Dennis Morlan, who for 32 years has provided ambulance service to the county, doing business as Greene County Emergency Medical Services, spent an hour Monday morning briefing the county supervisors of the challenges of his business. He said it’s time for the community to step up and provide financial support for ambulance service.
Like most businesses, the largest challenge is a tight budget. That challenge has grown with the state’s privatization of Medicaid.
Morlan admits he probably made “some serious mistakes” in his financial agreement with the contract. “We’ve been here 32 years. We’re getting the same amount of money today that we asked the county for 32 years ago,” he said. “We’re all smart enough to know what inflation has done.”
The county budgets $50,000 per year for EMS. Of that, $38,400 is paid to Morlan, and the remainder covers insurance on the building and utilities. Morlan has kept the supervisors apprised when ambulances need to be replaced and the supervisors budget more for those purchases.
Morlan said there are people interested in purchasing the business, but they can’t with the current financial constraints.
Morlan can’t offer health insurance as an employment benefit, making it very difficult for him to recruit and retain staff, he said.
The “Medicaid mess” – privatization of Medicaid – has reduced his revenue by 25 percent due to decreased reimbursement, according to Morlan. He the privatization is “an absolute, total, complete disaster,” “a fiasco,” as he described it.
Also, because Grand Junction and Churdan rescue squads are struggling with staffing, Greene County EMS responds to every page for an ambulance. Morlan incurs expense, but if Greene EMS doesn’t transport a patient, there is no bill and no payment for the service. Last year Greene County EMS answered 830 calls; of those, more than 100 were “dry runs” with no patient transport.
All financial support comes from user fees and the county stipend.
“There seems to be a significant amount of money floating around the community from the casino, etc, etc,” Morlan said, and told the supervisors that in Emmetsburg, also home to a Wild Rose Casino, there is a formula for disbursing city funds from the casino to public safety. “Nothing is allocated in Greene County. We get nothing. But I notice we can take $20,000 and bring a rock band to town. Support isn’t there.”
He said there are between 300 and 400 calls for EMS in the city of Jefferson, but the city provides no financial support.
“Maybe the time has come for everybody to step up and say, ‘If we want an ambulance in this county, someone is going to have to pay’,” Morlan suggested.
“Sooner or later, we have to figure out how we’re going to do this,” board chair John Muir said.
Morlan said he would start looking at how neighboring ambulance services operate financially. He estimated it would cost $200,000 a year to keep Greene County EMS viable. That would be $100,000 if Medicaid privatization were reversed.
Morlan hopes to retire July 1. He told the supervisors he had hoped to work a few more years, but a battle with cancer has left him unable to meet the physical demands of ambulance service.
“I won’t just walk out the door. I have too much love for Greene County, and too much blood and guts into this to just leave,” he said. He added, though, that his worker’s comp insurance expires June 30, and that his license will soon be up for renewal.
