Ambulance Budget Accepted

Front Page / Jan. 27, 2007 12:00am EST

By Randolph Selectboard
By M. D. Drysdale

By Randolph Selectboard By M. D. Drysdale

An agreement hammered out between the Randolph Budget Committee and the White River Valley Ambulance management Monday may have averted a crisis, convincing the Randolph selectboard to include money for the ambulance in its Town Meeting budget.

The agreement, resulting in $55,000 in cost-cutting by the WRVA, was to be reviewed by the Ambulance board Wednesday night.

Tuesday, however, the reports from the Monday meeting were enough to convince the Randolph selectboard to change course.

At a previous meeting, the board had banished the WRVA's $250,000 request from the budget, placing it instead on the ballot as a separate appropriation. That decision came because the request was 41% higher than last year. It also seemed to constitute a vote of no-confidence in the WRVA's management.

As a separate item at Town Meeting, the ambulance request would have been at high risk for being turned down altogether. This would have been a severe, perhaps fatal, blow for the WRVA, since Randolph is the biggest contributing town by far.

This week, however, Selectman Stephen Springer and the Budget Committee brought a new proposal. It resulted from an analysis by committee member Carol Flint that was the basis for negotiation Monday night. The $55,000 reduction in the WRVA budget reduces the local contribution to a 28% increase.

The proposal came to the board with a memo entitled "Why the town of Randolph should support the White River Ambulance and the proposed, revised budget."

The memo, and Springer's presentation, was critical of aspects of WRVA's management over the last few years but asserted that starting last fall "the situation at WRVA has begun to be reversed, and continues to be corrected.

"2007 will be a pivotal year in bringing WRVA back on sound financial footing," the memo said. "This is not a time to lose confidence in what, historically, has been a fine regional ambulance service."

The memo implied that the Budget Committee had found that there had been a lack of cost control, ineffective collection practices, and other management defects, which have now been corrected.

In the past, the organization also "practiced less than full disclosure of its financial affairs," the memo said.

It also indicated that two local banks have said they are willing to provide financing up to $150,000 to the organization.

Selectboard Chair Jim Hutchinson quizzed Budget Committee members Mary Hardy and Carol Flint, financial officer John Clough, and acting town manager Joe Voci. All recommended that the new budget be accepted.

The selectboard agreed, by a 4-0 vote, to put the request back into the regular budget. Selectman Tom Schersten was absent.

"Thank you very much, Budget Committee," Hutchinson concluded.

Support from Stohl

In a separate interview with The Herald, the president of the WRVA board of directors, Jocelyn Stohl, confirmed that Monday's meeting had been positive and that she will support the new, reduced budget at Wednesday's ambulance board meeting.

She warned that there is still a chance that in eight months the WRVA would find itself "cash poor" because of declining payments and would in that case have to go back to the eight towns it serves.

She said that the financial problems were caused partially by the low rate of increase in payments from Medicaid and Medicare that do not cover costs.

The resulting "cost shift" means that WRVA must look to other patients, and the eight towns, to make up the difference. Also, collections from those other patients can be difficult.

An increase in Medicare reimbursements a few years ago caused the WRVA to be over-confident about its budget and not raise assessments much at that time, she said. Now that the reimbursements are increasing only by 2% a year, the agency finds it must catch up, she explained.

Call volume has remained relatively steady, with 1315 last year, Stohl said. However, some 268 of those calls resulted in no transfer of patients and were thus unbillable, she said.

Stohl defended the agency's decision a few years back to obtain paramedic licensing, requiring a certified paramedic to be available 24/7 every day. The increasing reliance on paid paramedics and less reliance on volunteers has been blamed by some for the increased cost of the service.

"They are really providing the level of care we need in a rural setting," she said, noting that WRVA has been recognized as one of the best ambulance services in Vermont.

Since the resignation of Amy Estey as administrator this last August, Patricia Edwards has been acting administrator of the service.

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