Va. county to 'hard bill' for EMS services

Officials said if the plan passed it would bring in addition income of $127,270 for the county's rescue squads

The Carroll News

CARROLL COUNTY, Va. — In an effort to generate an additional $127,270 of revenue for its fire and rescue agencies, Carroll County will begin aggressively billing non-residents and non-property owners for EMS services.

The Carroll County Board of Supervisors unanimously approved a proposal during a recent meeting to “hard bill” non-residents and non-property owners of Carroll County for EMS services. The county will continue to soft bill for Carroll residents and taxpayers.

“Basically you get a bill and hopefully you end up turning that into insurance and someone will end up paying the bill. If it is not paid for, then we end up writing that off, and it has gotten to the point we cannot write off all those expenses,” Larrowe said. “One of the things we have checked on and worked with a billing company about is more aggressive out-of-county billing. It would be hard billing for anyone that is outside of Carroll County, not a resident of Carroll County, not a taxpayer of Carroll County, so we would have additional revenue coming in.”

Using historical data, Larrowe said if the plan passed it would bring in additional income of $127,270 for Carroll’s rescue squads. He said Carroll County Fire and Rescue could expect to bring in $74,300 more dollars if the plan passed. Cana would bring in an additional $28,000, followed by Pipers Gap Rescue (an additional $11,000), Laurel Rescue ($7,000) and Laurel Fork ($6,000).

“The rescue squads would be picking up additional revenues that they actually need,” Larrowe said. “It’s not requiring anything of Carroll citizens and it’s trying to keep the services going as long as possible without going to some other billing source in the future.”

Assistant County Administrator Nikki Cannon said the county can go back a year to collect accounts receivable listings that have been billed and are outstanding for out-of-county billing. “With all the data we have received and knowing what the expenses are doing with our paid services as well as our rescue squads, the problems that we are having, it looks like that we do need to aggressively pursue out-of-county billing,” Chairman Phil McCraw said. “We’re not talking about folks who live in Carroll County, we are talking about anyone outside of Carroll County.”

Supervisor Dr. Tom Littrell wanted to know how the county would determine which citizens are out of county. He has a Galax address, as do many people in that area, so you would have to determine which people are actually in Galax and which are in Carroll County, he said. Cannon said it is currently determined by zip code, which still presents a problem.

“The proposal says that presently the EMS personnel will determine that,” Cornwell said.

Supervisor Joshua Hendrick pointed out the policy is pretty direct. It states it is for non-residents and non-property owners. You could have an address in Kalamazoo, he said, but own real estate in Carroll and get billed at the county citizen rate.

“One of the reasons for being able to do this is because you think of taxpayers as part of the corporation of Carroll County, so you treat all members of the corporation equally,” Larrowe said.

Cannon said Carroll’s total income from EMS has decreased from $1.1 million in 2012, to $1 million in 2013, to $981,000 last year. It continues to decrease over time, she said. Hendrick said that is a 15 percent increase in funds the county should have received, but taxpayers instead had to cover through real estate and personal property taxes.

“And let me also point out that those costs are also escalating upward, so as the costs are going up and the revenues are going down, that gap gets wider,” Cannon said.

And that gap will probably continue to widen, McCraw said, unless something happens with the Affordable Care Act. At that point, Littrell said Carroll has surveyed other counties to see what they are doing.

“I don’t know what else we could change, so just for the sake of argument I will make a motion we approve the information we have on out-of-county billing,” Littrell said.

Hendrick seconded the motion, which passed unanimously.

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