Maries-Osage Ambulance District board approves call-in pay

By Colin Willard, Staff Writer
Posted 11/30/22

VIENNA — Maries-Osage Ambulance District (MOAD) board members approved a plan at the Nov. 14 board meeting to provide ambulance crew members with extra pay for call-in work.

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Maries-Osage Ambulance District board approves call-in pay


VIENNA — Maries-Osage Ambulance District (MOAD) board members approved a plan at the Nov. 14 board meeting to provide ambulance crew members with extra pay for call-in work.

Board member Laura Stratman asked MOAD administrator Carla Butler if the call-in pay would apply when there is only one crew working, and they are out of the area.

“Or potentially if both crews are gone (when two crews are working), we could even do a third crew,” Butler said.

Laura Stratman asked how often MOAD has two ambulance crews working at once. Butler said there are two ambulance crews working simultaneously more than half the time unless someone drops a shift.

Butler said the district sometimes struggles to get workers on Fridays and Saturdays. She talked about requiring employees to provide availability for one weekend shift per month starting in January.

“That’s not fair that it’s the same people working every single weekend,” Butler said. “Not that I’m going to use them (those weekends). But I need availability to pick from people.”

Butler told the board that recent local hires would help the district get more coverage when ambulances leave the area.

At the time of the meeting, one crew was on shift. Butler explained that if the crew were to respond to a call, dispatch could send out a message requesting two more workers to act as a second ambulance crew while the first crew is away. The second crew would receive a flat call-in rate plus their hourly pay until the first crew came back to the district.

The amount of time the call-in crew works would vary based on the call. Butler estimated most call-in shifts would take about three hours.

“I’m not saying it’s going to happen a lot,” Butler said. “But it’s a little bit of incentive plus it would get our district covered. Sometimes there might be four calls going on in our district at one time, and we’re having (help from) Dixon or Osage or Phelps.”

“Everybody goes through that,” board vice president Steve Maxwell said. “That’s what mutual aid is all about.”

Laura Stratman suggested that the board could always try a call-in pay plan for a few months.

“My concern is that if we start we can’t stop it,” Maxwell said. “You (Laura Stratman) suggested three months, but once we started it, it would be awfully hard to stop it.”

“If you have other districts come in and cover us, and we have that potential employee helping cover our district, it’s better than having somebody else come in (to the district),” Butler said. “But it’s not going to happen as often as you think.”

“We’ll take the call and get paid for it, and now they’re not waiting for another crew to come in from Rolla or Belle,” MOAD paramedic Bruce Grotewiel said.

Board secretary Laura Miller voiced concern that workers might not sign up for shifts and instead work when they would earn call-in pay. Butler and Laura Stratman both said they doubted that would happen.

Butler said it would be the responsibility of crews leaving the district to let dispatch know to request a call-in crew.

The board decided the pay would only apply if two workers responded to the call-in request because an ambulance crew requires two people. MOAD would still need to get help from another district if only one worker came in.

“That kind of defeats the purpose,” Butler said.

Maxwell suggested $25 as the call-in pay rate. The board approved a motion to pass the $25 call-in pay with the requirement that two employees answer the call.

South Repeater

The board reviewed a $1,080 bill that Vienna Fire received for repairs to the south repeater, which is the repeater on the tower along Highway 28 toward Dixon that retransmits communication signals. Vienna Fire gave the bill to the Maries County Commission, and the commissioners asked MOAD to pay half of the bill.

“The fire department had their repeater put in,” board president Don Lanning explained. “We had ours put in at the same time. Due to licensing, everything was put in the county’s name, so the fire department decided since it’s in the county’s name, they’d send their bill to the commissioners. We fixed what I consider ours ourselves. We could have sent our (bill) to the commissioners, too. It’s in the county’s name. So what’s going to happen next time it has to be replaced?” He said he does not believe the county would want to replace it. “Next time the bill might be $25,000,” he said.

Butler said when she talked to a technician about getting the repeater bills out of the county’s name, he recommended leaving it because of the frequencies going in and out of the repeater.

“It sounds to me like the commissioners need to come up with something stating that somebody else will be responsible for them, but who’s it going to be?” Lanning asked. “Nobody knows how many people are using that repeater.

“I’ve been told Dixon Fire uses it, and Vichy Fire and Vienna Fire,” Butler said.

Lanning said MOAD donated money to Vienna Fire to put an air conditioner in their repeater shed, but an air conditioner was never installed. Butler said Vienna Fire would be returning the money.

Board member Victor Stratman said that the cost of splitting the bill would be $540, and Butler using the money Vienna Fire gives back for the air conditioner would make the relative cost to the district even lower.

Butler said that she does not want to burn bridges while acknowledging the district’s positive relationship with the Maries County commissioners. Laura Stratman said that the district wanted a good working relationship with Vienna Fire.

“I think it needs to be put in writing that somebody needs to be held responsible for that repeater,” Butler said.

Laura Stratman made a motion that MOAD pays half of the bill and suggest to the commission that the district, the county and the fire department split future repeater bills. The board approved the motion.


