County cuts for 2016-17 budget continued for a second straight month, this time with a transformation in how Medicaid transportation will be handled starting in 2017-18 and a sizable reduction in funding for Clinton-Sampson Rescue.
County staff recommended awarding the Medicaid Transportation contract to Sampson Area Transportation beginning in 2017‐18. Although there is an increase in personnel and equipment needed, increased revenues can be used to fund 100 percent of the county match for transportation and a portion of the county match for Aging programs, county manager Ed Causey stated.
“It is our belief that it would be beneficial in many ways to Sampson County government,” Causey stated. “If we provided the Medicaid Transportation service, it would provide a huge benefit for citizens of Sampson County who do not currently receive Medicaid, but who are still struggling financially and need transportation services.”
There are areas within the county that are mostly underserved at this time, because the county does not have enough drivers, vehicles or funds to meet the needs. While providing Medicaid services in all areas of Sampson, the move would greatly improve access to transportation for all Sampson residents in need, he and other administrative staff members said.
The net revenue of $465,249 would be used to fully fund Sampson Area Transportation — current county funding to Transportation is $229,501 — and fund a portion of the match for the Aging programs (current county funding is $438,591).
The mileage rate would be $1.54 per mile, based on operating costs for the current fiscal year.
Medicaid transportation has been a hot topic of discussion, and contention among board members, for years. Van-Go operated the service from 2013-15, with Enroute taking over earlier this year. That current contract will expire in summer 2017, when Sampson Area Transportation will assume the responsibility.
As a service contract, it is not required to be bid by the county.
Among the added costs, the county would hire 16 part‐time drivers with at a cost of $185,548; two full‐time administrative support specialists, at a cost of $88,472; and reclassify a part-time support specialist to full‐time, at a cost of $16,418.
“It’s equivalent to adding two and a half positions, and 16 part-time drivers just to do the Medicaid contracts,” Finance officer David Clack noted. “We are augmenting our current transportation service for the county. With this we can go in parts of the county we could not because we didn’t have the money or the resources.”
Some commissioners who were against the county shouldering the service a year ago did an about-face when given a detailed cost analysis and the savings that would come with the measure.
“The bottom line is this: if we can save money, I’m all for it,” said Commissioner Albert Kirby, who noted that normally he would opt for the private sector handling such operations because he felt costs, staff needs and the like, could balloon should the county handle the contract. “That’s not what I’m seeing here. If it’s going to be a savings, you’ll get no argument from me.”
Commissioner Clark Wooten agreed, saying he was “vehemently against” having the county taking over services — a discussion was held about a year ago on such a prospect — for reasons similar to Kirby.
“Having been here a year and seen how our staff operates and works like a business, I’m much more comfortable with this,” Wooten remarked. “Talking about my goals and possibly returning some money back to the taxpayers and increasing the amount of money we send to our kids, if we can put $465,000 in that coffer, I’m more and more inclined to do it.”
Commissioner Sue Lee said she felt much the same way.
“I was very reluctant to add more employees because it frightens me to death,” Lee stated, “but like Clark said, I’ve watched the staff and seen how conservative they try to be. I’m much more comfortable with this.”
Clinton-Sampson Rescue reduction
Several departments have made difficult decisions to voluntarily cease programs as volunteers become increasingly unavailable, a situation with which Clinton‐Sampson Rescue has also been confronted.
The squad’s response to dispatched calls has dramatically decreased in the past few years to a rate of less than 1 percent of their calls — from 330 responses in 2011 to 219 in 2012 and again to 54 in 2013. It dropped even lower, to 34 in 2014, despite more than 1,000 calls.
Despite the invaluable role the department has played in the development of Sampson’s current EMS system, their unavailability warranted consideration of discontinuing the squad’s current contract, county officials said. Cutting that annual stipend to Clinton‐Sampson Rescue would result in a savings of $33,528 per year.
“Our call volume has dropped drastically and we knew over the years that was going to happen as we put on paid services,” Clinton-Sampson Rescue’s Jerry Bradshaw said.
Bradshaw has been in talks for months with county officials about possible reductions. He said the squad wanted to do everything it could to help the county, but asked that the yearly contract be kept in place with just a stipend of $3,600, or $300 a month.
In the end, commissioners kept the contract in place, but at the nominal county cost.
“That allows us to keep a contract where we can continue to participate and be members of the Rescue Association. On our roster right now, counting those actively involved and those who are part of our squad, there’s over 530 years of service to this county,” Bradshaw said. “We have been a training ground for paramedics, nurses, physician’s assistants and other employees for paid agencies who come there to train. It’s a starting ground.”
Both Causey and Emergency Management director Ronald Bass acknowledged the importance of Clinton-Sampson Rescue through the years.
“As a former volunteer myself, I would be remiss if I did not acknowledge the long-standing service of Clinton-Sampson Rescue and the valuable role they have played in the development of our current EMS system,” Bass stated.
The recommendation to suspend the stipend as of Jan. 1, 2016 and negate the contract the following July 1 “in no manner devalues the dedicated service” Clinton-Sampson Rescue has provided since the early 1960s, Causey concurred. He also praised Bradshaw on his “distinguished” personal service dating back to the 1970s.
“There is certainly no question of your members’ commitment to our citizens and the role your organization played in the development of our emergency medical system,” the county manager stated.
Bradshaw said considerable effort has been expended in trying to recruit members that would allow the department to respond to more calls. That work continues.
“We are working,” Bradshaw stated. “We want to continue to serve our county and we want to do our part to balance the budget.”
In other cuts, the board eliminated a stipend for Clement Rescue as volunteers have dwindled and the crash truck is not being used to respond. Currently, both Clement Fire Department and Clement Rescue receive $6,000 annually for rescue technician (RT) services. The agencies have combined resources to respond to RT calls and, given the partnership and the proximity of the two agencies, the cut was recommended.
Last month, Causey presented proposed cuts totaling $247,219.42 for 2016-17 and nearly $50,000 for 2017-18, all approved by the board, leaving just $100,000 to go toward meeting the initial goal toward moving implementation of an employee pay plan forward.
On Monday, another $36,000 was cut from the 2016-17 budget to go with a whopping $465,249 anticipated reduction in 2017-18 with the Medicaid move.
The pay plan will be implemented over four years at an estimated cost of $3.7 million, including roughly $1.1 million and matching fringes for the 2015-16 budget. The plan further calls for $1,193,391 in real permanent savings over the next four years, necessitating a reduction of $345,497 starting in the 2016-17 budget.
Reach Managing Editor Chris Berendt at 910-249-4616. Follow the paper on twitter @SampsonInd and like us on Facebook.