County health center hopes to work toward county-run ambulance service

MT. PLEASANT - As the Henry County Health Center temporarily halts discussions about emergency medical services with the county Board of Supervisors, the hospital will continue to explore long-term solutions involving the service.

Henry County Health Center Chief Operating Officer Michelle Rosell presented a letter from the hospital's board of trustees to the supervisors on Thursday morning. The letter was approved by the hospital's board on Tuesday.

The letter notes 'there are a number of outstanding issues that still need to be determined in order to move forward with any one proposal” and due to the quickly approaching deadline for a levy to be presented to voters on the November ballot, the hospital has decided to pause discussions to 'better evaluate what is best for the EMS program.”

In the letter, the hospital indicates it will approach the supervisors again 'at a later time … if needed.” Rosell said the hospital does not currently have a specific time frame on when discussions would resume.

Before halting discussions, the Board of Supervisors and the hospital were working to present a levy to voters that would cover the approximately $670,000 in losses the hospital incurs from continuing to operate EMS. The proposal came after the supervisors spent several months considering taking on EMS as a county service.

'The concept of a subsidy to cover the overhead allocations … that's appreciated, but the more we really assess that, we're not sure that is the right type of fix because it is not removing the service from the hospital, and we aren't having a long-term impact on the overall reimbursement,” Rosell said.

The COO added the hospital could 'adjust its levies for that short term fix” more easily, but its overall objective would still be to see EMS under county ownership.

'It boils down to that Medicare reimbursement impact that having a nonreimbursable service [has],” she added. As a critical access hospital, Henry County Health Center continues to lose reimbursements by running EMS.

Rosell said another component that contributed to the hospital's decision to pause discussions was the recent closure of its labor and delivery unit in June.

'We've seen just in the month and a half a positive financial impact to our payer-mix ratio. Just that slight shift in payer-mix ratio, changes our reimbursement. It's really early, but we've seen a slight positive shift,” she said.

At the hospital's Board of Trustees meeting on Tuesday, the hospital's Chief Executive Officer Robb Gardner said a higher propensity of Medicare and Medicaid in the hospital's payer mix leads to lower income statements for the facility.

Supervisor Greg Moeller asked Rosell whether there are any federal or state efforts that would help resolve the reimbursement issue. During the most recent state legislative session, a measure that would have allowed counties to fund EMS died before it could make it to the Senate floor.

Rosell added potential efforts at the federal level include rural emergency hospital legislation which would give critical access hospitals an opportunity to be redesignated as rural emergency hospitals, which would make EMS a cost-based reimbursed service.

'There's also discussion at the federal level about other needs for critical access hospitals and reevaluating what services can and cannot be cost-based reimbursed and EMS is on that discussion table,” Rosell said.

Supervisor Marc Lindeen added the board would like to help advocate for changes with local representatives.