Delta County Ambulance District has applied for a grant to maintain staffing levels while it mounts a second effort to increase property tax revenues.
A ballot question seeking a mill levy increase was defeated in November by a margin of 47 percent in favor, 53 percent against. DCAD was asking voters to double the current property tax assessment of 2.5 mills. The additional property tax was cited as vital for maintaining service and staffing levels.
The grant application for $123,000 essentially represents the cost of two full-time employees, ambulance director Kirby Clock noted at a Dec. 13 meeting of the ambulance board.
The grant program is offered through the Colorado Department of Public Health and Environment. DCAD has previously been successful in winning grants with a 50 percent match for ambulances and pricey equipment like heart monitors.
Due to limited funds, DCAD is seeking a waiver that will slash the district match to 10 percent. The grant application will only be considered if the waiver is granted in a separate hearing, Clock said. If the grant is not approved, then budget revisions will be needed midway through 2017.
At the Dec. 13 meeting, the board approved the 2017 budget which reflects an 8 percent increase in rates. But because Medicaid and Medicare reimbursements are set at the federal level and will not change, the rate increase impacts only a small percentage of billings. Clock estimates a $161,000 increase in gross billings, but mandated write-offs, contractural allowances and bad debts will drop the estimated net revenue to just $27,000.
The ambulance district is also implementing a $150 charge for non-billable calls. For example, if the ambulance responds to a home for a "lift assist" or to evaluate a patient who refuses transport, the $150 fee will be levied. Previously, the ambulance district billed only those patients who were transported to the hospital. That will remain the case when DCAD responds to traffic accidents. The patient will be billed only when transport is required.
On the expense side of the budget, 2017 expenditures for maintenance, clothing allowances, medical supplies and equipment have been cut.
No equipment purchases are planned in 2017, although DCAD previously tried to replace heart monitors and ambulances regularly. "We used to try to replace ambulances every two years," Clock said, "and now it's going on four years since we bought a new ambulance."
With an unassigned fund balance of just over $62,000, there's little wiggle room in the budget and DCAD board members feel they have little choice but to go back to the voters in November.
The budget has been cut gradually every year for the past five to six years, board members said. With an increasing Medicare/Medicaid patient load and few alternatives for pumping up revenues, they believe a mill levy increase is the only way DCAD can maintain current 9-1-1 coverage and provide a structured plan for ambulance and medical equipment replacement.
"We've got an exceptional ambulance service here with exceptional staffing and I don't want to see that diminish," board president Tom Huerkamp said. "It's a big increase but I think it's a justifiable increase."
A Friends of the Delta County Ambulance District has been formed to help educate voters. Two representatives of that group, Teri Kinkade and Linda Lowitz, were at the board meeting. They said a number of DCAD employees attended a planning meeting last week, where fundraising and opportunities for outreach were discussed. The group has established a Facebook page and is analyzing precinct election results and demographics to determine how best to target voters for a more successful outcome in November.
"We greatly appreciate the involvement of the Friends group," Clock said. "It really is a matter of educating the voters, in my opinion."