Town of Olive
County of Ulster
State of New York
August 6, 2001

Minutes of the monthly audit meeting of the Town Board of the Town of Olive held Monday, August 6, 2001, 7:30 pm at the Town Meeting Hall in Shokan, NY.

 The Town Board audited the bills for the month of July.

Supervisor Leifeld introduced Phil Hawver from the Olive First Aid Unit. Mr. Hawver stated the unit has been discussing new ideas for their department and noted that the major issue is lack of manpower. He stated that people don’t have the time to take all the training that is required and there is no large industry located in town; therefore, they have a lack of volunteers. Mr. Hawver stated the unit has looked at different avenues and the best solution they have come up with is to do as the Town of Shandaken does. He noted that Shandaken supplements their personnel with paid shifts during the day and at night they run on a per call basis and they guarantee coverage. Mr. Hawver noted that the ambulance service would bill those who use the service thus taking care of paying the personnel. He stated Olive is looking at the same situation in an effort to increase the personnel coverage. Mr. Hawver stated that Olive First Aid would like to go into billing so they would have people available in the daytime. He noted at this point everyone would be billed equally. Mr. Hawver stated that the first aid unit receives money from the town but they would bill everyone who receives their service though they would not actively go after collecting the fees, further noting this is soft billing. Council Member La Monda stated this practice is discriminatory. Mr. Hawver and Council Member Johansen stated it is not. Mr. Hawver stated if they subcontract to an ALS agency then they submit the bill and they pay the subcontractor for the work done so the patient will have Medicare pay for the call. He stated that many patients are now driving themselves to the hospital since they are being stuck with intercept bills that Medicare will not cover. He stated they have looked at other aspects; however, a commercial service can’t come in and run it since there are not enough calls to make a profit. He stated they have looked at changing their status and becoming part of the town with the town having control of the unit and personnel. He noted, however, this could be more costly. He stated if they did go with the town then there might be something in the future that Shandaken and Olive could combine efforts. He noted the daytime personnel would be paid around $30.00 per day plus an approximate amount of $25.00 per call. He noted that billing should cover the amount of paying for a person on call. He noted they would have to have a paid person who would do the billing. He stated they would not have to pay a shift at night since there are more volunteers at home at night—they would pay per call only at night. In response to Council Member Burkhardt, Mr. Muller noted the first aid unit has 15 EMT’s. Mr. Hawver explained subcontracting with Shandaken for the Company 5 area noting Alamo gave the better deal for subcontracting this area. He noted that $175.00 would be the subcontracting fee when they come. They would bill the Olive First Aid and OFA would bill Medicare. Mr. Hawver stated if their crews were to be paid then he would like to see these people give first aid instruction and CPR instruction back to the community. Supervisor Leifeld stated that once you start billing you have to guarantee 24-hour service. Mr. Hawver replied that by having a subcontracted unit you can guarantee full time coverage. Council Member Johansen stated the Olive First Aid Unit needs to attract more people and in order to do that they have to offer the personnel something. Mr. Muller stated that some functional items should be provided at the unit facility such as showers, for example. Supervisor Leifeld asked if it could be feasible to implement this system on a probationary period. Mr. Hawver stated it would take about two months to get everything going with Medicare. Supervisor Leifeld stated he would like to see a point in time where the system is checked to see if it is really working—possibly reevaluating it in a year noting it should at least be monitored and looked at. Supervisor Leifeld stated he definitely felt that a professional outsider should do the billing. Council Member Burkhardt stated she has a concern that someone who is paying taxes is also getting a bill. Mr. Hawver stated the taxes are paying for the first aid equipment but with this newly implemented system they will be guaranteeing coverage. Council Member Burkhardt stated someone without insurance will be getting a bill. Mr. Hawver stated they would have contact with these people and would work with them in financial hardship cases. Mr. Hawver stated for the $65,000.00 the unit currently gets from the town they are not talking about hard billing. Council Member Johansen stated what the unit will be doing will allow them to charge the minimum allowed and Medicare will pay it. Council Member Burkhardt stated she is not worried about the people with insurance; she is worried about those people who don’t have insurance. Council Member Burkhardt stated concern that there will be people without insurance going in a car versus the ambulance for fear of being billed. Mr. Hawver stated you will have far less of that than those in the situation of Medicare not covering. Council Member Burkhardt stated her understanding of insurance laws is that you have to bill with the intention of collecting. Mr. Hawver stated they are not going to chase those people who can’t pay—they will work with them. Council Member Johansen stated you would not be billing separate amounts with everything being billed equally across the board. Council Member La Monda stated the Olive First Aid Unit is a private corporation and questioned why they are asking the Town Board about this. Council Member La Monda asked about outside agencies auditing the corporation noting that if 100 bills are being paid by Medicare and there are 100 bills that are not being paid for by people without insurance that something is going to come up. Mr. Hawver stated as long as the unit is billing equally there is not a problem. Council Member Johansen stated there would not be a problem with soft billing. Council Member La Monda asked if the unit expects the insurance companies to pay the bill. Mr. Hawver stated, “yes”. Council Member La Monda asked if he felt it a discriminatory practice if they are not expecting individuals to pay but they are expecting the insurance companies to pay. Council Member La Monda stated that the insurance companies would be going after Olive First Aid and not the town. In response to Council Member Burkhardt in how they will be informing the community, Mr. Hawver stated they will be stressing education and will be attending meetings and doing a mailing. Town Clerk Rozzelle asked if the town is allowed to tell people it will be soft billing. Mr. Hawver stated they will be billing people with the intention of collecting but if people can prove that they cannot pay then they will not have to. Council Member Burkhardt asked if the unit knows how many insurance companies do cover or don’t cover the ambulance. Mr. Hawver stated if the emergency is documented medically necessary then they will pay. He noted the unit is not in the business of making money and if a response call is not necessary they have the patient sign off and suggest they seek medical attention. Council Member Johansen stated the first aid units that are struggling are those that are not doing paid shifts and billing. Mr. Hawver stated that approximately eight weeks from the time of applying, the system should be in effect—approximately around the first of the year. Supervisor Leifeld asked if the statistic of 30% to 40% of the Olive First Aid calls not being answered is true. Mr. Hawver stated that figure is probably around 35% but their average response time was still be better than most. Supervisor Leifeld stated that with the town providing $65,000.00 in tax dollars he feels the board still has some say in the process and has the right to ask questions; but, he feels that to improve the response time and to improve the service is the main objective. Council Member La Monda asked if the unit feels the $30.00 will really help the problem of coverage. Mr. Hawver stated he is not sure; but they are trying to address the issue instead of ignoring it. Supervisor Leifeld stated that members of the Town Board will be glad to assist the Olive First Aid Unit in letting the public know this is being done to simply keep the organization going and giving coverage. Town Clerk Rozzelle requested knowing a contact person in the unit to refer residents to regarding the new procedure.

All business pertinent having been discussed the Town Board adjourned on a Leifeld/Burkhardt motion at 8:35 pm.



Sylvia Rozzelle, Town Clerk