Ambulance plan stirs controversy
Lou Marzeles
Editor
Klickitat Valley Health (KVH) is thinking about outsourcing its ambulance service as a cost-savings measure, and the move is sparking controversy.
“Nothing’s been done yet,” says KVH Chief Executive Officer MaLisa Mudgett. “We’re just in information-gathering stages.”
Some KVH emergency medical staff, however, are concerned that outsourcing ambulance service will cost jobs.
“I am completely and totally opposed to outsourcing ambulance service,” says Connie Kayser, an ambulance staff worker at KVH. “The people on the service are faces we know. They’re the people we expect to see when we need help.” Kayser also suggests that the exploration of outsourcing reflects an attempt to recoup a hospital overbilled expense to Medicare on the order of $1 million.
“We’ve heard that,” Mudgett says. “It’s a misunderstanding of how Medicare has changed its reimbursement process. It’s complicated,” Mudgett understates. “Essentially, KVH was on a cost-based reimbursement process from Medicare [for ambulance service], but we were informed that we are not eligible for cost-based reimbursement and now have to go to fee-based reimbursement. That’s caused an adjustment of about $1 million. The change is based on the determination of ambulance service being available to this area within a 35-miles radius of our location, even though those services are not always practically able to respond to our area.”
“I understand that explanation,” Kayser says, “and I understand too that this mistake was made by previous administrations at KVH. But it’s still a mistake, and we shouldn’t have to lose our ambulance service because of it.”
The consideration of outsourcing ambulance service arises from KVH projections that it will lose about $550,000 in 2010 in operating its own ambulance service, Mudgett says. Initial indications are that the hospital could mitigate that loss considerably by outsourcing ambulance service. “We would save about $150,000 in salary and benefits,” she says. “That would reduce our loss to about $400,000 a year.”
Savings in salary and benefits means, of course, people lose jobs, and that concerns those whose jobs are at risk. “But you also have to look at the fact that if we outsource ambulance service, the outsourced ambulance service has to hire people,” Mudgett says. “We would want them to hire ours if possible.”
KVH Chief Financial Officer Leslie Hiebert says the consideration is aimed solely at maintaining fiscal responsibility for the hospital. “We wouldn’t be doing our jobs properly if we didn’t examine every way possible to provide needed services in the most cost-effective way,” she says.
Rural hospitals commonly struggle with ambulance service. Just days ago, Chelan passed a levy to help with its ambulance service costs, and Ellensburg and Yakima are considering doing the same. It is increasing rare for small hospitals to have their own ambulance service because of the steep costs in maintaining ambulances, which cost hundreds of thousands of dollars by themselves, and the staff to operate them. Most public hospitals districts run separate levies just for emergency medical services.
Kayser says KVH needs to conduct such a levy to take up the financial slack in operating the ambulance. “That’s what we need to do, to keep the people we know and trust here,” she says. “We need people who have a stake in our community, not just someone who wants to make a buck.”
“We’re bringing all this information to the board,” Mudgett says. “I think a decision could be made in about 30 days.”
Goldendale graduate killed in Afghanistan
Sunday May 2, Mark Coleman of Centerville was killed in action in Afghanistan by a land mine. The 40-year-old was on patrol Sunday morning when he stopped his vehicle to inspect something; he stepped out of the vehicle, and while walking he stepped on or near a landmine that took his life.
Mark Coleman was a graduate of Goldendale High School in 1988, and his mother is Alice Eschelman of Centerville.
City votes in new phone system
Andrew Christiansen
Reporter
Goldendale’s city offices’ phone system will soon be integrated, allowing more efficient communication among public works, police, fire department, city offices and even the animal control facilities, following Monday’s council approval of $29,405.26 capital outlay.
The system will be installed and serviced by NW Communications Systems Inc., in Bingen. Their bid for a Toshiba-based system will correct problems the current system has in managing calls and it gives versatility of forwarding to other phones, or recorded messages and even cell phones. There was much discussion about the details of the system and warranty, but all council members voted to proceed with the purchase.
Monday was also the second public presentation of the six-year street plan. One public comment questioned why northeast Second Street was not included in the plan. Jack Runyon said there are more than 50 pot holes there.
Meghann Dallin, with the Klickitat County Health Department and Jim Daniel, Klickitat Valley Hospital commissioner, asked the council to incorporate Center for Disease Control and Prevention (CDC) ideas about transportation system design and quality of life and health. The CDC recommendations include plans to reduce human exposure to air pollution from combustion engines and not only accommodate, but encourage walking and biking.
In other business, the council passed an ordinance aimed at community beautification and provided a real case of civic education. Rick Milliren appeared before the council to request changing two parking tickets to warnings. Milliren received the tickets for parking facing the wrong direction, something he explained he has done at his residence for 17 years without prior complaint. The first vote waived the first ticket, but not the second. Milliren was persistent and during the public comment portion of the meeting, brought the issue up again. This time around the council voided both tickets. It was a lesson on how good intentions and seemingly black and white issues take a different turn when faced with the human element.
Following the meeting, City Administrator Larry Bellamy said, “The intent all along has been to improve the appearance of the city” and gently change behavior with a warning system followed by tickets. The city will continue to enforce the new laws that, in addition to parking on the wrong side of the street, include such things as illegal U-turns and driving over curbs. Bellamy hopes the same type of problems don’t emerge with the latest ordinance, one that forbids putting out garbage in plastic bags.
“We will work with people to understand the law and only move to ticketing where problems persist,” says Bellamy. Garbage must be placed in covered trash cans or other approved containers. Storing garbage bags in a trailer or back of a pick-up for a month is not allowed.
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