$21 million EMS Levy Proposal

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$21 million EMS Levy Proposal

Posted: 06/29/2022

(c)2022 The Dominion Post (Morgantown, W.Va.)

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June 29, 2022 by Ben Conley, The Dominion Post

MORGANTOWN — Mon EMS is asking the Monongalia County Commission to place a four-year levy worth just over $21 million before the county’s voters in November.

Executive Director Forest Weyen presented details of the levy request on Wednesday.

According to information presented by Weyen, the levy would cost a county resident $28.03 for every $100,000 of appraised Class II (owner occupied) property and $56.06 for every $100,000 of Class III and IV (rental).

That number is comparable to the four existing county levies combined, as the public transit (13.20/26.40), parks (6.96/13.92), volunteer fire (4.56/9.12) and library (3.24/6.48) levies total $27.96 for Class II and $55.92 for Class III and IV.

If approved by 60% of county voters, the EMS levy would generate $4,675,000 for Mon EMS in fiscal year 2024. That number would climb each year, topping out at $5,411,897 in fiscal year 2027, based on current numbers.

Weyen announced in March that a levy presentation was in the works as Mon EMS — a 2019 merger of EMS services provided by Mon Health and WVU Medicine — was not immune to the issues shuttering EMS providers across West Virginia and the U.S.

In fact, of the agency’s $12.3 million operating budget, $4.6 million is direct support from the two health systems while $6.8 million is generated through patient revenues and reimbursement.

The issue is two-fold, starting with the reimbursement system.

If an ambulance shows up, provides aid at the scene but doesn’t transport a patient to a hospital, there is no reimbursement.

If transport is provided and the patient is using Medicaid or Medicare, the allowable reimbursement is capped and the remainder has to be written off by the EMS agency.

In an example bill provided, Mon EMS was able to charge Medicaid about $285 of a $940 bill, with the rest written off as a “contractual allowance.”

Medicare and Medicaid patients made up 74.4% of the transports provided by Mon EMS last year.

The billing issue compounds inefficiencies built into EMS through the nature of readiness costs.

Weyen explained that in the best-case scenario — all calls end in a transport of a patient with private insurance — it takes 6.2 calls per day to make a vehicle financially viable.

Two of Mon EMS’s seven zones, downtown and Evansdale, hit those daily call numbers in 2021. The Blacksville vehicle averaged between .8 and 1.2 calls daily. That number hovered between two and three calls for Cheat Lake.

“But making sure that our folks in those areas have access to EMS is super-important,” Weyen said, explaining that without dedicated vehicles in places like Cheat Lake and Blacksville, response times would likely triple.

It was explained levy dollars would be used for 911 service and facilities, but not for special events like WVU football games, for which separate agreements are in place.

The commission allocated $1 million for Mon EMS as part of its upcoming 2023 budget. It’s now tasked with ensuring the levy proposal is ballot-ready.

“The commission will note receipt of the levy. We’ll start doing our due diligence; at the same time we’ll have the state auditor do his due diligence with it,” Commissioner Sean Sikora said, explaining the process will likely take a couple weeks before the item appears on a commission agenda.

“We may have some questions. We may have some back-and-forth,” he said.