Butler told the board that MOAD is losing money completing transfers. One example she presented was a patient who the district transported 72 miles. The patient’s bill was $1,996, and the patient’s insurance company allowed $364.82 for the transfer. The provider paid $349.82 for the transfer, and MOAD had to write off the rest of the bill. Butler provided a couple more examples of bills sent for long-distance transfers that insurance companies only partially paid.

“If you take into consideration the $30 meal allotment, the fuel, the wear and tear on the vehicles and taking a truck out of our district, is it worth us doing them?” Butler asked the board about the transfers.

Butler said she plans to talk to an administrator at Phelps Health to show him the financial effect transfers have had on MOAD.

“It’s not that we don’t want to help,” Butler said. “We have to be business-motivated.”

Lanning said he thinks MOAD should stop doing transfers. “We can’t keep going in the hole on them,” he said.

Financial Report

MOAD made $57,572.03 in September. The total expenses were $46,024.33, which meant a net income of $11,547.70 for September.

The district made $40,313.14 in October. Total expenses were $48,845.29, which meant net income was a loss of $8,532.15 in October.

Laura Stratman asked why there was such a large difference in the two months. Butler said in October MOAD purchased EMS equipment and split the cost with the county from ARPA funds. The district also bought six tires for one of the trucks.

So far this year, MOAD’s actual revenue exceeds its budgeted revenue. The budgeted revenue was $523,500, and the actual revenue is $552,714 for a variance of $29,214 more in revenue.

The actual expenses total $440,150 against the $523,500 budget for a total of $83,350 more in the budget than expenses.

In total, MOAD is ahead by $112,564. Butler said staffing issues at the beginning of the year caused the district to have unexpected savings on the payroll. Butler had hired two EMTs and one medic since the last board meeting.


Butler reported that the district has made all purchases with the American Rescue Plan Act (ARPA) funds it received from Maries County. The district is waiting on reimbursement for one purchase. All of MOAD’s new equipment is working except for tablets. Butler said Maries County IT manager Shane Sweno is still working on programming them.

“They’re trying to get all the bugs worked out with dispatch, and then they’re going to get our tablets to us,” Butler told the board.

Butler informed the board of an ARPA grant for emergency services. It is a fund-matching grant, so if MOAD spent up to $20,000 in equipment and upgrades, the grant would match that money. Butler said the money could go toward stretcher extenders, IV pumps and a laptop for the third ambulance.

“This $20,000 is a lot of money that we can get for free to spend on equipment we really need,” Butler said. “If we could get a little bit more equipment that we do need, we’d come a long way.”

Butler asked the board if they would have interest in matching up to the $20,000 for the grant.

“I think so,” Laura Stratman said. “To me, it’s a no-brainer. Yeah, we have to have the money, but we could get stuff we need anyway.”

“We need the third laptop for sure,” Butler said. “Every month we switch trucks. They have to take the equipment out of the Freeburg truck and put it in the third truck. All the trucks need the same equipment so they don’t have to be switching all the equipment.”

The council approved a motion for Butler to put in an application for the grant. She planned to ask the staff to suggest the equipment MOAD needs.


In September, MOAD made 60 responses. There were 47 responses in the Vienna zone and 13 responses in the Freeburg zone.

Of the Vienna responses, 27 were urgent emergencies, 18 were dry runs and two were routine non-emergencies.

Of the Freeburg responses, five were urgent emergencies, five were dry runs and three were routine non-emergencies.

In October, MOAD made 39 responses. There were 32 responses in the Vienna zone and seven responses in the Freeburg zone.

In the Vienna zone, one response was a life-threatening emergency, 18 were urgent emergencies, 11 were dry runs and two were routine non-emergencies.

In the Freeburg zone, two responses were urgent emergencies, two were dry runs and three were routine non-emergencies.


Two notes in the employee suggestion box requested the option to wear either MOAD polos or  t-shirts as uniforms when responding to calls.

Victor Stratman said he was fine with the suggestion. Lanning asked Butler for her opinion.

“My only opinion is that when we go to PR events, they wear the polos,” Butler said.

Laura Stratman said that while she thinks the polos are more professional, she understands that MOAD wants its crews to be comfortable. She agreed with Butler that the employees should wear polos at PR events.

“I agree,” Lanning said. “I wear t-shirts all the time.” He said the board would leave the decision up to Butler.

Other business

Butler said she had been in contact with Maries County dispatch and she hoped to have quarterly meetings with them to improve coordination. She said Shannon Fannon of the Maries County Sheriff’s Office had invited her to join the Crisis Intervention Team program. The group will now hold meetings at the MOAD’s Vienna base. The base will host the December meeting of the Mid-Missouri EMS Administrator’s Coalition.

Lanning’s and Maxwell’s terms expire next year. If they choose to run for reelection on April 4, 2023, they must file between Dec. 6 and Dec. 27.

September and October standby and PR events included a picnic, cross country meets, a high school softball tournament, CPR with teachers at Maries R-1, a live propane burn with Vichy Fire, Kiddie T Junction Daycare, state sectional softball game, a haunted hayride, three trunk or treats (Vichy, Vienna and Freeburg) and a power load demonstration with Argyle Fire.