Marion County Ambulance District employees to see cost of family insurance plans rise

HANNIBAL, Mo. — A larger-than-anticipated increase in insurance means a tight 2025 budget for the Marion County Ambulance District (MCAD).

The MCAD Board of Directors approved a $6.838 million budget during its meeting last week. The board also approved the insurance increase, discussed mobile integrated health and approved year-end incentives, a contract with Ralls County and a banking resolution. 

The board also approved the filing dates for the April 8 election, which open Dec. 10 and close Dec. 31. The positions for Sub-District 1, currently held by Larry Coleman, and Sub-District 4, held by Cheryl Arntzen, are open.

The budget will include $782,000 for insurance for district employees. Interim Chief Marshall Miller says that amount is higher than anticipated.

“After we had enrollment in early November, we were informed we had more people enroll and more families enroll than (insurance carrier) Angle anticipated, and they presented us with this increase,” he said. “They suggested we pass that on to our employees, but we had less than two days to inform the employees. Who wants to hear their family plan is going to cost them an additional $600 a month?

“Eric (Murfin, interim deputy chief) and I discussed it and decided we would try to make the budget work around the increase, and that is what you have in front of you.”

The budget includes $3,245,400 for hourly salaries and $425,000 for administrative salaries. Operation expenses total $476,000 and include fuel, vehicle maintenance and repair and medical supplies.

Board members discussed, then approved, not taking their stipend, giving the district those additional funds for the 2025 year.

In his report, Miller discussed mobile integrated health, saying it appears Missouri is moving in that direction, especially since Medicare, Medicaid and some insurance companies want it.

The program uses community paramedics, of which the MCAD has a small group. Miller said there are enough to get the program going. 

A community paramedic has additional certification above a paramedic, and the approach to health care is different, Miller said. He noted patients would be examined in their home, and the paramedic would stay with the patient throughout the process.

“The goal is to keep the patient in their home and hopefully eliminate the repeat patients at the emergency room,” Miller said.

While the board took no action on the program, Miller said he would keep an eye on it and what the legislature does with it.

Miller also reported MCAD had received a $101,382.82 ARPA grant to buy 28 Kenwood Viking VP8000 series portable radios with batteries, desktop chargers and vehicle chargers. The current radios were discontinued in 2021, and the district has had difficulties finding the parts to maintain the equipment.

The grant is a 90/10 state/local matching grant. MCAD will be reimbursed $91,382.82 from the state for the radios, Miller said.

Miller also reported he, Capt. Chris Dolbeare and Capt. Chris Kelle recently attended a three-day peer support training presented by The Warrior’s Rest Foundation. Attendees received certification in individual and group crisis intervention. A grant from the Missouri Department of Public Safety funded the program.

In addition, meetings have been held with Hannibal Regional Hospital, Saints Avenue CIT Committee, Mark Twain Area Peer Support, NECOMM, HFD, Emergency Management and Ralls County Commissioners. The meetings have been a result of Miller stepping into the role of interim chief and Murfin as deputy chief following the retirement of John Nemes last month. 

A meeting was held with MoGEMT to review the cost reports for Fiscal Year 2024 with those reports being finalized and certificates signed and submitted. Miller and Murfin also met with the billing department to review patient care reports for quality assurance and to discuss the administrative change. 

The board approved year-end incentives based on how many hours the employees worked.

A banking resolution to change who can sign checks for the district was approved by the board, as was the contract with Ralls County.

The board also:

• Learned the contract with Evers & Company to conduct the 2024 fiscal year audit has been renewed. That audit will be conducted in March 2025.
• Learned the renewal application for VFIS Insurance through First State Agency has been completed. The 2024 Chevy Traverse and the 2017 Kawasaki Mule have been added. The district will not be replacing the Tahoe currently in use.
• Briefly discussed the organizational structure of the district but tabled further discussion until January.

Information for this story was provided by Patty Cheffey, former owner of the Palmyra Spectator newspaper. She now is on the administrative team for the Marion County Ambulance District.