Ambulance board presented with balanced budget

As other governing bodies in the area struggle to prepare budgets for fiscal year 2011, Callaway County Ambulance District Director Charles Anderson had good news for his board of directors Tuesday night.

"Our financial position still is pretty strong," Anderson told the board as he prepared to present the proposed budget for next year. "We have $1.7 million in reserves at the beginning of 2011."

He said sales tax collection for 2010 has been on track for what they had projected.

"It seems like (sales tax collection) has been on-target with our projections," Anderson said. "We're budgeting $1.566 million in sales tax for 2011, the same as in 2010."

The director proceeded to reference call volume for 2010, which he said has been strong, noting that by the end of October the district had responded to 252 more calls than the same period in 2009, which also resulted in an increased number of transports. Anderson said the current average charge per transport is $742.31, but added that changes in Medicare billing will reduce that amount by up to $11 per transport. He said the regulation change is anticipated to cost the district approximately $40,000 in 2011.

"To accommodate the loss I propose we increase our mileage charge from $11 per mile to $12 per mile," Anderson said.

He said he is budgeting a little over $2.01 million in gross revenue from patient care activities, which will be reduced by non-allowed charges of $603,036 and bad debt (uncollected patient fees) of $341,720.

Wages for fiscal year 2011 - including a 2.1 percent wage increase to be divided between merit and longevity pay - is $1.387 million, a 1 percent increase over 2010.

Other big line items included a $22,000 increase in education expenses, a 21 percent decrease in grounds and buildings expenses to $22,000 and a 30 percent increase for fuel to $65,000.

Total budgeted revenue from all sources is $2.694 million, a 3 percent increase from the 2010 budget. Budgeted expenses for 2011 come in at $2,212 less than budgeted revenues.

"Essentially we have a balanced budget ... and it is reasonable to think we can attain that budget," Anderson said. "Unless there is anything big you want to change, this will be the budget I present to you for approval next month.

"Take it, think about it, if anything stands out, let me know."

Also during Tuesday night's meeting, board president Georgia Ladlie asked about the district's first use of automatic CPR devices.

"Statistically (this machine) is put on someone who's not going to make it anyway, right?" Ladlie asked.

"You don't start CPR unless (a patient is) already dead, so yes," Medical Director James Stevermer replied. "Most people, if you've gotten to that stage before an ambulance arrives don't make it."

He pointed out that making a dramatic increase in the number of cardiac arrest patients whose lives are saved was not the primary reason the board voted earlier this year to purchase several of the devices.

"The big argument to use these is safety for paramedics," Stevermer said, noting the machines are particularly helpful when transporting a patient so that personnel are not thrown about the back of the ambulance while perched above a patient trying to revive them. "It also gives them hands-free compressions so (paramedics and EMTs) are able to do patient care."

Anderson also pointed out that the district's biggest challenge in helping cardiac arrest patients is response time.

"Most of the time our response time is over eight minutes, and by then their chances are close to nil," Anderson said.

Assistant Director Linda Ellis put in that "we have had a few saves (with the automated CPR machines) but every one of them has been in the city, with a two-minute response time or less."

Stevermer agreed that response time is critical for patients requiring CPR.

"If you really want to make a big difference, you have to get a wide net of first responders trained on the AED (automatic defibrillator) and even still, you have to be able to get their within two minutes."

Anderson said the district currently is working on a program in which they are trying to identify places and businesses throughout the county that have AEDs and making sure they are up-to-date.