Meadview, Lake Mead City, Dolan Springs and Mohave County Resources and Discussion
A A A
Avatar

Please consider registering
Guest

Search

— Forum Scope —






— Match —





— Forum Options —





Minimum search word length is 3 characters - maximum search word length is 84 characters

Register Lost password?
sp_Feed sp_PrintTopic sp_TopicIcon
Is the LMRFD ambulace service supporting LMRFD or is it subsidized by the fire district?
Gabe says the ambulance revenue supports LMRFD, Ellen says it doesn't
Avatar
Christine
Meadview, Mohave County
Admin
Forum Posts: 275
Member Since:
March 11, 2017
sp_UserOfflineSmall Offline
1
June 12, 2018 - 5:21 pm
sp_Permalink sp_Print sp_EditHistory

From https://highdesertdirt.com/blog/2018/06/08/my-open-letter-to-lmrfd-regarding-the-ongoing-disarray/

I wrote that the ambulance supports LMRFD and that's based on Gabe's (the accountant) statement.

Ellen wrote:

You got that backwards. The taxpayers in the LMRFD have always subsidized the ambulance service. The ambulance service has NEVER covered its costs of operation. There are some glaring errors and omissions in the recent ARCR filed with the State that make it appear that it is near breaking even, but in reality, when all of the costs are calculated, the taxpayers cough up hundreds of thousands of $$ a year to keep the ambulance service on the road… much of it to tourists on Hwy 93 who never pay their bill.

Like the Sheriff said about collecting on traffic tickets…try to collect from someone in China. You need only compare the proposed budget for 18/19 on the LMRFD website to previous budgets to see that ambulance revenue has been declining every year while tax revenue has been slightly increasing. When something breaks in the LMRFD, they don’t say, “Oh, let’s make collections more efficient, or “Let’s see how we might reduce the costs of operation on the ambulance service!” It is, “Let’s con the taxpayers into voting for a tax levy “. It is much easier to just gouge the sitting duck taxpayers than think outside the box or do something creative. ...

Let's discuss those errors and omissions in the ARCR, after I know what that is and we have a copy posted here. 

I also wondered how Gabe came to the conclusion that the ambulance supports LMRFD.

We really have to STOP the tourist hating and blame game and get with FACTS. 

"Like the Sheriff said about collecting on traffic tickets…try to collect from someone in China."  Just a few weeks ago I believe it was the undersheriff stating at the DSCC meeting that many of these tickets got paid.

And the tickets really have absolutely nothing to do with medical bills. You're working off what you'd LIKE to be true.

... You need only compare the proposed budget for 18/19 on the LMRFD website to previous budgets to see that ambulance revenue has been declining every year while tax revenue has been slightly increasing. ...

It's not nearly that easy and NO legislator will vote for reimbursement based on that and neither would I.

Again, you just make assumptions based on what you want to be true.   Three DOAs in the last report -- maybe revenue is down because people die before the ambulance gets there?

Maybe it's down because Meadview people want to live and choose private transportation due to the extremely long ETAs?

Maybe it's down because residents are afraid to have collectors drive them to commit suicide if they can't pay the bill? 

It might well be a combination of reasons!

And that goes back to my and Rick Sherwood's request for DETAILED ambulance revenue. 

I know it's so much easier to just blame tourists, but I really want to SOLVE these problems and to accomplish that I need to have FACTS.

Let's assume for the sake of this discussion that we have $100,000 in unpaid billes from Chinese tourists and $200,000 in unpaid bills from non Chinese tourist ambulance runs on 93.

Then the 93 fire truck runs need to be included, but of course listed separately. So if that's another 100,000 we'll just ask for $400,000 to be reimbursed.

As soon I have the EXACT number with all the documentation for the last two years, I will PERSONALLY ask our state legislators to cough up that money. 

93 is a state route and nobody can expect LMRFD to foot the bill.

We can also look into changing the CON area, Jay has been talking about that a lot, we'll make a separate topic for that.

So lets get FACTS and documentation so we can move along with this!

