the amount taxpayers pay to ….

the amount taxpayers pay to subsidize the department compared to last year. Overall the county’s subsidy of the ambulance service is projected to increase to $692,000. The actual amount of the subsidy will not be determined until the end of the hospital’s fiscal year.

“That is a lot,” said committee member Lori Floyd during the September 9 law enforcement and emergency services meeting.

Finance director Larry Brandl noted while the county’s subsidy was about $300,000 last year in the past it has been as high at $498,000.

While Taylor County owns the ambulance service, it contracts with Aspirus to operate it. Under terms of the agreement with Aspirus, the county is responsible for up to 45% of the operational cost of the ambulance service as well as the purchase of the ambulances and durable equipment.

According to EMS manager John Deal, the amount of the projected subsidy is after revenue from billing to patients is accounted for. He said the standard projected cost for ambulance services is about $500,000 per year per base of operations. Taylor County has ambulances stationed in Gilman, Medford and Rib Lake.

One of the challenges facing the county is the large percentage of patients whose transports are billed to Medicare (63%) and Medicaid (15%). Together they account for nearly 80% of all calls. Deal also noted that the vast majority of ambulance calls come during the day when their full-time staff is on duty.

Medicare has a set amount it will pay out for an ambulance call, Deal explained that other entities such as insurance companies follow a similar process. Historically the subsidy amount has been the difference between what Medicare will pay for the patient services provided, compared to what the actual cost to Aspirus was of providing the service.

Deal said the real driver for this year’s projected subsidy increase was in wages and personnel expenses.

Floyd questioned the need to switch from paid-on-call to full time positions. Deal explained that when he took over last fall there were large shortages in the number of volunteer responders. Floyd questioned if Aspirus was still requiring EMS personnel to get COVID vaccines, suggesting that peoples’ unwillingness to get the vaccine was why there were staffing issues.

Deal said that the vaccine requirement was cited by only four people as reason for them leaving. Floyd disputed that, noting she has heard differently and suggesting that if the rule was eliminated others would be willing to come back.

“It is a mandate, not a law,” Floyd said.

Aspirus representatives explained that the rule is not set by them, but is a mandate set by the Center for Medicare Services as a requirement for any health providers getting reimbursements from the federal program. Deal said that while the vaccine mandate is in place, staff members are able to get religious and medical exemptions and a number of staff including those currently on the ambulance crew have done so. Committee chairman Lester Lewis also noted that the numbers showing the overall number of on-call personnel included a number of people who no longer took shifts.

“My only squabble is the total expense,” said committee member Ray Soper.

Brandl explained that the subsidy will have an impact on the county tax rate, but clarified that this is outside of the overall tax levy limit so will not impact the other portions of the county budget.

After a lengthy discussion, committee members approved the subsidy projection and passed along to the county’s finance and personnel committee to be included in the county budget.

Emergency management

A request to increase the emergency management budget to allow coordinator Daniel Gellert to go from 35 to 40 hours per week divided committee members.

According to Gellert, the additional hours would translate into being $9,689 in additional wage and benefit costs for the department. He noted he was already working on average more than 40 hours per week to get the work completed.

“Being a one-man office there is plenty of work for my position,” Gellert said.

However Soper noted he felt this should be a personnel issue versus a budget issue. He said he would like to see Gellert make his case to the county’s finance and personnel committee. That committee will ultimately be the one to make the decisions on it.

Lewis said the option for the committee is to approve the department budget with 35 hours or with 40 hours. Gellert had presented proposed budgets with both options. With committee member Chuck Zen-ner absent for that portion of the meeeting, motions to send it with 35 hours failed on a tie vote and a motion to send it 40 hours also failed on a tie vote. Finally a compromise measure was reached to send it with 35 hours while also ensuring it was on the finance and personnel committee agenda for action prior to the budget review. That motion passed 3-1 with Floyd opposed. In other business, committee members received an update from sheriff Larry Woebbeking about feedback from recent jail inspections and the steps being taken to remedy areas of concern.

With the county about four jailers down in staffing, Woebbeking said there is concern that the sergeants are working shifts and not able to provide the needed oversight of personnel. He said they are looking at adding a corporal position to the jail staff to provide additional oversight on shifts without a sergeant or someone from department administration on duty.

“They would fill in the gap,” Woebbeking said. He said it would give someone a little bit of supervisory authority.

He also updated committee members on new devices they are looking at which are about the size of a smartphone and will be used to have reminders and log things such as when medications are delivered to inmates or to make sure those on suicide watch are being checked. He said there would be something by the cells that the devices would have to scan. He said they are working to have this data flow into the sheriff’s department existing data records system.