County moves on transfer policy

Many department updates were given during the Marion County Board of Commissioners meeting on Monday, Aug. 8 but the main topic of discussion was the transfer policy for ambulances in Marion County. This topic has been an ongoing topic at commission meetings.

EMS Interim Director Chuck Kenney explained that the EMS department is not bound legally to make transfers for public facilities but they are bound by public calls to take residents to local hospitals. He presented a hospital assists policy that read as follows:

“In the event either hospital requests assistance from Marion County EMS. The requesting facility shall be billed directly for services rendered. Marion County EMS will bill the hospital directly a fee of $700. No assistance fee shall be billed if EMS crews stay after transfer of care from EMS to receiving facility to assist to stabilize said patient.”

The board approved this.

The board also discussed a transfer policy meant to give guidelines for when and how the county and EMS handles transfers. That policy (Marion County EMS 08-2022) states:

At no time can requests for transfer take precedence over the ability for Marion County EMS to provide 911 services for the county. There must be appropriate staffing – personnel and vehicles – left to cover 911 calls. Transfers are not considered our primary purpose/goal. We will make every effort to take in county transfers, if able. We will not exceed a distance over a 60-mile radius of local hospitals. All transfers from facilities other than those in our county will be considered on an individual basis, as we have personnel/vehicles available.

In the event of a request for two ALS transports at the same time, the Director will contact the facility requesting the second transfer. We will not send two ALS units out of county at the same time as a common practice. In the event an emergency transfer is necessary with another unit out of county the Director will coordinate that with the facility.

Due to staffing issues, MNCO EMS will be staffing one ALS unit for the county at times. When staffing only one ALS unit, transfers will be declined with the exception of those going for immediate lifesaving surgical intervention.

A $2,000 transfer fee will be billed directly to the sending facility transferring a patient from a lower level of care to a higher level of care, in lieu of billing the patient. Transfer fee
includes medical supplies and mileage. Transfer fee includes transfers to all hospitals within the 60-mile radius.
In the event a patient is transferred from a higher-level care facility to a lower level care facility or nursing facility, billing and transport will be considered on a case-by-case basis.”

Commissioner Kent Becker emphasized that he would only like this policy in place as long as the county is short staffed.

Kenney brought up building issues including asbestos removal in the annex building. The board approved the bid from Supreme Floor to remove it. There was only one bid received for painting so the board discussed the department doing it on their own.

The board spent a lengthy amount of time discussing compensation and PTO for EMS staff, particularly since the employees do not tend to work eight hour shifts but rather work 24-hour shifts.

Weed/HHW/Transfer Station/Recycle Director Josh Housman gave a department update and submitted the solid waste management plan five-year worksheet. The plan noted that Marion County has seen an increase in solid waste due to Waste Connection moving out of the area.

Commissioner Randy Dallke brought up the idea of the county transfer station raising rates since Hillsboro and Marion are both raising their trash and recycling rates.

“I know that’s a lot of work, but I think it’s worth looking at,” said Dallke.

Housman said they have had a lot of calls regarding recycling and said that many haven’t realized that they can bring recycling only once a month rather than weekly. County Clerk Tina Spencer asked what the fee is and if they weigh it or not. Housman said it’s a flat fee of $5.00.

“When they bring it in to the bin, how do you want it packaged?” asked Spencer.

“They can bring it in plastic bags or boxes and dump it into the green bin and take the bags and boxes with them to use again,” said Housman.

Houseman reported that he spoke with Fort Riley and can get recycling going again. No decision was made.

In other business, the board:

n learned that the County Appraiser met the statistical performance standards established for the residential class of property. These included the overall level of appraisal and uniformity within the property class. In addition, the overall appraisal level requirement for the commercial/industrial class has been achieved. However, the commercial/industrial property class did not meet the COD requirement for overall appraisal uniformity. As a result, the Division of Property Valuation staff will meet with the County Appraiser to evaluate in detail the 2021 Real Estate Appraisal/Sales Ratio Study and discuss any actions which may be needed to address the areas of concern.

n heard from Planning & Zoning Director Sharon Omstead in a department update that there was a state well and landfill inspection and everything passed although there may be one or two little areas needing slight attention. One of the wells was dropped from further inspections so there will only be three water wells needing testing once a year.

Met in executive session for non-elected personnel.

n heard road and bridge updates from County Engineer Brice Goebel.

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