Avatar
Ellen Reh-Bower
Member
Members
Forum Posts: 23
Member Since:
June 13, 2018
sp_UserOfflineSmall Offline
2
June 13, 2018 - 1:36 pm
sp_Permalink sp_Print

"I also wondered how Gabe came to the conclusion that the ambulance supports LMRFD."I missed Gabe making that statement.  I would most certainly have objected if I had heard it.  I worked intimately with the LMRFD financial data for 11 years.  I KNOW what the facts are.  I have noticed we have been getting some obviously erroneous information at the LMRFD Board meetings to include...

1.   "Expenses for April totaled $39,912, which was over budget by $40,802.So the budget for the month was set at a minus $890.?  Am I missing something?
2.  Discussion re: LMRFD Out of District billing for fire/ems services.  "Mr. Buldra explained there has been $290K in revenue this year for the billing." ?? That number does not compute for either fire or ems and definitely not both. Where do these numbers come from?
3.  "Director Kiffer wanted to know the uncollected amount.  Director Cass noted it was around $200."  Is that just for fire billings?  Is there documentation for these figures?
4.  "Mr. Whittington had advised it would be a cost to the District of about $1K to keep it maintained (lien)."  Mr. Whittington is either an incompetent fool or somebody is lying.  Whittington surely knows that the cost of filing a Small Claim and maintaining a lien is less than $200. 
5.  "Chief DeMaio stated with insurance companies there is usually no issue in receiving monies".  BS!  That is NOT true with fire insurance which NEVER pays to the Fire District.  Fire insurance pays to the homeowner.  Homeowner may or may not (usually not) pay the Fire District.  A small claims summons puts a fire under them (pardon the pun) to do so.
7.  "Mr. Whittington and Mr. Buldra advised against that because a Board Member would have access to alter information inadvertently within QB.  More BS!  Anyone can be designated with a "look only" authorization in QB, having NO ACCESS to alter anything.  These guys cannot be so ignorant as to not know that.  Gabe would absolutely know.

 

So, until verified, I would take info received at the Board meetings from chief, Whittington and Gabe with a grain of salt.  There seems to be a communication disconnect somewhere along the way.

"Like the Sheriff said about collecting on traffic tickets…try to collect from someone in China." Just a few weeks ago I believe it was the undersheriff stating at the DSCC meeting that many of these tickets got paid."At a previous town hall meeting, I think it was the 4/14 one held at the DSCC, the undersheriff stated exactly the opposite, as he recited a list of foreign names and places to make his point. That meeting is on video somewhere.

"And the tickets really have absolutely nothing to do with medical bills. You're working off what you'd LIKE to be true".

Collection on tickets and collection on medical bills have everything to do with each other, when the reason they are both uncollectible is the same...out of country tourists that don't pay their tickets/ambulance bills and cannot be contacted or coerced to do so.  This has nothing to do with what I would LIKE to be true, or '"tourist hating", it is fact that must be dealt with in order to resolve the issues that revolve around it.

"It's not nearly that easy and NO legislator will vote for reimbursement paid on that and neither would I.

Again, you just make assumptions based on what you want to be true. Three DOAs in the last report -- maybe revenue is down because people die before the ambulance gets there?

Maybe it's down because Meadview people want to live and choose private transportation due to the extremely long ETAs?

Maybe it's down because residents are afraid to have collectors drive them to commit suicide if they can't pay the bill?

It might well be a combination of reasons!"

My point seems to have been lost here.  My statement about comparing budgets was making the point that the ambulance service does NOT subsidize the LMRFD, as supported by declining ambulance revenue.  The current budget has it projected to be about 43% of  tax revenue, slipping 7% from the long touted 50% of revenue.  There are obviously many reasons ambulance revenue is down, but that is not what we were discussing.  Again, my statement has nothing to do with what I want to be true, and you know me well enough by now, to know I deal in facts, not assumptions.  I have sent you plenty of documentation proving my points.

"I know it's so much easier to just blame tourists, but I really want to SOLVE these problems and to accomplish that I need to have FACTS.

