During the Fall of 2017, it became apparent that the Caledonia Ambulance/Genesee Valley EMS (GVEMS), who has a rich history of serving the emergency medical needs of the Mumford Fire District Area of our community, was at risk of not being able to continue to serve the community. As Town Supervisor, I personally attended various meetings with the Mumford Fire Commissioners, the Caledonia Ambulance Board of Directors and CHS Mobile Integrated Health Care (CHS) to gather information and to discuss service options. Caledonia Ambulance was at the point of considering closure due to the current health care reimbursement and regulatory climate. GVEMS held the Certificate of Need for that area of the town outside the Village west of Wheatland Center Road which matched the Mumford Fire District boundaries. At the same time CHS was assessing the feasibility of assuming the functions, liability and Certificate of Need of Caledonia Ambulance. Ultimately, CHS decided to undertake this transition and coverage in order to more comprehensively serve the south west quadrant of Monroe County.
While developing the 2019 town budget, the Wheatland Town Board discussed ways to approach ambulance coverage to the Mumford Fire District residents. Our two years of experience with CHS providing services to the Wheatland Fire Protection District has been a positive one. Quarterly reports are received, response times are within contracted time lines, satisfaction data is forwarded, annual reports are delivered, real time updates are sent via email. In addition, service statistics are documented and used to build the foundation for the following years contract. CHS provides a free loan closet for medical items such as crutches. We also have a local resident representative appointed to the board of directors.
The Town Board and I continue to support the philosophy that yes, CHS does bill insurance companies for calls, but in time of need and stress, we prefer that our residents not receive another “co- pay” bill. We also believe that CHS should not have to “eat” the cost of non-reimbursable “lift assists” (picking people up who have fallen) (mainly services to our seniors, disabled and/or seriously ill neighbors). Other non- reimbursable services/benefits include blood pressure clinics, public Cardiopulmonary resuscitation (CPR) and Automated External Defibrillator (AED) training at no cost to residents of the Town, AED inspection, first aid and CPR classes for our recreation counselors, as well as stand by vehicles and staff for public events.
Because of these additional benefits, the Town Board decided to act as “contract partners” and determine how best to ensure equal services to both sides of Wheatland Center Road – the entire town outside the Village. With the experience of data driven costs (number of various services delivered and costed out = cost of following years contract), the town board decided to fund the cost through an “ad valorem” tax on those residing outside the Village. An ad valorem tax is a tax for a specific service. The establishment of an ambulance district was considered but this would be another special district and would have “locked in” all future town boards to absolutely provide ambulance service through some provider forever or until NYS law changed. The ad valorem tax is reflected in the part B portion of the town budget – those services provided outside the Village of Scottsville. The rate for 2019 will be $0.21/ $1000 assessed value. Town residents outside the Village of Scottsville will not receive a bill from CHS for copayments, co-insurance or self-pay accounts. These costs will be absorbed by the tax funding. It should be noted the tax subsidy will not be used to offset deductible amounts for services. No one outside the Village will receive a bill from CHS. Anyone who is not a town outside village resident and requires CHS services, will be billed after insurance payments are made by their carrier. This would apply to someone visiting your home, someone attending an event or business in town, or someone driving through who is involved in a car accident. Your $0.21/$1,000 rate is likely less than any single copay expense. This holds true no matter how many times an ambulance is called to your home during the year.
The Town Board and I consider this approach as one of ensuring that all our residents are not only represented at the CHS table of decision makers but also that the town government receives an annual CHS financial statement and independent auditors report. Everything is “transparent” and the board can make informed decisions about the value of continuing as “partners” with CHS Mobile Integrated Health Care, Inc.