Hi Allen.  When we say “82%”, that means overall.  If any money is
received on any call at all, it shows as ‘Paid’.  Not just by insurances,
but by patients too.

We do not keep track of how many claims are denied by insurances, as it
sometimes seems like a standard practice of the insurance industry to deny
everything at times!  We appeal all denials as part of our process, if the
denials are truly medically necessary and reasonable.  We do pretty well
on those appeals, which is part of the reason we can hit that 82%.

Hope this helps.  Please let me know if you have any other questions.

read that again,

We do not keep track of how many claims are denied by insurances, as it
sometimes seems like a standard practice of the insurance industry to deny
everything at times!

It is not the intent of this policy to provide charity care to patients who are either underinsured or have higher deductibles or copayments.

It’s been an extremely busy year at the Town Hall and my sincere apologies for not squeezing in time to write newsletters. One idea floating around is to launch of an official Town newsletter that would include opinions from all the Town officials rather than simply yours truly!

MORE ON COMMUNICATIONS

At long last, the redesigned Town of Ulysses website is complete and can be seen at http://ulysses.ny.us/.  Our intent is to provide easier access to information for residents and visitors. We will be adding more information as time allows. Many documents and forms available previously only via a trip to the Town Hall are now on-line.  If you have requests for additions to the site, please let Marsha Georgia or me know. Glad to check this one off my to-do list!

HOME RULE AND HYDROFRACKING

As many of you know, on August 10, the Ulysses Town Board amended the Town zoning to prohibit all gas drilling within its borders. This was a long-considered action, and not taken lightly especially, considering that humans have a powerful thirst for energy, and alternative energy sources or actions to conserve are just not moving along fast enough. I use energy to drive a car, turn on lights, heat my house, cook my food and bring water to my tap, and the majority comes from oil, gas, coal, and nuclear sources, so might it sound hypocritical and NIMBY-ish to say no to natural gas extraction here.

However for over two years now, a huge chunk of my life has been devoted to understanding the costs and benefits of drilling for natural gas using hydraulic fracturing. While on the plus side there is certainly a need for this fuel under our existing (and inadequate) national energy policy, and without a doubt some people will become very rich, the cost to the community as a whole is just too great, in my opinion, to support this industry as the technology is used today, and especially under the current regulatory and enforcement policies. Unanswered questions abound, particularly when looking at how the industry will impact water, human health, property values, ecosystems, and taxes as local governments foot so much of the bill for extra police, emergency services, road repair and additional government administration when the companies march into to town. I not only voted for this prohibition, but actively worked to help other communities do the same to send a message to Albany and Washington that this method of gas extraction has a long way to go before I’ll consider it a greater good of our community.

DEMOCRATIC CAUCUS-SEPTEMBER 6

In Ulysses, the Democratic Party selects Town Board candidates for the ballot by caucus (i.e. a gathering of registered Democrats) for this fall’s elections. Both my seat and that of Dave Kerness expire at the end of 2011. And to make things a bit more exciting, there are at least three residents who hope to win those two seats at the caucus: Dave Kerness, John Hrubos and myself. In addition, the position of Town Justice is up for election (currently held by Roger Rector). The fun of it is, ANYONE can be nominated at the caucus and any Democrat can vote to decide who will be on the Democratic line of the ballot. Each nominee will have an opportunity to speak. I hope you will exercise your rights by attending and voting. And of course, I hope I have your support!

WHEN: September 6, 7:30

WHERE: Trumansburg Fire Hall

AMBULANCE SERVICE

Confused about what’s happening with the Trumansburg Ambulance Service? I love a challenge, but explaining this simply and concisely may be beyond my capabilities because it has become very complicated.

In 2011, the Town of Ulysses paid 48% ($378,938) of the total funds required to run the Village of Trumansburg’s emergency services (ambulance and fire protection). Of this, the Town pays $238,610 for EMS (a.k.a. ambulance) service alone. Ulysses pays the largest share of the total EMS and fire budget with the following breakdown:

48% Ulysses, 32% Village, 5% Hector, 15% Covert.

