn because the rest of Marengo County was not giving any money to TEMS. Demopolis seemed to be the only one that had provided money in the past,
Quote:
The Demopolis City Council’s decision not to include the Tombigbee EMS ambulance service in its 2008-09 budget was just the final step in the service’s request to be subsidized not only by the City of Demopolis, but also the City of Linden and Marengo County, each of which had also not provided any funds for the service.
It was just a formality, actually, as it was an “all-or-none” agreement, with each entity’s requested subsidy determined as a proportion based on the number of calls answered in each area over the last three years.
“The way it was originally proposed was we went to the three governments, and this was an ‘all-or-none’ concept,” said Arthur Evans, the chief financial officer of the hospital. “That was the difficulty, was that it had to be an ‘all-or-none’ concept, where they each equally and jointly shared in the responsibility to help assist the ambulance service.”
I think it is crappy for the city not to offer funds to TEMS, but the City of Demopolis cannot be the only place in the County that funds TEMS, the rest of the County must pay its fair share. On another note, all employees did get a 4% raise this year, that is up from 2% they have gotten the past few years. With cost of living going up, I think that is great!
The ER stays packed with indigents who use them as a doctors office.
Oh, they were doing that when I worked there back in 1992 - 1993. That isn't going to change unless they start turning them away and telling them they have to wait until the doctor's offices open the next morning. But that isn't going to happen because they aren't supposed to turn away anyone. It's a catch 22. Damn if you do, damn if you don't.
Hello my name is Melvin Yelverton, yes I am on the council and I voted to cut the money to the ambulance service. When the ambulance service asked for the money they said it was all three or nothing, that is: if one did not it was a no go. They did not say that we want to do just Demopolis if they paid. I have been unhappy with the responce time and have met with the hospital personal 2 or 3 times my first term in office about it . This is one of the main reasons I fought so hard to get the Fire Department certified as first responders. If they save just one life it is worth it. People ride by and see all the ambulances parked at the back of the hospital and think they are well protected. The ambulance service has 1 crew in Demopolis and 1 crew in Linden during the day and just 1 crew after midnight for the whole county.
If 1 ambulance goes on an out of town transfer there is just 1 ambulance to serve the whole county. This is not hearsay, I have proof and like I said I have had more than 1 meetings with the ambulance staff.
I do not mind people second guessing me about votes I make, that is their right, but I promise that I always vote on what I think is best for the people of Demopolis, and if you want to go back and check, this is the first budget in 3 years I voted yes on, because this budget in my mind was what was best for the city of Demopolis. I was elected and re-elected to do what is best and that is what I have always tried to do.
If you ever have questions about anything that you think that I have done please feel free to contact me. 334-289-4859 is my home number.
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Indigent care doesn't stop at the ambulance. The hospital is giving over a million dollars a year in "charity" care. The ER stays packed with indigents who use them as a doctors office. The hospital doesn't have the luxury of turning away patients who don't pay their bills.
The Demopolis payment wasn't a yearly deal. The money from the county was around $250,000 if I recall correctly.
From what I understood, a portion of the county mandated one cent sales tax was to be used to pay BWWMH for its indigent care. The county is responsible for paying BWWMH for this on a yearly basis. This was not a "one time payment", but a recurring expense to the county.
I believe you are correct in the decision by the City of Demopolis to give their share of the county's one cent sales to the hospital was a one time deal. That happened under the tail end of Austin Caldwell's administration if I remember correctly. Do you really think Cecil Williamson as Mayor of Demopolis would have considered giving the hospital the city's share of that money???
I am quite sure BWWMH is rolling this $260,000+ ambulance service loss into its charity care figures.
Back to topic......
A question I have asked previously and has never been answered......
What has BWWMH done in regards to recouping expenses from the indigent care it renders to people from other counties??? TEMS / BWWMH serves parts of Greene, Perry, Hale, and Sumter Counties, yet has not publicly stated it has attempted to collect monies from these entities. TEMS services Greene County as far north as Forkland and Boligee, Sumter County as far west as Bellamy and Coatopa, Hale County up to the Lock 5 turnoff, and into Perry County as far as Uniontown (although Perry County has utilized EmergyStat and more recently Care Ambulance to cover Perry County since TEMS pulled its operation out of Perry County years ago). Maybe they need to consider cutting response area to just Demopolis and Marengo County and let these other counties pick up their obligations if they are not providing funds to BWWMH / TEMS.
Another cost cutting measure would be to downsize the ambulance service. I cannot see why TEMS must have 5-6 ambulance vehicles when they can only staff maybe 3 of them at any one time. This would save them a tidy bundle in equipment, maintenance, fuel, and insurance costs. They could also go back to keeping ambulance crews in house unless they are responding to calls. I have noticed a change in policy from years past where ambulance crews are now allowed to leave the hospital and patronize local restaurants. With diesel fuel over $4/gal, that would save some money, too, especially when the crews leave ambulances idling in the parking lot of the restaurants while spending 30 minutes or more in a restaurant eating.
Another cost cutting measure would also be to do away with the SouthernLinc service they currently have in favor of using the VHF radio system they currently have and utilizing a more cost effective cell phone service.
I think Mike Marshall could do some "fat trimming" in the TEMS department without compromising service if he really wanted to do so. I am also sure if they worked hard enough, they could improve the insurance reimbursement for their services if they were to consult people who were better versed in ambulance / insurance reimbursement. Carol Howell who used to be co-manager of AmServ in Bibb County years ago is a pro at this! She knows Medicare / Medicaid reimbursement for ambulance services inside out, backwards and forwards! AmServ is a hospital based ambulance service just for the record.
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Need An Ambulance? Call the Council
Re: Need An Ambulance? Call the Council
Re: Need An Ambulance? Call the Council
