Minutes 05-19-2022 Business Meeting

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23 Kim Woodward, Emergency Medical Services Division Chief, said that Orange County has traditionally been under the rates of the other counties. Kirby Saunders said that the focus has been on rates rather than percentages. He said that a standard percentage is 150%, but that is community dependent. He said they must consider the payer mix and review if the rates will disproportionately impact any of the users of the system. He said that he is unsure of the payer mixes of the different counties but suspects that Durham and Wake will also be increasing their percent allowable. He said staff feels comfortable with the 150% recommendation. Commissioner McKee asked what the delinquency and write off is currently and how will the increase affect that. Kim Woodward said "self-payers" is the lowest amount that the county gets back as revenue, and that rate is currently 14%. She said that they have the EMS assistance program that assists payers currently below poverty level. Commissioner McKee asked if most of this is paid by private insurance. Kim Woodward said that is the intent, but private insurance will pay more. Kirby Saunders said 32% users are on Medicare, 23% are private insurance, and 20% are self-pay. He said they collect 81% from Medicare, 74% from private insurance, and 14% from self-pay. He said there are programs to assist those that cannot pay, and he is not concerned that this will disproportionately affect any payer. Commissioner Bedford read from the County Manager's FY23 Recommended Budget document and asked what "the redeployment of our agency's inventory management system, OperativelQ" meant. Kirby Saunders said it is the internal supply and logistics tracking software. He said that it helps determine what type of equipment is needed and is also what the department uses to make orders. He said they are working to redeploy that, and they want to reduce amount of time staff, crews, supervisors, are having to come to warehouse to pick up supplies. He said that this is coming back online after the pandemic. Commissioner Hamilton asked about the EMS SMART Goal #3 to improve the 60% adherence rate. She wanted to know if the dotted line meant everyone or an average. She asked if they are looking for every month or yearly. Kirby Saunders said it is month to month. He said they want to stay as close to 60% adherence as possible. He said that closer to the dotted line, the better the response time. He said he expects it to stabilize when the new units are online. He said that this will help with response time and that it is their assumption that adding resources is the only way to decrease that time. Commissioner Richards asked about the reliance on mutual aid. Kim Woodward said South Orange Rescue Squad is a partner and they have expanded as much as possible. She said that the community is being impacted. She said they have not had the same attrition in staff compared to surrounding agencies, they are going down units. She said that the BLS resources have helped reduce reliance on mutual aid compared to surrounding agencies. She said that the reliance on mutual aid drives up call volumes, Commissioner Richards asked if there is data on response time for mutual aid compared to intra-county. Kirby Saunders said it is about 20 minutes, compared to 11-minute average for all calls. He said they are under 10 minutes for Advanced Life Support (ALS) calls. He said the goal is to get the calls to 60% rate under 9 minutes. Commissioner Richards asked if the county has given out almost double the mutual aid than they have received. Kirby Saunders said yes, but that does not mean they ran a call in another county. He said that a lot of that is moving a county line to standby in case they are needed to assist a