Being the largest contributor (and even if we weren’t) I feel the Town of Ulysses has a responsibility to air some concerns over what I see as major shortcomings of the EMS policy that the Village has offered. While some members of the Town and Village Boards are interested only in obtaining the least expensive EMS service, my biggest worry involved how low income and the working poor (i.e. those who work full time but still cannot afford to buy health insurance) are being treated by the Village policies.

First of all, the Village policies are now final and  clearly state EVERYONE WILL BE BILLED for ambulance service. This is not an insurance-only billing policy. The only people who are not billed are either dead or were not treated or transported. Today, any person having an accident within the boundaries of the Village of Trumansburg will be billed for the ambulance ride regardless of whether he/she lives in the Village or not. If the accident is outside the Village, in the Town of Ulysses, there is no bill…yet.

The Village passed a number of separate and somewhat unconnected policies when they went to billing. Although the Village passed a “Charity Policy”, the new EMS Billing Policy makes no reference to it in the details.  The Schedule of Fees set by the Village are unusually high, much higher than other municipal emergency services—more in line with what private ambulance services charge and much higher than Medicaid and Medicare reimbursement rates. While the Village must accept the Medicare and Medicaid payment rates, residents with no insurance will pay the full price. In the Charity Policy (if it ends up officially connected to the Billing Policy), the Village states they will limit a patient’s payment liability to between 10%-30% of the household’s annual income. Really? Only 30% of a person in poverty’s income? What a deal! One would think the logical reason for having a municipal ambulance service is to subsidize it to some degree in order for everyone to be able to afford the service. If the cost is similar to a private ambulance service, why are we paying taxes, and if the objective is to have the service be completely self-funded, why are we competing with the commercial ambulance service? The bottom line for me is that we have swung so far into the libertarian mode that the idea of common good and common care funded through municipalities has disappeared. The number of people who would need a municipally subsidized ride is small—maybe 6-10 per year. All others have insurance either through Medicare, Medicaid, their employment, or through their automobile insurance—and why not use it?  But for those who don’t—how about we give them a break? They have it hard enough. We need to remember those who are financially troubled and enact solid policies that ensure their care.

For nearly two years the Towns of Ulysses, Covert and Hector worked together to draft policies, but unfortunately about a year ago, prior to completion, the Towns were excluded from the communications. The final policies do include an Inter-Municipal Managing Cooperative but the Billing Policy itself does not mention this Cooperative. According to the text, all the discussions from the Cooperative are confidential. There is no public input, no mention of minutes, voting, nor whether the Village will adhere to any recommendations from the Cooperative. Essentially as the Cooperative stands now, the Towns have no meaningful voice.

Ok. Enough grousing you say. But there’s more. Because the Village went ahead and officially severed EMS from the Fire Protection District (it is now a separate department), the way the Town can raise funds to pay for this service changes. Town and Village residents used to be assessed a Fire/EMS tax that was a separate taxing line. The Town can no longer do that because EMS is now a department not a district which has different budgeting rules that require the Town to contract with Village. So for 2012, our options are to do one of the following:

* Contract for EMS service with all the policies the Village now has in place, and no meaningful voice to change them. With this scenario, the Town would need to contract with the Village for EMS service for the entire Town (Town and Village areas combined). In this case, Town residents could end up paying about 34% higher taxes for EMS since the cost would be split over the assessed value of properties in a different way than it is currently. Plus residents will be billed for an ambulance ride. In turn, Village taxes for EMS would be significantly reduced.   The Town would need to pass a local law to override the State tax cap legislation in order to adopt the budget.

* Form a separate Ambulance District of the Town separate from the Village. With this option, the Town would still contract with the Village, but could charge different fees for ambulance and have a different Charity Policy.  The Ambulance District would include the Town but exclude the Village, and have a separate tax rate to raise revenue to pay the annual contract, just as the Fire Protection District does for fire coverage. However during our meeting last week with the Village, we realized we cannot do this in time for inclusion in the 2012 budget.

