Public ambulance district steers in the right direction
Exeter District Ambulance (EDA) has made some great strides since its change over at the top. Only one board member remains from a tumultuous 2014 that sent the district spiraling into a spring of discontent. But all of the changes seem to be good for business, or at least EDA thinks it is.
At its Sept. 24 meeting, the district’s Board heard a report from District Manager Kim Damico comparing EDA finances from August 2014 to the present. At first glance, the news was excellent as EDA had cut down its net loss from $140,000 in August 2014 to just $3,000 in August 2015. Hired to replace Lifestar as management in May, Damico said the district should have been about $7,000 in the black if not for a $5,100 fine for breach of contract in October through December of last year for failure to meet its 97% rate of arriving to calls within the designated time set by Central California Emergency Medical Services Agency.
“We ended up not being in breach but we had to pay the fine when it was due,” Dimico said.
EDA should have finished the 2014-15 fiscal year in June with a net income of $13,000; however, Damico said about $111,000 was spent to replace or repair aging equipment and correct errors made by the previous management. A portion of that, about $20,000, was used to purchase new billing software that will allow better tracking of calls for service including peak time, payer mix, peak days, peak locations, etc.
“Our intention was to fix this place overnight and I come in every day with that mentality,” Damico said.
Damico has managed to cut several categories of operating expenses through the first two months of the new fiscal year. Communications, such as dispatching and the office phone, as well as vehicle maintenance and building maintenance have been cut nearly in half. Utilities are down nearly one-third and fuel costs are down 60%. Expenses did rise in key employee areas including salaries, workers compensation and retirement much of which is due to paying a full-time manager instead of contracting out management. Despite all of the good news, new Board Treasurer Stacey Walter said with all of the changes it is impossible to get a clear picture of finances at this time.
“It will be at least a year before expenses and revenue match up,” said Walter, who is an accountant by trade. “It could end up better than it looks on paper.”
Roger Dillon, a certified public accountant with Morris, Sprague, Graen and Neese, presented the district’s year-end audit to the Board. Both revenues and receivables were down for the year. Revenue from calls was down nearly $200,000 and receivables from calls were down $70,000 due to dwindling reimbursement for MediCal and Medicare.
“Being here just a week or two there seems to be a lot of change,” said Dillon, whose firm was hired in April. “All of these things will affect expenses by the end of the year we just don’t know by how much.”
And while some expenses appear to be up, EDA may be bringing in a lot more revenue this year. Damico told the Board she has filed all of the paperwork to apply for MediCal reimbursement through the State of California retroactive to 2010. Known as the Ground Emergency Medical Transportation (GEMT) Agreement, the program could increase the public ambulance agency’s reimbursement rate from the less than 10% it collects from the State now to 50% of allowable total certified costs on each Medi-Cal patient from Jan. 30, 2010 going forward.
Medi-Cal reimbursements have been cut nearly every few years since the 1980s. Because many Tulare County residents fall under Medi-Cal, the dwindling rate nearly forced EDA to close its doors in the mid-1980s and implement major cutbacks in 2002.
Dimico said it is unclear how much money the district will receive but said it has ranged between $50 per call to $150 per call with other agencies. That could be significant since EDA responds to about 200 calls per month with about 70% being Medi-Cal and Medicare.
“Although call volumes are going up, most people do not have private insurance in Tulare County, so we don’t see much of that money,” she said.
EDA was also approved for a Cal Card, a State-issued credit card for public agencies that allows them to make purchases without finance fees and charges.
“It’s a huge difference from where we were to where we are now,” Damico said. “It’s great to stand on our own two feet.”
The next meeting of the EDA Board will be at 3 p.m. on Thursday, Oct. 22 at the District Office, 302 W. Palm St. in Exeter.