Tuesday, March 14, 2017 - Updated: 4:55 PM
By Rachel Keller Collins
Marshall County Judge-Executive Kevin Neal presented the commissioners with a draft of a proposed form seeking bids for management of the ambulance service. It was early in the conversation when Commissioner Bob Gold stated he didn’t feel he would be ready to make a move by the March 31 deadline and after two separate rounds of discussion, one during the allotted time in the agenda items and again just before adjournment, all three commissioners remained silent as Neal sought a motion to approve the request for proposals (RFP).
Gold said, “I’ve spoken to a lot of folks about this and probably need a lot more time to get at least myself satisfied with separating from the hospital. Early next year I would be happy to look at it again before the contract or whatever that deadline date is but…I just can’t, right now, get myself to support separating from the hospital.”
Gold said he’s been speaking with everyone possible from county magistrates to insurance providers in an attempt to put together hard numbers and solid research that would make him feel more comfortable with exploring the unknown but so far, he’s had a difficult time doing so.
“One of the county magistrates that I talked to that has two ALS (Advanded Life Support) ambulances taking their runs and supplementing then on top of their runs at $800,000. I heard that more than once,” he said. “Most of them told me that if we could stay with the hospital that’s what we need to do. I don’t have the justification for that either, that’s why I’m trying to put all that together. If we can save money I don’t have any problem with that but I just haven’t been able to find a way to support it yet.”
“My concern is that if we separate our cost won’t be any better and our service may or may not be as good. I just can’t right now,” he added.
Neal reiterated, as he had in the previous two meetings regarding the subject, his belief that the county was in a “good position” because it owns the ambulance service and the capital that comes with it. He also reiterated his belief that the county was in a good position to seek RFPs and that because of the previously listed circumstances, the entities interested could lead to a more competitive service.
But the commissioners seems less enthusiastic about the idea and Commissioner Rick Cocke said he wasn’t convinced competitiveness was something that would benefit the county nor the county’s employees that would be affected by the decision. He too said he needed to see hard numbers and solid evidence the decision would be positive before making a change that large.
Neal said he had the numbers and while he didn’t share them in open court, he had shared them with Gold, who according to Neal requested to see them.
“We ran our own numbers based off of what we could get from the current ambulance service and when you tie into we have the capital, we are in a very good position to put out an RFP,” Neal said.
Gold said he reviewed the numbers and it didn’t provide the same level of solace.
“I took just the 2016 numbers that I got as best I could and they showed quite a bit of difference but you all showed an average where I just had the one year. From my understanding they did have a new billing system that they had a little trouble with so it might not have been the best year to look at but it was the easiest one for me. The expenses were quite a bit more and the revenue was quite a bit less just for that one year. That was my concern; it didn’t show that we would even be even with the subsidy, we would be in the hole for that one year, just for ’16 and that didn’t count the medical director or the malpractice insurance.”
Gold said he reached out to an insurance provider requesting hard numbers for malpractice insurance costs but was still waiting for those numbers as of last week. He said he hasn’t been able to put together anything that shows with solidarity what the actual cost for separating from the hospital is going to be. He said he wants to see an outline of hard numbers that show what it’s going to cost for malpractice insurance, a medical director, and all of the other inner workings.
Gold said he would be open to revisiting the topic at the next meeting but said he doubted he would have been able to conduct enough research in those two weeks to satisfy his concern that the county would end up with a management service that costs the county more and may or may not provide adequate service.
Neal reminded the commissioners they would have to make a solid decision at the next meeting on March 21 because if the county were to terminate the contract with the hospital and seek RFPs, the hospital must be formally notified by March 31.
Despite his best efforts in the approximately 20 minutes leading up to the meeting’s adjournment, both of Neal’s requests for motions to approve seeking RFPs fell flat as all three commissioners sat silently.