* Have no Town contract for EMS for in 2012, and be serviced primarily by Bangs as Enfield and Ithaca do, with each patient billed for the service and no tax revenues raised to support EMS. But this would in essence eviscerate the Trumansburg EMS since the Town is the largest contributor to the budget. And there would be no Charity Policy at all. This may happen by default this year if we run out of time to find a solution working cooperatively with the Village.

* The Village attorney handling the EMS has hesitantly suggested that the Village can have 2 ambulance services, with one working for the Fire Protection District which includes the Town (as currently is the case) and one for the Village Ambulance Department.  This allows the Village to offer a combined Fire and EMS contract to the Town, supported by taxes (as it is now).  By law this does not allow for a billing option, and would keep the Fire & EMS service and taxes for 2012 very much as they are now.  This would be a one-year solution, and the Town would need to act on one of the above options for 2013 and beyond.

Finally, and really necessarily for any option to work sustainably into the longer term, the Village and Town could work in a meaningful way through regular meetings to create a solution that does not impact quality of the local EMS, and gives all the Towns involved and the Village a meaningful voice in the billing policies.  The only problem: we might have run out of time. Only your tax bill will tell.

All of this last-minute craziness might have been avoided had the Village and Towns been working together all along but since January, in spite of many requests, the Village has only agreed to two meetings where negotiations could take place. With a topic of this level of importance, meeting on a regular basis is critical. It’s not like I hanker for more meetings (believe me, there are plenty already), and granted, the meetings are not always pleasant (um rarely), but this is literally about life and death. It’s about the Village and Town being a unit, not being divided. We simply have no other choice but to hammer this out together, with civility and some level of compromise from all involved.

Please let your Village and Town representatives know if you have any qualms about the direction we are heading. The Village ultimately holds the cards—but the Towns want to be in the game.

SNIPPETS FROM THE YEAR

Changes at the Town Hall: Alex Rachun has partially retired (or at least he’s working to that end). He will continue as the building and fire code inspector. Picking up the remainder of Alex’s time on the planning and zoning is Darby Kiley. Darby has experience working with the Towns of Lansing and Ithaca as well as currently coordinating the efforts of municipalities to understand the impacts of the natural gas companies as they approach our area.

I too am working more at the Town Hall as Deputy Supervisor assisting Supervisor Roxanne Marino with the seemingly endless to-do list. This is a temporary appointment which can terminate when we are a bit more caught up.

Leaky pipes: Thanks to our Supervisor’s tenacity, the Towns of Ithaca and Ulysses settled discrepancies over leaks in the water district pipes.

Zoning: Changes in zoning along the lake have now moved back up the priority list. The Town will have final drafts available for the public within the next month or two.

Drilling: This topic consumes a huge chunk of time—assessing and documenting our road conditions prior to the onset of heavy truck traffic, communicating our concerns with state and federal officials, participating in county-wide activities that address drilling, evaluating our emergency response plans, tracking how real estate values are changing based on leasing, and on and on.

Enjoy the last days of summer and hope to see you on September 6!

Local commercial ambulance charges are covered except the first $35

The Trumansburg Ambulance Company is a municipal agency, not a “commercial” one.  Am I covered?  Don’t know.  But I do know that many of my neighbors have no health insurance, or policies with large deductibles.  Can they afford $1050?  Will they hesitate to call if they need help from the EMS system that they have supported with their tax dollars for many years?  Is this fair?

The billing policy also includes a charity provision for low-income individuals.

Will this charity provision cover my neighbors?  Do we know what the criteria will be?  Will my neighbors be knowledgeable about the criteria and their current income/wealth status on the night that they have an emergency?  Should they have to be?

she expects the village board to vote billing into law at its April 11 meeting

“There has been a flight out of the village because of the taxes. Long-term economic viability for the village depends on a vital population within the village.”