VMH STAFF ADDRESSES AMBULANCE ISSUES DURING BOARD OF SUPERVISORS MEETING

By Tanya O'Connor
Addressing the Veterans Memorial Hospital ambulance situation at the July 24 Allamakee County Board of Supervisors meeting were Mike Myers, VMH administrator, Scott Knode, VMH chief financial officer, and Jeff Mitchell, Emergency Medical Service coordinator.
Also in attendance were Bernard Welsh and Richard Leiran, members of the county ambulance board.
"Medicare," Myers informed the Board, "has been cracking down on what they consider a 'necessary' ambulance trip. More and more, things are being defined as 'medically unnecessary'."
Medicare's decision, in terms of hospital finances, translates to the following scenario:
Patient is in need of medical attention. Patient is transported by the VMH ambulance into the hospital. Patient is a Medicare recipient. VMH administers the emergency services. VMH contacts Medicare for bill verification. VMH is told that while patient is indeed covered by Medicare, the ambulance trip was "unnecessary," as in perhaps the patient could have been transported by private vehicle.
At this point, VMH must then inform the Medicare patient they are responsible for the bill. If they cannot pay, VMH is often forced to assume the charges.
The majority of ambulance trips, 85 to 90%, stated Myers, entail the transport of Medicare recipients. Presently, other hospital services hold up the sustained financial loss in the Waukon EMS department, the only county ambulance service operating with paid staff positions.
"Finances are going to be tight at the hospital," stated Myers of the current VMH situation. While he expects the new critical access unit to offset other hospital costs, the new area can in no way assume the bulk of losses the independent EMS program is currently suffering.
In addition, EMS Coordinator Jeff Mitchell reported a shortage of EMT personnel throughout the county. Mitchell stated busy work schedules and learned skill retention, simply due to lack of constant exposure, as issues of concern.
Currently, several county townships support their volunteer fire and ambulance service. Under discussion, the Board asked the VMH representatives to review township and City financial obligations before further steps are taken. The Board also requested current updates on the ambulance situation.
Myers expressed his wish that the hospital be able to find a plausible solution to the financial situation, but let Board members know VMH would take steps as necessary. "I have to make my decisions," stated Myers, "based on the best interests of the financial stability of the hospital."
Also meeting with the Board over Allamakee tourist matters were Jana DeBrower and Heidi Pearson of the Eastern Iowa Tourism Association, and Rachelle Howe of Allamakee County Economic Development.
Executive Director DeBrower discussed tourism grant options with the Board and Howe reported the county to be in the process of researching available grant opportunities.
DeBrower advised the county to "move into different avenues for advertising." She stated out-of-state marketing grants to be a potential resource. "Use unconventional options," she suggested.
According to DeBrower, the county's obvious strength lies in area scenic beauty. Allamakee does not, however, provide accommodations for large bus groups of tourists, or "visitors."
"They come," said Board member Campbell, "but they can't stay. They'll stay in Decorah or other communities and spend their food dollars elsewhere."
While grant funds are available to promote an "attraction," per se, money is not available for businesses such as hotels. Such ventures require an independent financial investor.
In addition, DeBrower stated a need for more "outfitter" type of services in the county. "Throughout Allamakee," she said, "that's something we're sorely lacking."
Campbell also addressed the Mississippi in terms of visitor dollars. "I see the whole river as something we're not completely tapping into," she said.
DeBrower reported an expected December release date for a revised state visitor guide, in which a travel itinerary of the Allamakee area will be available. Data given the Board by DeBrower indicated that in 1998, $16.94 million visitor dollars travelled through Allamakee. Updated statistics, stated DeBrower, will be published this fall.
In other matters, Tony Vondra of Alliant Energy spoke with the Board concerning the Courthouse air conditioner and generator.
Concerning the air conditioning, an energy study is currently underway, with 50% of incurred cost to be assumed by Alliant.
The project is to assess the fourth floor air conditioning and potential replacement of the cooling system in floors ground through three.
The final objective, according to a report by Kalmat Engineering of LaCrosse, WI, is to "provide cost effective air conditioning for the entire facility." The report indicates the project to be a "significant remodeling effort," which would bring the Allamakee County Courthouse "up to the current codes for new construction."
Study costs are projected at $6,000, the necessity of which remains in Board agreement. Work on the project will begin at a later date.
Vondra also addressed the Board concerning operating technicalities of the new courthouse generator. A maintenance schedule was discussed as well as plans for drain installation. The old generator is to be placed at the county engineer's office.
Dianne Egan of the Allamakee Women & Children Resource Center, notified the Board that the Center is fully operational. The facility is located at 29 1/2 West Main in downtown Waukon.
It was decided that County Planning and Development Administrator Laurie Moody will keep office hours each morning between 8 and 9 a.m. Those needing to reach her may telephone 568-3014 or 380-0857.