Seeley ambulance rates nearly doubled to fund more services

SEELEY LAKE – The Seeley Lake Fire Board voted March 15 to increase the base rates for ambulance service from $600 - $750 to $1,177 - $1,339 depending on the level of care. With this adjustment in rates, the board also approved Fire Chief Dave Lane to increase the base pay he is offering for the paramedic/firefighter position outreach from $40,000 to $50,000. The board also heard comments from the public regarding unprofessional conduct and a request to develop a strategic plan.

Ambulance Rates

Lane reported that since the Seeley Lake Ambulance Service started in 1984 the rates have not changed. They currently charge $600 for a Basic Life Support (BLS) call and $700-750 for an Advanced Life Support (ALS) call with an additional $20 per mile.

"To my knowledge these have not been looked at so there has not been an adjustment in 40 years," Lane said. "That is why the rate seems to increase by such a dramatic amount because times change and we did not keep up with the times."

As requested by Trustee Jon Kimble at the February meeting, Lane narrowed the rate survey from 354 ambulance services across the country to 45 like-sized communities (population 2,000-5,000) across the nation. The average BLS rate was $1,222 up to $1,491 for the highest ALS care. He pointed out this is higher than the overall average of $1,177 for BLS calls up to $1,442 for the highest ALS call.

Lane again requested the board adjust the ambulance rates to the national average based on his survey of $1,177 for BLS calls, $1,339 for ALS calls and $1,442 for ALS2 calls. There would be no increase to the $20 per mile charged.

Board Chair Scott Kennedy said the District is hoping to provide better coverage and staffing with this increase. They could also potentially provide resources to outlying areas if they had enough staffing.

Kimble proposed increasing the base rate by $300 not $700. That would still satisfy the Chief's aim of being able to offer a compensation package to a new employee and two it will limit the impact of the fees on the community.

"The community is not going to be impacted other than their insurance," Lane said. "We do have a small amount of our patients that don't have insurance and we've always said contact us and we will help you with your bill and we have done that."

Lane further explained that around two-thirds of the patients they transport are on Medicaid or Medicare. Even though they bill the full amount, they can only collect $300 - $400 from Medicaid/Medicare plus their negotiated rate for mileage. This also applies to other insurance companies. If the patient's insurance has a contract or negotiated rate with the District's billing company, the insurance will only pay the agreed upon amount and the District accepts it as payment in full.

Lane said he did not know the rates the insurance companies would pay since he does not deal with billing. Since there are so many variables, he does not know the payment schedules for the individual companies.

Fire Department Captain John Baker said this will help the community. The people using the service would pay instead of running a levy where everyone would have to pay. Since insurance is a personal decision, residents just need to know their program.

"Insurance is there to assist, it is not to cover everything. It is not a freebie," Baker said. "I personally think this is a really good opportunity to advance the medical program without impacting the community as a whole."

Kennedy said he felt it was a reasonable alternative to a levy or other funding. Visitors who use the service would pay the increase.

Trustee Connie Clark asked if anyone checked how the rate increase would affect coverage from any of the common insurance providers, a suggestion made by a member of the public at the February meeting. No one had done that.

Clark said she was not comfortable doubling the rates.

Lane said they had not adjusted the rates in 40 years, "so we are way behind the curve in adjusting the rates."

Kennedy said they have been able to absorb the ambulance up to a certain point but that is no longer an option.

"We need some additional funding to help expand operations and provide more service to the community," Kennedy said. "That is the attempt."

Lane explained the taxes are paid to the Fire District. Those funds go into the general fund that is used to provide service.

"We are getting to the point where that fund is not nearly enough to support our services," Lane said. "Because most of our calls are EMS, my plan is to raise EMS funding to support more of the ambulance service."

Member of the public Kristy Pohlman suggested the board should think about the impact of increasing a bill for those that are uninsured and cannot afford the bill that they receive at the current rate.

"Then they need to get insurance," Lane said.

Trustee Rita Rossi made a motion to increase the base rates from $600-$750 to $1,177.13 - $1,442.32. The board unanimously approved raising the base rates.

Paramedic Position

The District is currently advertising for a firefighter/paramedic position starting at $40,000. Lane said there has been no interest or applicants for the position. When he checked last month, the average paramedic salary was $47,411 and current job postings and advertisements are offering $62,000 for a dual position.

Lane would like to offer $50,000 base pay to see if they can get some interest. He understands the board still has not approved the position. Taxes, training, uniforms, vacation/sick leave and additional benefits would total around $65,000 for the position. The increased ambulance revenue would offset that cost.

Lane said the intent for the position is to support the volunteers and provide the best service they can to the community. Currently he is the only paramedic on the department.

The paramedic would work five days a week, during the day, the busiest time for calls.

"Let's do the best we can with what we've got," Lane said. "That is my solution to provide more ALS care."

Kimble motioned to advertise the position at $50,000. The board passed it unanimously.

Public Comment

During public comment, Seeley Lake resident and Fire Board Candidate Alyssa McLean said she thought it was "weird and off-putting how [the chief] chastised a woman for not coming to [him] first when she was just concerned for the community" at last month's meeting.

McLean said she has her own concerns. She pointed out Kennedy and Trustee Rita Rossi because they were EMTs on scene when she was involved in a head-on collision where she and her 10-year-old son both had facial trauma. She said she was never put in a C-collar and a head-to-toe assessment was not done.

McLean explained she shattered her right humorous, broke her left ulna, broke her left fibular head, completely tore her PCL ligament and tore her calf. She walked from the scene of the accident to the stretcher even though the report said they loaded her in the ambulance. She was transported with a BLS ambulance with her 10-year-old son and waited more than four hours before she got medication.

"That is crazy to me. I'm not going to stop making it a public thing because I can't figure out where the accountability is between your two EMTs that are also your board of trustees," McLean said. "I know life flight was available to me, I know MESI was available to transfer at the Junction."

McLean said she talked with Lane two months ago. When she asked him why Life Flight did not respond, he told her he needed to check the weather. When she contacted Life Flight, they said they were not dispatched.

"When ALS calls start getting sent and treated as ALS calls, when we are no longer your cash cattle because you just wanted to transport me to town," McLean said. "I just want you to know I'm not going to stop speaking up. Something is going wrong here."

McLean requested to be put on next month's agenda.

Following the meeting, Kennedy contacted the Pathfinder. He provided this statement in response to McLean.

"Regarding Alyssa McLean's derogatory comments at the Fire Board public meeting stimulated from a vehicle accident last October 2021 she was involved in. The Fire District Board has no oversight or direction over medical personnel. Also, due to privacy issues, it is unfortunate though, the medical personnel noted (or not noted) were unable to respond to Alyssa's comments regarding her accident and to correct any misconceptions or inaccuracies in her statements or address medical command decisions, triage judgments, level of care provided, dispatch resources or hospital protocols or delayed treatment at hospital as stated," Kennedy wrote. "Six patients were involved in this incident located approximately six miles south of Fire Station 1. Response time after hours [was] approximately nine minutes first on scene with eight responding members. This included five EMT'S which included a Nationally Registered Paramedic. Two Seeley Lake ambulances were used [to transport] four patients. I commend and thank everyone involved for their efforts."

Pohlman requested the Fire Board consider creating a strategic plan. This would incorporate input from Fire Department members, community members and the board and provide direction. It would also help past, present and future board members be on the same page. She requested it be reviewed at the next board meeting.

The next meeting is scheduled for April 18 at 6 p.m. at the Seeley Lake Fire Hall, 200 Firehouse Lane. The agenda will be posted at seeleyfire.org.