RUMFORD — Selectmen learned Thursday night how Med-Care Ambulance Service determines the town’s subsidy assessment based on a state-estimated population.
No action was taken following the information-only presentation by Steve Brown, president of Med-Care’s Board of Directors.
At the Jan. 20 selectmen meeting, the board learned Rumford’s assessment was increasing from $16 per capita to $18 per capita for a total of $105,264 and asked why.
It’s an increase of $12,384 over the current assessment, which ends on June 30 and is based on Rumford’s population estimated at 6,192.
The new assessment is figured at $16 per capita for Jan. 1 to June 30, or $49,536, and $18 per capita for July 1 to Dec. 31, or $55,728.
Brown explained the process Thursday night, saying the Maine Office of Data, Research and Vital Statistics determines town populations based on a Municipal Revenue Sharing Distributions formula that uses birth and death certificates, car registrations and school populations.
The population estimates are needed in the years between release of actual U.S. Census numbers.
“Do you know if this formula has been accurate through the years?” Selectmen Chairman Brad Adley asked.
“I think it has,” Brown said.
“You’re going to have fluctuations … where it’s based on car registrations and school populations, and we’re going to find out, because they did the federal census in 2010 and they’ll be releasing it at the municipal level I believe in May.”
He said adjustments will be made then.
“We needed a consistent method to do this to determine the populations and that’s what it does,” Brown said,
Rumford’s population was estimated at 6,192 as of July 1, 2008. Population estimates for the 10 other towns that run and are served by Med-Care are: Andover, 917; Byron, 137; Canton, 1,101; Carthage, 502; Dixfield, 2,582; Hanover, 305; Mexico, 2,881; Newry, 367; Peru, 1,575; and Roxbury, 391.
Brown said the state estimates of town populations will always be outdated by a year, “because they’re using birth and death certificates from two years prior.”
Adley then wanted to know why there is a $2 per capita increase this year.
“We figure what our best estimates are for costs to run the ambulance service, what revenues will be taken in, the projected number of calls, and then the adjustments in the Medicaid/Medicare reimbursements, which for the most part have been favorable,” Brown said.
“The call volume had dropped off, but then it’s picked up again this past year.”
Also figured into the budget is just over $80,000 “to cover expenses that may come along” for the new facility project.
Brown said town subsidies cover 17 percent of Med-Care’s 2011 budget, while the other 83 percent is paid by patient revenues and fees that are charged and collected.
“The overall population of the towns we serve fluctuates around 17,000, so $1 per capita generates $17,000,” he said.
Med-Care’s 2011 budget is about $1.7 million.
Selectman Buccina then asked about the per capita hikes.
“It seems to be going up $10,000 to $12,000 annually,” Buccina said. “I just don’t like not having any control over an increase that’s going to affect our budget, but I guess it has to happen.”
He also wanted to know why ambulance transport to a hospital costs so much.
“I had an opportunity for the first time in my life to ride in an ambulance and it just seems kind of outrageous what you have to pay to ride in an ambulance,” on top of what the town pays for subsidy, he said.
He said the costs never seem to decrease.
“Our assessment never seems to go down,” Buccina said. “It keeps going up and … it just seems to me there should be a flattening out period where it will level off.”
“We hope we’re getting there, Greg, as the business stabilizes here, and the number of calls that we have and revenues,” Brown said. “Our rates are determined primarily by Medicare and private insurance rates.”
Brown said Med-Care is obligated to respond if it gets calls.
“We’re not asking how are you going to pay for this or can you; we have to go, and there are some patients that can’t pay and that’s where some of the subsidy money goes,” Brown said.
“If we were paid everything we charge, of course we’d be self sufficient. I understand your concerns.”
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- Med-Care Ambulance Service Director Jim Pulsifer, right, of Peru, responds to Selectman Greg Buccina’s concern about annual hikes in town subsidies from the nonprofit corporation that was formed by and serves 11 River Valley area towns.
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- Steve Brown of Carthage, Med-Care Ambulance Board of Directors president, explains to Rumford selectmen Thursday night how the nonprofit corporation determines its subsidy assessments to each of the 11 River Valley area towns the Mexico-based service serves. In his right hand, Brown holds a handout that describes how the Maine Office of Data, Research and Vital Statistics estimates town populations; in his left hand, a handout showing the office’s population estimates for the 11 towns.
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