HCHC vows not to end ambulance services until viable option found

Supervisors discuss forming an exploratory committee to look into possibilities for future

MT. PLEASANT — The Henry County Health Center (HCHC) announced Tuesday it will continue to provide ambulance services until another viable option is found.

On Tuesday, Nov. 12, HCHC CEO Rob Gardner spoke during a joint meeting of the Henry County Board of Supervisors and HCHC board of trustees and said although the hospital is looking to drop the service, it has no date in which it will drop service.

“We will not cease ambulance services in June 2020,” he said in response to an article published in The Union where Fairfield City Council Member and Ambulance Board member Paul Gandy was quoted as saying it would. Henry and Jefferson counties had discussed pursuing a joint ambulance service.

HCHC representatives have previously stated the hospital would drop the service because it is too costly to maintain, however no firm date had been stated. At the meeting Tuesday night, Gardner said he felt the services was critical to citizens of Henry County and wanted to make sure there was a way it would be maintained.

“Really what we’re here to talk about is EMS being a county service,” he said.

Because emergency medical services (EMS) are not deemed essential by the state of Iowa, the county does not have to have the service. However, Gardner said he feels it is an essential service and wants to find a way to keep it around.

He said HCHC had a proposal for the county to take over the service that spelled out how it could be feasible for the county. Reimbursements from Medicare and Medicaid would stay the same if the county took over, said Michelle Rosell, Chief Operating Officer for HCHC, however, as a county entity and no longer a for-profit company, the county would be eligible for grants and additional funding that would help offset revenue.

Jacob Dodds, EMS Operations Coordinator for HCHC said as of last year, 20 percent of EMS revenue comes from Medicaid and 60 percent from Medicare. Gardner said in 2017, 19 percent of the population was on Medicaid and the number is slowly rising.

“There’s nothing in Iowa code that (says) either of us, the county or the health center, have to provide EMS services and that’s the crisis in rural areas,” he said, explaining many studies have been done on the matter but the best way to maintain local control is to make it a local entity. “The better option is having it under the county umbrella.”

Gardner said this would allow the control to be in the hands of local, elected officials rather than at a federal or state level. He said 19 percent of Iowa hospitals have EMS service and nationally only 15 percent have it. He said it is “not a normal thing” for the hospital to run the EMS service and it makes more sense for the county to take it over.

Rosell said Calhoun County has gone through a similar transition with transferring services to be county run and has been very successful. She said by following this framework local control would be maintained and the transition would be smooth and there would be no issues with transparency and collaboration as have been reported by other agencies who have received their ambulance services by third party vendors.

“I think because of the solid, functional foundation that we have with our existing service, being able to carry that forward and ensuring good public response, public safety and quality care is provided just makes sense and it would be a much easier transition for us,” she said.

In late October, Henry and Jefferson counties decided against pursuing a joint ambulance service. Carmen Heaton, member of the HCHC board of trustees, said Jefferson County needed a decision quickly because they needed to give notice to the private company they currently have ambulance services with. Additionally, the company, Midwest Ambulance Services, was unwilling to share numbers with either county making the decision more difficult.

Gardner said without the numbers, the timeline was not feasible for them. This contradicts what council member Gandy said during the Fairfield City Council meeting on Monday, Oct. 28, when he was quoted saying HCHC, the City of Mt. Pleasant and the Henry County Board of Supervisors were not as unified in a decision as it originally appeared.

At the time, Gandy said the possibility of a collaboration in the future was not being ruled out. At Tuesday’s meeting, Gardner said he felt a partnership was the best way to handle the situation.

He said for the past seven years, the county has been involved in the Southeast Iowa Link (SEIL), a mental health and disability service that covers eight counties. He said through the regionalized system, the county would be able to share costs and expand services.

Dodds said he did not foresee any significant changes in operations if the county were to take over the service. More staff would need to be hired, he said, regardless of who was in charge of the service. Currently, the department has four ambulances, two staffed 24/7, and are looking to add a fifth ambulance due to an increase in call volume. Dodds said in 2013 the county had just under 1,700 calls and will be on track to take more than 2,300 calls this year.

Marc Lindeen, Henry County Supervisor, said he was in support of the possibility a regional service because he did not feel EMS would ever be an essential service on the state level because only 11 states have deemed it essential. A member of the SEIL committee, Lindeen said he has seen first hand how regionalization has positive potential.

Dodds said no matter who runs the service, the issue at hand is ensuring there are EMS services available for the citizens of Henry County. He said the county will not make money on the endeavor, but it is essential it considers the option of running the service.

“The reality is it doesn’t matter who runs it ... it’s going to cost money and the option of looking at a private company, I think the president has been set in our surrounding counties for how well that’s worked out. They’re going to come to you and they’re going to ask for a check every year and that check amount is going to get bigger every year. You can either have a say in how that money gets spent or you can write them a check,” he said. “This is a service that I think the people of the county expect one way or another.”

On Thursday, Nov. 14, Henry County Supervisors discussed creating an exploratory ambulance committee that would oversee the process of looking into a new ambulance service. Supervisor Marc Lindeen said the committee would not be responsible for making decisions, simply looking into the options that are available for the future of the ambulance service in Henry County. No action was taken.