County takes input on resolving ambulance issue

The Mountain Home County Commissioners' special meeting on Wednesday at the Elmore County Jail was a final wrap up on what the public in attendance thought about the joint ambulance study.

A study that Denny Neibaur, EMS Regional Consultant for the State Medical Emergency Services Bureau, said he was highly impressed with after reviewing the results. Neibaur plans on using the study for other counties as a model.

The discussion began with a question as to why Grand View and Bruneau are referenced in the study. County Commissioner Connie Cruser responded that their service is in Chattin Plats, which is still in Elmore County.

"But the collaboration is important to the patient care," said Greg Mauer, Elmore Medical center administrator.

Cruser spoke of the next request for the proposal. "How do you put oversight into a proposal? It's probably not a hard thing to do."

From there, Cruser developed an idea to appoint an emergency services group, three members from Mountain Home and two members from Glenns Ferry. The group would help the commissioners review every matter involving the ambulance service.

"We can't do it alone. We need help in this area," said Cruser.

Mountain Home Rural Fire District member Alan Roberts asked about, where will the money go and how will it be spent when the commissioners go back for a bid for a private proposal. "What are we getting for our tax dollars?"

Cruser responded, saying "figures can be so manipulative. It's really difficult to get a clear picture."

Commissioner Arlie Shaw recommended that a stipulation that the ambulance be required to submit an audited financial statement every year be added to the contract. Shaw later noted that the commissioners should determine how much money is available and use that money to contribute to the ambulance budget.

Fire Chief Phil Gridley asked Shaw how much is now spent on the ambulance each year. Shaw replied approximately $420,000, with extra money kicked in. He said additions were made to the ambulance budget because the current levy for the ambulance service didn't cover all the ambulance service costs.

"The best thing I could say, is that the people in this room and the taxpayers, are they willing to spend $75-$100 more a year on taxes. Nobody wants to pay additional taxes and I don't know how you do that and not make it painless," said County Commissioner Larry Rose.

Rose discussed Medicaid rates (when an ambulance picks someone up, the rates determine what the service gets paid).

"The ambulance service, I don't care if it's hospital based or NPA, that's what they get paid because they just have to accept it."

Representing Glenns Ferry at the meeting, was Mayor Jo Anne Lanham and Fire Chief Bob Janosheuk. Janosheuk discussed how Glenns Ferry is covered by one ambulance, and how difficult it is when receiving one call and then another call would come and there would be no second ambulance available.

In the original contract with NPA, it states that Glenns Ferry was entitled to two ambulances with two crews.

Shaw spoke on how this year, at least two ambulances would have to be purchased. Within all the mixed discussion, Dr. John Bideganeta said, "we have to come up with an RFP (request for proposal), then we can decide what we want. We're here now and we don't know what we want."

Police Chief John Walter concurred with Bideganeta.

"If you haven't made a decision yet, then you would make one by default by going with this RFP."

When asked what is the hospital's next move, Mauer said it "will be doing an evaluation, but the board hasn't given the go-ahead. We want to bid it but under one condition -- it has to be sustainable. It'll depend on what the county is looking for and how we would respond."

The next step involving the ambulance is the preparation of the RFP.