CCMSD looks to bolster ambulance service funding with resolution

Crook County Medical Services District (CCMSD) has proposed the county pass a resolution that would increase the amount of reimbursement it receives for ambulance services and therefore ensure that these services remain affordable to keep providing in the future.

A public hearing for the resolution has been set for January’s regular meeting of the county commissioners, after a 45-day notice period is complete.

The resolution would significantly increase the amount CCMSD makes through reimbursements for its ambulance services, said Ellsbury, and that’s why it’s important.

“We are not making money [on our ambulance services] and so with the lower reimbursement rate it could become unaffordable,” said CCMSD Board Attorney Kara Ellsbury.

“Our residents need us. That is why we’re asking you guys to pass this resolution.”

The aim of the resolution, explained Ellsbury, is to tap into newly available reimbursement funds through Medicare, which can only be done if the district is providing the only ambulance transfer service in a 35-mile radius.

“CCMSD is designated by Medicare and Medicaid as a critical access hospital,” said Ellsbury. “…As a critical access hospital, it’s potentially eligible for more money back from Medicare.”

Ellsbury told the commission that around 48% of the patients transported by CCMSD’s ambulances are Medicare recipients.

“It’s a big share of our patients, it’s a big reimbursement issue,” Ellsbury said.

The regulations for Medicare were recently amended, she continued, and, “Right now, a critical access hospital such as us is eligible to be reimbursed for 101% of the reasonable cost – but only if there is not another ambulance service within a 35-mile drive that’s legally authorized to transport patients to or from the hospital.”

Unfortunately, this is not the case.

“We have a couple within 32 miles – right under the 35,” Ellsbury said. “We’re the only critical access hospital, so we’re the only ones eligible for this type of funding in Crook County.”

The resolution solves the problem by specifying that CCMSD’s ambulance service is the only one legally authorized to transport patients from the hospital.

“Anyone can transport to our hospital, so there’s no modifications there,” she said.

When asked by Commissioner Bob Latham what would happen if a patient needed transport elsewhere and all the Sundance ambulances were busy, Ellsbury said the resolution provides two exceptions for this situation.

An ambulance can transport from the hospital in an emergency if Sundance’s ambulances can’t do it or if CCMSD has a written agreement with another service.

“Micki [Lyons, CEO] reached out to all the other ambulance services in the county, explained this and answered questions. They are all supportive,” Ellsbury said.

CCMSD is therefore already working on memorandums of understanding with those services.

Ellsbury stressed that this resolution will not impact any of the other county ambulance services or the residents of the county.

“That’s really the important goal: making sure that they have ambulance services available,” she said.

Commissioner Fred Devish wondered if the other county services could also benefit from the reimbursement if they were to come under the auspices of the hospital as satellite services and bill accordingly. Lyons confirmed that this would be the case.

The resolution does not impact the county budget, or the budget of any municipality.

County Attorney Joe Baron provided a legal opinion on the resolution that confirms the county has the authority to enact rules that declare a critical access hospital in Crook County.

“The board is in charge of performing the local Homeland Security Program for the county, and the Crook County Medical Services District is a public safety agency,” he wrote.

“…Coordination between them is necessary to continue to keep necessary services available to Crook County’s only hospital.”

Latham called the proposal a “no-brainer” and the commission moved to continue forward with the process of providing 45 days of notice and setting a public hearing.

Citizens with questions are directed to contact Lyons at the county hospital.