Scott County full speed ahead on folding Medic EMS under its wing

After months of study, the Scott County Board of Supervisors has taken the first formal steps needed to take Medic EMS under its wing and make it a county department.  The supervisors unanimously approved an initial reading of an ordinance creating the department at their Thursday, April 13, meeting and are expected to take the […]

After months of study, the Scott County Board of Supervisors has taken the first formal steps needed to take Medic EMS under its wing and make it a county department.  The supervisors unanimously approved an initial reading of an ordinance creating the department at their Thursday, April 13, meeting and are expected to take the final steps at the board’s meeting Thursday, April 27.

Even though final approval appears likely, a range of other tasks need to be completed before the transition is complete, which is expected in January. Board Chairman Ken Beck has characterized these remaining steps as “challenges” rather than “deal breakers.” In an email in April to the QCBJ, Mr. Beck said “I am confident that the team of professionals we have assembled will move forward through any challenges that may occur.” He added that if there aren’t any comments about the ordinance by the April 27 meeting, he expects the board will suspend its rules and approve 2nd and 3rd readings that evening. He said he had not received any comments of concern about the ordinance so far. The county still must hire a director for the new department, and it has taken on a recruiter to help with that task. Acquisition agreements and transition applications with outside agencies, among other steps, must also be completed. The future structure of the Scott Emergency Communications Center also is a remaining question. The SECC, as it’s known, is an intergovernmental entity that performs dispatching services in the county for local governments. A unit of Medic that dispatches its ambulances is co-located at the same facility. The county also will hear again from Public Consulting Group, the company it agreed to hire last year to study the Medic operation. The firm was brought in to conduct a two-phase study – the first involving an operational analysis of such factors as call volume, response times, dispatching and an organizational structure. In March, it made its first report. A report on the second phase of its analysis, which county officials have said will include a more detailed financial analysis, including revenue projections, is expected this summer. In a memo in March, county officials said that they anticipate the county-run emergency services department will run a nearly $400,000 deficit on revenues of nearly $13.2 million in fiscal year 2024. Supervisors approved a budget Thursday, April 13, for the 2024 fiscal year that included $850,000 in county funds for the new department to cover any losses. In previous years, the county has set aside $200,000 a year to help if Medic experienced financial losses, but county officials say the maximum funding was never needed and in some years none was needed. The financial sustainability of providing emergency medical services in the county has been a key question for years. For three decades, Medic, a non-profit entity, has been the major provider of emergency medical services in Scott County. But in recent years, Medic and local government officials have raised concerns about its financial future. As a non-profit, Medic doesn’t have access to some potential revenues and cost control options that government-run services have. When the county takes control, some of those financial doors will likely open. Among those options is the ability to tap into federal Ground Emergency Medical Transportation funding, or GEMT. The voluntary program provides supplemental payments to cover the difference between the costs of providing emergency medical transportation and Medicaid’s base payment and other sources of reimbursement. Medicaid reimbursement rates typically do not match costs. David Farmer, Scott County’s budget manager, said the county is requesting that the State of Iowa accept data for a six-month period, between Jan. 1, 2024, and June 30, 2024. This would enable GEMT revenues to be received beginning July 1, 2025 (fiscal year 2026.) If the state declines, those revenues would be delayed until fiscal year 2027. In an email to the QCBJ, Mr. Farmer said the state has indicated it may be able to accept six months of data, but that depends on a number of factors and has not been confirmed yet. The state of Iowa administers the Medicaid program along with the federal government.