Let's assume for the sake of this discussion that we have $100,000 in unpaid billes from Chinese tourists and $200,000 in unpaid bills from non Chinese tourist ambulance runs on 93.

Then the 93 fire truck runs need to be included, but of course listed separately. So if that's another 100,000 we'll just ask for $400,000 to be reimbursed.

As soon I have the EXACT number with all the documentation for the last two years, I will PERSONALLY ask our state legislators to cough up that money."

Among the documentation I have sent you previously, Christine, you have the breakdown of runs by zone from 2015, which is the most recent available, because the LMRFD no longer has a functional reporting system that can provide that information.  That would be the first issue to resolve.  How can we take facts and data to state legislators when we don't have current facts and data?  I have asked repeatedly for that reporting system to be fixed.

As you can see from that breakdown I sent you for 2015, 26% of ambulance runs were "Out Of District" (OOD) and 51% of those were uncollectible.  OOD includes the dead zone between Dolan and Meadview, (also heavy tourist related incidents), and Whitehills. Whitehills, like Dolan and Meadview are primarily Medicare and AHCCCS patients, with easily collected bills, so it is safe to assume that approximately 50% of those "uncollectible" OOD ambulance bills were tourist related.  As I've calculated for you before based on ambulance costs as posted on the LMRFD website, with a run from Hwy 93 or the dead zone costing around $2400, and total ambulance runs for 2015 at 746 (as shown on the report I sent you), the calculation would go like this:  26% of 746 = 194; 51% of 194=99;  99x$2400= $237,600 !  Potential lost revenue to the LMRFD due to uncollectible ambulance runs on tourists on Hwy 93 and Pierce Ferry Rd. Even allowing for a 50% margin of error, the loss would have bought the new ambulance we the taxpayers are on the hook for the next 5 years for.  BTW, the trend was continuing upward for OOD ambulance runs.  As of  March 2016 when the last data was available, OOD runs were at 30%.  I would expect an ongoing upward trend with crazy traffic continuing to increase on Hwy 93. 

"We can also look into changing the CON area, Jay has been talking about that a lot, we'll make a separate topic for that."

John Flynn worked with the AZ Dept of Health Services, Bureau of Emergency Services, to attempt to get the C.O.N. reduced to the boundaries of the LMRFD.  He was told that unless there is another agency willing to take over the C.O.N. on Hwy 93, the LMRFD CANNOT get out of it.  AMR would be the most likely (possibly only) candidate and they don't want it because it is a $$ loser.  It is my understanding that the reason LMRFD has its C.O.N. is because AMR didn't want it to begin with. 

I am convinced it will take an citizen uprising to get any changes made at the County and State level.  Individuals get nowhere.  The newly formed "Meeting the Needs of Dolan Springs" group with 3 Committees designated to work on specific issues is a beginning.  Committee "C", of which I am a member, is responsible for communicating with our elected representatives to address our issues.  One of our issues is funding for the LMRFD, which directly affects Meadview as well.   

Avatar
Christine
Meadview, Mohave County
Admin
Forum Posts: 275
Member Since:
March 11, 2017
sp_UserOfflineSmall Offline
3
June 13, 2018 - 11:41 pm
sp_Permalink sp_Print sp_EditHistory

Ellen, am very happy to see you got the posting here figured out.

But we'll never get ANYWHERE unless we have each and every ambulance run info.   We need the patients' home town and state to determine whether they were tourists, I don't know how you figured who's a tourist and who isn't and which bill was paid and which wasn't.

How about you put it on the agenda for the next meeting, demanding a report with EACH and EVERY ambulance run since the board took over.  I can only send ONE mean letter per meeting 🙂

This is what I'm looking for:

[Date] -- [from] -- [to]  -- [miles driven] -- [miles transported] -- [Patient hometown / state / country]  -- [type of injury]  --   [amount billed] -- [insurance/patient] -- [$$$ paid by insurance] -- [$$$ paid by patient]

Am I missing something?

If LMRFD can't produce that report it does NOT deserve to exist!

