County seeks stability in EMS costs

Supervisors call for a cap on the amount the county pays to Aspirus

Members of the Taylor County law enforcement committee want to take some of the guesswork out of budgeting expenses for the county ambulance service.

The county owns the ambulances and equipment and contracts with Aspirus to manage and staff the service. Aspirus bills patients for calls and care received with the county paying a subsidy each year to make up the shortfall in operations.

At last month’s county board session, supervisors had called for a cap to be put on the subsidy amount due to voting to authorize the ambulance to increase the number of full-time staff by 10 people.

The subsidy for 2021 is $498,041 which is the highest amount the county has had to pay. The subsidy, as with other ambulance expenses, is paid out of a special tax levy that is not part of the general county budget.

Committee chairman Lester Lewis was ambivalent about a formal cap, noting Aspirus has indicated they are making changes to lower the cost of the operating the ambulance service. “If their cost is lower, our cost should be lower,” Lewis said.

“The subsidy is a moving target,” said committee member Ray Soper. He supported that instead of a hard dollar amount, they should look at limiting the subsidy increase by 5% a year. Ambulance director John Deal told committee members that the county is currently covering 46 to 47% of the total operation costs for the service.

Committee member Scott Mildbrand said he was most concerned with the additional cost of the full-time employees and suggested limiting any increase for next year to being $10,000 more than this year’s subsidy.

Deal said another option would be for the county to set a certain amount of the operating cost that it would pay. Lewis said he was OK with however they set a cap, noting that under the terms of the contract as written Aspirus is allowed to keep any revenues that exceed expenses. He complained that the county has had to take Aspirus at their word on what those amounts were because the healthcare provider has not shared any of the books or records with the county.

“I don’t actually know what the cost to operate the ambulance in any given year is,” Lewis said. “At one time I was told there wasn’t any way I would get that information.”

“How do we set a percentage of what we don’t really get informed about?” he asked.

Lewis said that it is not that they don’t expect Aspirus to be making money on the service, but that they don’t know what the actual expenses are. “How do we know we are 47% of the expense or are we 60% of the real expense.”

“It is a moving target,” Soper said, noting the subsidy amount has bounced all over the place over the years.

Lewis said in his opinion the county’s portion should be quite a bit lower, considering the county foots the bill on the purchase of the ambulances and non disposable equipment. County finance director Larry Brandl said that historically, the county has been in about the 45 to 50% ballpark for costs. It was noted that if the county set it to not exceed 50% the cost could end up being $600,000 next year.

The challenge is not knowing the impact of having the additional full-time ambulance workers and not having any way to control how many times people call for ambulance assistance.

After a lengthy discussion, committee member Catherine Lemke moved to set the subsidy at 45% of the operating costs with Myron Brooks seconding it. The motion passed with all members voting yes. Lewis said he will take that guidance and use it when he meets with the county’s attorney to draft a contract. The contract will eventually go to the full county board for approval.

Ambulance purchase

Committee members voted 4-1 with Mildbrand opposed to purchase a new ambulance from Jefferson Fire and Safety of Middleton for a cost of $247,960.

Unlike existing ambulances in the Taylor County Ambulance Service which are built off a van chassis, the new one will be Superliner Type I built on a 2022 Ford F-450 truck chassis with four-wheel-drive capability.

Committee member Ray Soper questioned the need for liquid spring suspension that was in the ambulance specifications. He questioned the value of the liquid spring suspension over the expense of the upgrade and future maintenance costs.

Currently none of the county’s ambulances have liquid spring suspension, although Deal noted they have them in use elsewhere in the Aspirus system with six or seven out of 47 ambulances in Aspirus have liquid spring suspension. The intent of the suspension is to create a much smoother ride for the patients and the EMTs working in the ambulance.

Lewis noted he has been in a situation where an air transport was called out by a doctor to transport a patient from Park Falls to Marshfield because the roughness of the ride might hurt the patient. He noted that perhaps if a smoother ride was avaible, that patient could have saved the $12,000 cost of the air transport.

Deal estimated the cost of the upgraded suspension at about $7,000 toward the whole ambulance cost. He also noted that it comes with a five year, 60,000 mile warranty. Lewis noted the county intends to keep the ambulance in service for 14 years meaning it is 9 years without a warranty covering it, He suggested that if the county found that the maintenance costs were higher with that suspension type, the county would not include it in future ambulance purchases. “It would be the last one we would order that way,” he said.

Mildbrand opposed the liquid spring suspension saying he would vote for it if that was removed. In the end, committee members approved the purchase of the ambulance.

In other business, committee members:

_ Received an update on the interactions between the emergency management office and the human services department during a weather event that occurred in December that resulted in sustained power outages in Stetsonville leading to the opening of a warming shelter. Although no formal emergency declaration was issued in Taylor County, emergency management director Colleen Handrick followed the established response plan and directed human services to staff the warming shelter. Handrick reported she was met with questions about staffing after hours and whose budget it would come out of. Handrick noted that historically there had been a lack of involvement from human services in emergency planning and that they have set up a table top exercise on April 14 with other agencies to work through situations so that people are aware in the future. Lewis said he was disappointed with the attitude of negativity and reluctance to help in an emergency situation.

_ Received information that upgrading the sheriff’s department squad and mobile radios would cost about $295,000. Sheriff Larry Woebbeking raised the need for upgrading the 20-year old radios as the county’s fire departments are looking at radio needs. It was noted that the fire departments will be each submitting requests for their needs.

Supervisor Ray Soper questioned if the benefits in smoother ride from a liquid spring suspension were worth the additional costs in equipment and maintenance for a new county ambulance.BRIAN WILSON/THE STAR NEWS