Ground Emergency Medical Transport legislation, which was recently signed into law, provides certain ambulance providers with a partial reimbursement for care given to Medicaid patients, according to Scott Clough of AP Triton, a consultant who worked on the legislation.
However, as ambulance service in the county is now structured, the Central Valley Ambulance Authority and Aero Skagit probably would not qualify for reimbursement under the law, Clough said at Monday’s EMS advisory group meeting. CVAA handles about 80 percent of the county’s patient transports.
“The smell test is ... they have to have taxing authority,” Clough said.
The Anacortes Fire Department, which provides ambulances on and around Fidalgo Island, would qualify for reimbursement.
Representatives from AP Triton presented three ways the county’s system could be structured and how each would receive reimbursement.
The first, which was to form an ambulance district that incorporated CVAA and Aero Skagit, was received poorly by the advisory group because Clough said it’s likely to be expensive, timely and could require public vote. Further, it would net less than $1 million in Ground Emergency Medical Transport money, less than either of the other two models.
Clough’s second model would make the county the ambulance provider, have it take on billing and collections, and have it contract with the CVAA and Aero Skagit, he said.
This would increase reimbursement to about $2.15 million because the county could get reimbursed for work done by the EMS office.
The final model would dissolve the CVAA and Aero Skagit, and the county would take over ambulance services. This has the maximum reimbursement potential, Clough said.
At the meeting, County Commissioner Lisa Janicki and EMS Director Mark Raaka said the county is discussing internally the feasibility of establishing a county-based ambulance system.
“Regardless of GEMT and your levy, I think you should have a good look at your system,” Clough said, adding that the county’s EMS system relies too heavily on levy dollars. GEMT money would make the system more sustainable, he said.
He also suggested increasing ambulance transport fees and relying more on EMT patient transports to free up paramedic units.
While it’s unknown whether the Center for Medicare and Medicaid Services would approve the CVAA for Ground Emergency Medical Transport money as the CVAA currently exists, AP Triton’s Kurt Henke said it’s better to be safe than sorry.
“Do you want to roll the dice or do you want to build a system that works from the start?” Henke said.
CVAA Director Kirk Hale said giving more responsibility to the county in exchange for more GEMT money sounded good, and that Monday’s presentation served to narrow the options for the future of Skagit EMS.
“If there’s good leadership and good management, it will probably work fine,” Hale said.
— Reporter Brandon Stone: bstone@skagitpublishing.com, 360-416-2112, Twitter: @Brandon_SVH
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