Ambulance district approves almost $6 million budget

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Marion County Ambulance will continue to expand coverage and see an increase in training after the district board approved a $5,967,320 balanced budget during their meeting last week.

In addition to approving the budget, the board also discussed grants and upgrades to communication needs, reviewed employee incentives and approved revised policies.

Of the total budget, $2.8 million was approved for salaries and $862,600 for administration.

Vehicle and maintenance accounts for another $361,000 of the budget, and $347,320 is budgeted for vehicle and equipment replacement and other capital expenses.

In addition, the budget included the annual administrative and employment contracts with Ralls County. 

Chief John Nemes said the 2023 employment contract fee with Ralls County totaled $49,975.46 per month and the administrative contract fee was $6,000 per month. 

Ralls County Ambulance Board approved the contracts with Marion at their last meeting, Nemes added.

Nemes noted there are some line item changes in the 2023 budget, including a $200,000 increase for field employee payroll, citing the district’s ability to exceed 50 employees and expand coverage under the new insurance plan. 

The district has been staffing an additional ambulance in Hannibal to help expand coverage and reduce crew fatigue, Nemes said, noting he hopes to continue to build on that in the future. To date, the district has had approximately 6,500 emergency calls, which was up about 200 over 2021. 

Nemes also said the budget included increases in training and training equipment to expand EMS education in the region. 

The district still has the education contract with the University of Missouri to provide EMT and paramedic training in Hannibal, Nemes said, adding the district intends to add a night program to allow for more flexibility to those who want to become an EMT,

“We have also been working with the Hannibal Area Vocational-Technical School for the past year in providing EMS education there,” he said, stressing the importance of these programs in keeping a steady flow of locally trained personnel to avoid the shortages that other area agencies are experiencing. 

In his report, Nemes aid the grant for a PowerLoad system in the new van has been awarded to the district. 

“We will be receiving $10,000 from Missouri Employer’s Mutual towards the total price of $25,690.07, leaving the us covering $15,690.07 of the equipment and installation. 

Nemes also reported he submitted a grant to Missouri ARPA for funds towards the purchase of an additional Zoll X-Series cardiac monitor. 

If awarded, MCAD will receive $16,474.42 towards the purchase of a new Zoll monitor and accessories, currently quoted at $32,948.83. 

The district should find out about that grant sometime in December, Nemes said, noting that because the quote on the Zoll is only good until the end of the year, he asked the board to approved the matching funds, if a grant is awarded, since they will not meet again until January.

“If we do receive it, I will go ahead and make the purchase without waiting for board approval at the January meeting and before any potential price changes at the first of the year,” he said. 

After discussion, a motion to approve the purchase upon grant approval was unanimously approved.  

Also under new business, Nemes said he and his operations supervisors met with NECOMM personnel and a representative with Public Safety Solutions to continue discussing the upgrade to the district’s communication needs in each ambulance. 

“After looking at several different options available, the consensus was to use the Sierra Wireless RV55 routers,” he said, presenting the board with a quote from Public Safety Solutions for the purchase of 16 routers and installation at a total of $15,558. 

After discussion, a motion to approve the purchase upon grant approval was unanimously approved. 

Nemes did note the new Apple iPhones were now in service and the communications between crews and receiving facilities has remarkably improved with the upgrade.

The board also reviewed the annual employee incentive, which will be included in the December payroll.

The board had budgeted $60,000 for this in 2021, which was distributed to employees based upon hours worked in that year. 

After discussion, the board approved an increase to this amount to $70,00 as board members felt many employees worked many additional hours to keep the district covered during days of short staffing from vacations, injury, illness, etc. 

In addition to the $70,000, the board approved an additional $250 to each of the top five employees working the most hours.

The board also approved a revised policy for retirees and health insurance. 

The district’s new health insurance plan allowed for retirees and/or their dependents to stay on the plan until the age of 65 or in the event that an employee goes on disability. 

“The current policy provides qualifying retired employees with a monthly stipend of up to $1,000 per month to purchase their own health care plan,” Nemes said, noting an employee must be 55 or older and have 20+ years with the district before qualifying for this benefit. 

“The current policy also allows for qualifying employees to choose the option to stay on the district’s healthcare plan as opposed to the stipend,” he added, “Employees can also add their spouse/dependents, at the employee’s expense, if they were already enrolled in the district plan at retirement.” 

Last on the his report, Nemes said the next ambulance was taken to Braun before Thanksgiving and the newly remounted ambulance was brought home. 

“We had planned to take two of the remaining three ambulances to be remounted out to Ohio this time, but one of them had a mechanical issue and was in limp mode,” Nemes said, adding that ambulance must be towed to Brawn for the new chassis. That installation is now delayed until mid-January of 2023.

MCAD answered 518 calls for emergency service in October.  Base 1 (Hannibal) – 2711 handled 173 calls, 2721 handled 89 calls, Base 2 (Hannibal) handled 161 calls, Base 3 (Palmyra) handled 77 calls, and there were 18 off-duty transfers, Nemes said.  

The next meeting is scheduled for Thursday, Jan. 19, 2023.