Avatar
Ellen Reh-Bower
Member
Members
Forum Posts: 23
Member Since:
June 13, 2018
sp_UserOfflineSmall Offline
4
June 14, 2018 - 1:06 pm
sp_Permalink sp_Print

"But we'll never get ANYWHERE unless we have each and every ambulance run info. We need the patients' home town and state to determine whether they were tourists, I don't know how you figured who's a tourist and who isn't and which bill was paid and which wasn't."

The old reporting system at the LMRFD had runs broken down by Zones.  Hwy 93 was 1 zone; Pierce Ferry Rd. to Dolan was another zone; D.S to 23rd; Meadview, etc..  This allowed for number of runs to be calculated based on zone.  Not many locals call for the ambulance from Hwy 93, so, safe to assume most of those are not LMRFD taxpayers.  Same with dead zone between 23rd in Dolan and Smith Rd. in Meadview, to include Diamond Bar Rd.  Then, the billing service was able to correlate those runs by zone with their receivables to determine that 51% of the uncollectible bills came from the "out of district" zones.  You don't need "each and every ambulance run info" to determine where the losses are; you just need a functional reporting system in the LMRFD that interfaces with the billing company.  Unfortunately, since the spring of 2016 the LMRFD has not had a functional reporting system.  It cannot provide the detailed ambulance run data that the old system did.  Detailed data on each and every run is available through Kingman Dispatch Service, but they aren't going to hand that out to the public.  It should be provided to the LMRFD for monthly reconciliation purposes.

Avatar
Christine
Meadview, Mohave County
Admin
Forum Posts: 275
Member Since:
March 11, 2017
sp_UserOfflineSmall Offline
5
June 14, 2018 - 3:55 pm
sp_Permalink sp_Print sp_EditHistory

Ellen, when it comes to the billing system, as was recently discussed, there are other options, LESS money to them and they'll just have to go with someone with enough competence to provide these reports.

Not many locals call for the ambulance from Hwy 93, so, safe to assume most of those are not LMRFD taxpayers.

I wouldn't go with that to a legislator, but since you'll do that, we'll see ...

You make this reporting sound like it's something complicated.   When I was 16 I could have done the ENTIRE YEAR in a day or two -- at most (depending on the paperwork), just working off the invoices and payments received.  I had an adding machine with a tape and ledger paper and it was guaranteed to be accurate to the penny.

Considering how much time I've wasted TALKING about this and WRITING about this, I'm certain I'd have 2017 done in the time I've already wasted.

Of course we did our receivables reconciliation monthly because we were running a real (startup) business and while we ate a lot of spaghetti and tomato sauce anyway, we would have had NOTHING to eat if we had operated like LMRFD!

I'll never get used to the American and especially Mohave County mediocreness, but I can't change it. 

So I'll just let this go -- I give up!

Avatar
Ellen Reh-Bower
Member
Members
Forum Posts: 23
Member Since:
June 13, 2018
sp_UserOfflineSmall Offline
6
June 16, 2018 - 6:16 pm
sp_Permalink sp_Print

"You make this reporting sound like it's something complicated."

The reporting on ambulance activity is much more complicated than tracking income and expenses for a standard business.  You aren't asking just for the income and expenses, which is reported (albeit erroneously, I believe) in the ARCR's filed with the State.  What you are asking for is infinitely more difficult.  You want dates, places, times, purpose of calls, mileage, destination, etc. for each ambulance run... a LOT more data than tracking invoices and receipts. 

Avatar
Christine
Meadview, Mohave County
Admin
Forum Posts: 275
Member Since:
March 11, 2017
sp_UserOfflineSmall Offline
7
June 16, 2018 - 7:34 pm
sp_Permalink sp_Print sp_EditHistory

[Date] -- [from] -- [to] -- [miles driven] -- [miles transported] -- [Patient hometown / state / country] -- [type of injury] -- [amount billed] -- [insurance/patient] -- [$$$ paid by insurance] -- [$$$ paid by patient]

THAT is complicated?  How?

You open a spreadsheet and enter the data.   Since there are only 11 pieces of data required, it can't be more than 11 different sources to compile.

In my sleep .... yawn ...

Probably only takes the incident reports and the corresponding billing.