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By LeAnn R. Ralph
COLFAX — The Colfax Rescue Squad is proposing a 50 cent per capita increase for the 2020 budget to $17.17.
The $17.17 per capita charge represents a 3.06 percent increase, said Don Knutson, director of the Colfax Rescue Squad, at the rescue squad’s annual meeting August 21.
In the annual report, Knutson provided some comparisons to other ambulance services.
While the Colfax Rescue Squad’s proposed per capita is $17.17, the per capita in Chetek is $15.18, while Durand is $11, Cumberland is $10.50 (the ambulance service is subsidized by the hospital), Spooner is $19.85, Shell Lake is $19.65, and Menomonie will be increasing from $20.75 to $21.
The highest per capita Knutson found was Ashland in 2017 at $143.54.
The City of Chippewa per capita is $27.50, the Chippewa Fire District is $24.50, and the Eau Claire Fire District will be going from $12 per capita to $22 to $24 after losing the hospital subsidy.
The Boyceville ambulance service does not charge a per capita fee, but instead, the district charges member municipalities based on a formula of percentage of equalized value and a four-year average number of runs in the municipality, Knutson said.
Based on a Boyceville budget of $466,372 for 2019, compared to the Colfax budget of $423,328, Boyceville paid $97,907 to the ambulance service in 2019, and Colfax paid $18,972 in 2019.
The Colfax Rescue Squad’s per capita charges ranged from $33,120 in 2019 for the Town of Elk Mound (population 1,929) to $5,872 for the Village of Wheeler (population 342).
The proposed per capita revenue for the 2020 Colfax Rescue Squad budget will be $140,708.
The total proposed revenue and expense budget for 2020 is $414,023.
The proposed “public charge” revenue for ambulance runs in 2020 is $273,315.
Overall, the proposed 2020 expense budget is $10,857 less than the 2019 budget, and the proposed revenue budget is $12,024 less than the 2019 budget.
One of the challenges of running an ambulance service is collecting the amount invoiced for ambulance runs, Knutson said.
The payer mix for the Colfax Rescue Squad is that 47 percent of the ambulance runs are covered by Medicare; 13 percent of the ambulance runs are covered by Medicaid; 22 percent are covered by insurance; and 16 percent are self-paid by individuals.
Because Medicare and Medicaid — which accounts for 60 percent of the ambulance runs — only pay a percentage of the total ambulance bill, the Colfax Rescue Squad is forced to adjust the receivables amount to match what was paid.
One example is that Colfax Rescue billed out $1,313.47 for an ambulance run, but Medicaid only paid $269.71 toward the bill, which forced Colfax Rescue to adjust the receivables by $1,043.76.
One way to try to make up for the lower reimbursements would be to increase the rates charged by the rescue squad for ambulance runs beyond the increase in the Consumer Price Index (CPI).
The Colfax Rescue Squad usually increases the rates according to the CPI, but every so often, a “catch up” year must be included, and this year is proposed to be a catch up year, Knutson said.
An example of the proposed “catch up year” increases would be the resident base rate, which is $864.45 this year.
If the resident base rate is increased by the CPI, it would be $888.64 in 2020, representing an increase of $24.20.
If the resident base rate for basic life support is increased at an amount to help the rescue squad “catch up,” the base rate would increase to $1,088.65, representing an increase of $224.20.
Under the proposed catch-up increases, the non-resident basic life support rate would go from $1,067.85 to $1,297.75, representing an increase of $229.90.
The resident base rate for advanced life support is $1,118.70 this year, and under the proposed catch up rate, the amount would be $1,350.02, representing an increase of $231.32.
The non-resident base rate for advanced life support is $1,220.40, and under the proposed catch up rate, the amount would be $1,454.57, representing an increase of $234.17.
The Colfax Rescue Squad had 471 runs in 2018, Knutson noted.
Coverage of the hours can be a problem, too, because the state mandates the rescue squad be covered 24 hours per day, seven days per week, 365 days per year, he said.
If there are not enough EMTs to cover all of the hours, then the Colfax Rescue Squad ends up paying time and a half, which also has an impact on the budget, Knutson said.
Last year, in 2018, the rescue squad experienced a budget deficit of about $80,000.
At least part of the deficit was because Knutson had to be off on medical leave, and in order to cover the hours, some EMTs ended up being paid time and a half.
Knutson told those who attended the annual meeting that when rescue squad hours need to be covered, he will be “on call” at home but only receives payment for going out on an ambulance run.
The Colfax Rescue Squad has changed billing software, and the change gives Knutson more responsibility and also allows Sheila Riemer, deputy clerk-treasurer, to do more of the collections, he said.
While the billing software was expensive, hiring a company to do the rescue squad’s billing would cost 6.8 percent of the charges billed out, Knutson said.
So far this year, the Colfax Rescue Squad has $105,000 in outstanding invoices that have not been paid, he said.
After a certain amount time that the invoices are not paid, the amounts are turned into the state’s Tax Refund Intercept Program (TRIP), so when an individual is scheduled to receive a tax refund from the state, the tax refund is instead diverted to the Colfax Rescue Squad to pay the ambulance bill.
Some of the unpaid invoices are also turned over to a collection agency, Knutson said.
The collection agency charges about 20 percent on the amount collected, he said, noting that a collection agency previously used by the Colfax Rescue Squad charged about 30 percent of the amount collected.
If the ambulance bill goes to a collection agency, and the agency puts the outstanding invoice on the person’s credit history, then that person will have to pay the Colfax Rescue Squad before he or she can get a loan, Knutson explained.
“We want to work with people, and we will take payments, but (the Colfax Rescue Squad) still needs to be paid,” he said.
Unlike businesses, the Colfax Rescue Squad cannot turn someone down for service if the person has a bill that has not been paid, said Terry Stamm, a representative for the Village of Elk Mound at the rescue squad’s annual meeting.
If someone cannot pay an ambulance bill, when they receive the bill, “call us,” said Lynn Niggemann, village administrator-clerk-treasurer.
One patient told Knutson because of her ambulance bill at the Colfax Rescue Squad, her children could not get new shoes for school.
Another patient told Knutson she did not have any insurance but that she would make payments on her ambulance bill.
The woman paid $50 every month until the bill was paid off, and when she was finished paying, the Colfax Rescue Squad received a nice letter from her thanking them for taking care of her, he said.
“I have no problem taking payments from people,” Knutson said.
The collection agency also will take payments from people, but if someone misses a payment, then the collection agency will tag the person’s credit history, he said.
Here are the proposed per capita charges for the municipalities in the Colfax Rescue Squad service area for 2020:
• Village of Colfax — $18,972.85.
• Town of Colfax — $21, 926.09.
• Village of Elk Mound — $14,903.56.
• Town of Elk Mound — $33,120.93.
• Town of Grant — $6,782.15.
• Town of Otter Creek — $8,550.66.
• Town of Sand Creek — $9,855.58.
• Town of Tainter — $20,724.19.
• Village of Wheeler — $5,872.14.
The Colfax Village Board will officially approve the 2020 budget for the Colfax Rescue Squad later this year since the ambulance service is owned by the village.