December 22, 2014 - During Commissioners' Court Monday morning, a long discussion time was held before Commissioners approved a request from ACE EMS for a $15,000 monthly temporary subsidy on December 22, 2014.
Dale Alexander, ACE EMS owner, was the first to address the court concerning the subsidy request. "Since the close of the hospital last July 11th, [ACE EMS] has run 3,845 calls. We average about 226 calls a month. You are looking at about 98% of all these calls that are 9-1-1 which goes back to our contract, we agreed to cover all these, as many as possible with the terms of the contract, the two 24-hour trucks with a call-in truck."
Alexander addressed self pay patients who have no medicaid/medicare, insurance, or no way to pay. When a 9-1-1 call comes in, they can't discriminate as to whether or not the patient can pay. Alexander said, "Now these people have totaled up a bill, they can't or don't pay, for whatever reason, of $615,025.80. Over each month that averages out currently up to this point during the year, averages to just a little over $51,000 a month that we absorb our self."
"Bottom line is with that is, covering the contract, it still costs us more than what it brings in. It's hard to cover that, but the county has to have it. There is no way we can cut back. I just, I don't believe we can cut back on the service we offer, so that Shelby County takes care of all the people the way they need to be taken care of and that's the reason we started it, was to take care of Shelby County," explained Alexander.
To summarize the situation, Alexander said, "In the end it comes down to you need a certain amount every year to operate." He continued, "At the end of this year right now we expect to collect approximately $1.5 million. Well, what we actually collect is about $1,030,000 at this point, that is just kind of a rough number of what we've collected. But it costs $1.25 [million] to $1.3 million just to operate, just to break even, to cover the county with the service we are giving right now."
ACE EMS owner, David Chandler said, "Just like Dale said, we don't have a choice, we get called 9-1-1 we go knowing that it is going to cost us $1,200 to $1,500. A person gets out of the hospital two days later, the exact same person calls for an ambulance 9-1-1, guess what, we lose another $1,200 to $1,500 but we have not choice, we've got to go. Kind of stings sometimes."
Discussion was held about the opening of the new Center Emergency Department (CED) and if it would help with the expense burdens the ambulance service is having to absorb. Alexander explained with the assistance of Jesse Griffin, ACE EMS manager, some patients will be able to be taken to the new ER; however, the CED informed ACE during a previous meeting, there are certain calls which will still need to be taken to other hospitals depending on the call type including broken bones because there is no ortho, anything requiring emergency surgery such as appendicitis, cardiac care, and anything ICU.
Judge Rick Campbell asked, "Are you asking for a subsidy, do you think the subsidy is something that you need every month from now on."
Alexander replied, "I believe it is or at least, at the very least, through one year of the new hospital being open to see if that's going to be what it takes to change everything. At this point we don't know that, we can't guarantee that, that will change very much."
Judge Campbell asked, "Year to date since y'all have been in service, have you shown a profit?" Alexander replied, "No. Not yet. We have been in business since August of 2012 and not one penny of profit yet. We've actually shown a loss every time."
Alexander addressed recent questions from people about their new recent purchase of two brand new trucks by explaining it was cheaper to replace the two diesel trucks needing repairs with two new trucks with gasoline engine in the long run partly because the reduced cost of maintenance over the diesel engines.
Roscoe McSwain, Precinct 1 Commissioner stated, "Don't forget the fact that any service you go into like this, you know there is always going to be an amount of goodwill." In response Alexander said, "Like you said there is a certain amount of goodwill that is going to be involved in it. But where is your breaking point. We are presenting you with our breaking point," and Chandler added, "I'm afraid we are about there."
Rodgers asked the two owners of ACE EMS if the service could survive without the county helping. Alexander replied, "At this point, it can't survive without the county helping because I've watched the last two months, our last month that we received subsidy was in October, that's when our original agreement was up. And then we've had November and we are almost done with December, I already see a difference and its not a good difference."
McSwain expressed his desire to hold off on approving the subsidy and having the ambulance service run three to six months without the subsidy and then return to the Commissioners' Court and show the court if the subsidy is still needed considering the opening of the new Center Emergency Department.
Commissioner Jimmy Lout made a motion to give ACE EMS a temporary subsidy of $15,000 per month with requirement of the company providing a financial statement to the court prior to any continuance of the subsidy in the future. The motion carried with votes of approval from Jimmy Lout, Travis Rodgers, Bradley Allen, and Judge Rick Campbell and a negative vote from Roscoe McSwain.
The money for the subsidy will come out of the contingency fund starting January 1, 2014.
Following approval of all items on the agenda and prior to adjournment, Clint Porterfield, County Auditor, stood up and addressed the court. He said, "I believe scripture tells us that we're supposed to give praises in the good times and the bad. So, in light of that, I would like to thank Judge Campbell, since this is your last court meeting, and give you the praises for the job you have done. You've been with us through the good and the bad. We've had to do a lot of tough decisions and we've had some easy times, so I just want to acknowledge the fact that we do appreciate your service and wish you the best of luck." Campbell replied, "Thank you, it's been an honor. I've enjoyed it."
Following the words from Porterfield and Campbell, the audiance and the commissioners all stood and applauded Judge Campbell for his service.
Agenda items receiving approval include: 1) Approved monthly expenses and to amend budget line items. 2) Approved bonds for newly elected officials 3) Approved subsidy to ACE EMS. 6) Approved moving County Attorney's office and Justice of the Peace, Pct. 1 to an office space located on Loop 500 near the intersection of Hwy 7 East. Mike Kyle, Area Manager of Azure, offered the office space on Loop 500 free to the county for a term of 5 years. 7) Approved incoming Justice of the Peace, Pct. 1, Mike Crouch to rent a new office space in downtown Timpson for $400 per month. 9) Approved Commissioners McSwain, Lout and Rodgers to each purchase a John Deere tractor and brush cutter for their precinct through the Buy Board. The motion was made with $150,000 coming out of Right-of-way fund and $59,000 out of each of the three commissioners cash carry over. Pct. 1 and 2 will receive their brush cutters first, Pct 3 will have to wait for the 3rd brush cutter to be built. 10) Approved Commissioner Rodgers to advertise for bids to sell a Ranch 2 door belly dump, a 1975 Chevy Silverado flatbed truck and a Fiat 175 maintainer. 11) Approved increasing the County mileage rate from 55.5 cents to 57.5 cents which is the new approved IRS published rate. 12) Approved closing the Courthouse on Friday, December 26, 2014 with all employees agreeing to take a vacation day for the extra day off. Items reported to the court 4) Recorded the creation of Fund 83 - District Attorney Non-Traffic Forfeiture Fund and Fund 84 - District Attorney Traffic Forfeiture Fund. 5) Recorded the establishment of Forfeiture Budgets for District Attorney Forfeiture Funds (Non traffic and Traffic). 8) Reported mandatory hours of training for Tax Assessor, Debora Riley, a requirement under Texas Property Tax Code Section 6.231 (d). Riley has received 50 hours of training, only 20 hours were mandatory. 10 hours of the 50 can carry over to the next year.
