If you’re in Salem and need to be transported to the hospital, it could soon cost you more.
In a Salem City Council work session on Aug. 14, Salem Fire & EMS Chief John Prillaman and two officers explained to Council members how the number of ambulance calls is going up – almost 5,000 this year – but the amount of revenue the EMS receives isn’t.
More complex equipment for medical procedures during transport, decreased insurance payments and more people not paying for services contribute to that, Deputy Chief Matt Rickman told Mayor Randy Foley, Vice Mayor Bill Jones and Councilmembers Jane Johnson and Jim Chisom. Councilman James Martin was absent.
An EMS committee is studying the possible solutions, and will make recommendations to the city’s Audit & Finance Committee which in turn will make a recommendation to Council later this year. Right now, it looks as though Salem might put in a place a fee schedule 130 percent above Centers for Medicare & Medicaid Services will pay.
Salem has one of the lowest emergency transport charge structures in the area, Rickman said, with a current charge of $410 for Advanced Life Support, $350 for Basic Life Support and $802 for Advance Life Support 2, plus mileage.
If 130 percent Medicare allowable charges were instituted, the costs could be $554, $466 and $802 per patient, respectively. Mileage charges could also go up from the current $9 per mile to $9.48.
Those charges would be the same for Medicare-Medicaid and people who have insurance, Rickman emphasized, because it is illegal to have two separate fee schedules. Private insurance companies are billed for the services, and not all the costs are covered.
So far, EMS has $156,000 in bad debts from people who haven’t paid for being taken to either LewisGale Medical Center in Salem or Roanoke Memorial’s emergency rooms, Rickman and Battalion Chief Teddy Crow said.
Some of the cost is from people who don’t pay even if they are not poverty level and could pay, Rickman said. “If documentation is there (on income level meeting poverty guidelines), that is not who we are after,” he explained.
“There may be some of these people (who don’t pay) who assume just because they pay taxes they are entitled to be transported without paying,” Jane Johnson observed.
Chisom suggested Salem City government should find a way to get a message to citizens that “By the way, it isn’t free.” Councilmembers mentioned getting an article into the next quarterly magazine published by the city which goes to all residents and is also distributed in the Salem area in The Roanoke Times.
EMS representatives and Council members emphasized they do not want people who genuinely need to call 911 not to keep from doing so because they think they don’t have the money to pay. Residents who meet reduced income guidelines will still be covered, but those people will have to fill out forms to show they qualify.
Other fee changes that might be possible in order to recover EMS costs, Rickman said, are for Council to consider:
- Billing commercial insurances for supplies;
- Removing the $75 ambulance transport mileage cap;
- Participating in High Deductible Revenue Recovery Program with EMS-MC;
- Adopting updated charitable care process.
Currently, 20 percent of transport charges are commercial insurance; 18 percent self pay, 53 percent Medicare, 8 percent Medicaid, and 1 percent Worker’s Compensation, the EMS fee report said.
In other information at the work session, Council learned these updates:
- Shoney’s property – The vacant Shoney’s restaurant property on Wildwood Road may soon see some action; Economic Development Director Melinda Payne, who was not present Monday night, has been in contact with Shoney’s ownership, Salem City Manager Kevin Boggess told Council;
- Lidl grocery – Plans for construction of the German grocery store Lidl, which has announced plans to locate next to Lowe’s in Salem, is moving forward, Boggess said. Last week Lowe’s signed off on a piece of property Lidl wants, and “as soon as Mason Mechanical and Pine Ridge are demolished” there may be construction action, Boggess said.
- Storm Water Banking – Assistant City Manager Jay Taliaferro and Director of Community Development Chuck Van Allman talked with Department of Environmental Quality officials in Richmond and development of “Storm Water Banking is going very well,” Taliaferro told Council. Under the state plans, developers could use credits to dispose of storm watter off site, Boggess added. “Nobody else in this part of the state is doing Storm Water Banking,” Taliaferro said.
The regular Aug. 14 Salem City Council meeting after the work session lasted eight minutes. Council approved, on second reading after first reading approval in July, amendments to city code clarifying downtown business district commercial use types including Dance Halls; commercial use types pertaining to microbreweries and distilleries, and buffer screening and landscaping plantings.