BELLE  — Following significant economic and staffing challenges, Osage Ambulance District (OAD) has signed a 10-year contract with Ozark Central Ambulance District (OCAD) to assume financial and operational control of what will be known as Base 3 in Belle.

“There are a lot of benefits to this agreement,” said OAD Administrator Josh Krull, who was named interim administrator while the two districts worked out details. 

Agreements such as this are not uncommon among districts, Krull said.

“The Ozark Central Ambulance District, like ours, is supported by local taxes, and service fees,” Krull explained. “Both boards will remain in place but operational control will fall to Osage Ambulance District.”

OAD board members Chairman Bob Goodenough, Doug Schreiman, Luke Probst, Marion Starr, Tim Thoenen, and Ricky Cramer unanimously agreed to establish a contract with OCAD. 

“We are pleased to extend our services to their district and look forward to working in their community and providing the best possible emergency medical service to the residents and visitors of both districts,” said Goodenough.

OCAD board members President Cindy Butler, VP Andy Littrell, Steve Conrad, John Dorsey, Mark Cooper, and Caisie Nowack likewise approved the deal and made the following statement: “The decision to contract with another ambulance district to provide our emergency services was not an easy one. With general business costs increasing and a decrease in qualified staff available industry-wide, we struggled to maintain sufficient advanced life-support staff, equipment, and supplies while maintaining financial stability. Our employees will benefit from increased wages and benefits while our taxpayers and patients will benefit from increased staffing, upgraded equipment, and ambulances. Joining forces with Osage Ambulance District will provide the stability we desire in our emergency services. Josh Krull has proven to be effective in managing an ambulance district by improving both financial stability and the emergency care provided. We are excited to see this change for our district.”

OAD board members will continue to meet at 6:30 p.m. on the third Wednesday of each month. The OCAD board, Krull said, will meet this month to review the transition, and determine how often meetings will need to be held, aside from setting the tax rate in August.

FINANCIAL/BUILDING DETAILS

“We are consolidating management, insurances, the vehicle fleet, medical supplies, etc., which will allow us to save money and improve the situation,” Krull said.

OCAD’s building loan will be paid off in five years under the current plan instead of the 14 years left on the note taken out in 2019.

OCAD will use existing funds to pay $80,000 toward the building and retain $50,000 in cash to handle miscellaneous expenses.

After that, under the agreement, OCAD will transfer all other cash assets to OAD, and Krull will oversee the management of those funds.

In the first quarter of fiscal year 2023, Ozark Central will pay $50,000 on the building loan, leaving a balance of approximately $150,603.34. After the $50,000 building payment and $10,000 in retention money, OCAD will pay/transfer its FY 2022 tax monies and cash assets in the FY 2023 budget year to OAD. This process will continue through 2026, at which time the building will be paid off.

OCAD will retain $10,000 in cash in each fiscal year 2028-2032 to achieve its objective of being debt-free, with $150,000 in cash assets, and no operational costs. All other tax monies will be transferred to OAD.

OAD will prepare OCAD’s annual budget, ensure that election notices are published, tax-setting hearings are publicized and held, necessary audits are conducted, and the annual financial report is filed with the State Auditor’s Office. Tax rates will be set as determined by the state.

OAD will also take responsibility for accurate, honest, and timely billing for Ozark Central and may employ billing companies, collection agencies, and attorneys as needed. OAD will assure compliance with CMS Medicare and Medicaid regulations regarding billing practices. Correction of billing errors and any consequent refunds will be handled by OAD, and OCAD will adopt OAD’s fee structure.

Krull noted that OAD will also obtain adequate insurance to insure all buildings and property titled to Ozark Central and leased to Osage.

Over the course of the contract, OAD will be responsible for basic maintenance — including snow removal and lawn care service — while major structural repairs or replacement of HVAC systems will be handled by OCAD.

STAFFING CHANGES

Krull will oversee all operations between OAD and OCAD, with the help of two paramedic supervisors, Carrie Hickman and Josh Cohen, who will respond to high-priority calls and help oversee day-to-day operations.

With the merger, OAD now has 53 employees, including nine full-time and seven part-time paramedics, 12 full-time and 16 part-time EMTs, two full-time and two part-time office staff members, and two part-time nurses. 

Krull said he is very happy to have extended the recent benefits package to crews at OCAD.

“We just rolled that out for OAD employees and by extending it to OCAD, we had the opportunity to immediately hire four additional paramedics which has been historically difficult to do,” said Krull.

Dr. Mark R. Katsaros, an emergency medicine physician in Jefferson City, will continue his role as medical director. 

FLEET IMPROVEMENTS

Four aging trucks that have been used by OCAD will be sold and the proceeds will be put toward the cost of a remount ambulance through Osage Ambulances in Linn.

“We have always worked with Osage Ambulance and their trucks are excellent quality,” said Krull. “The trucks in the OCAD fleet were not Osage built, so they would not fit into our fleet replacement and remount cycle. By having 100% of our fleet be Osage Ambulances, we maintain that local connection both to support our community and to get the best possible vehicles.”

Last year the OAD board had approved two ambulance remounts for 2022 with the first scheduled for delivery on Feb. 23, and the other, 90 days later.

Krull noted that the district has purchased three used trucks that were manufactured by Osage Ambulances and those have been put into service.

“We added decals and stocked them, and they’re part of our rotation,” he added.

That gives OAD a total of 11 trucks in the fleet for both coverage areas, with one ambulance in a primary service role at Belle and another as a backup. Krull said OCAD had been staffing one crew 24 hours a day, with a second crew working during the day on occasion, and Krull said that will continue. 

With the new configuration, there will be six trucks in service between the two district areas on weekdays with one supervisor, three ambulances on the night shift, and five trucks during the day and three at night on weekends. All vehicles will respond to both emergency and non-emergency calls.

Last year, OCAD handled 1,039 calls. Krull anticipates this year that crews will respond to approximately 4,000 emergency and non-emergency calls for service between the two coverage areas.

One of the four OCAD trucks was equipped with a power-load system, and Krull said he plans to invest in the purchase of power-load devices for the vehicles without one.

“These power-load systems are a necessary part of what we do in emergency care,” Krull said. “When we are on a scene, moving a patient can be challenging and in some cases, dangerous, so being able to use these power devices prevents injury and improves overall safety.”

Krull added that medical supplies are fully stocked and another immediate improvement includes the purchase of extrication turnout gear, including pants, jackets, and gloves which are worn by crew members when responding to motor vehicle accidents.

This contract was effective on Jan. 18 and signed on Feb. 16 by all parties. Either district can cancel the contract with 180 days’ notice.