South Barry County ambulance service to switch from Cox to Mercy in 2016

November 18, 2015
Charlea Mills
In a controversial decision last Tuesday night, the South Barry County Ambulance District (SBCAD) opted to change the Ambulance Service Provider (ASP) contract for southern Barry County from CoxHealth to Mercy after 27 years. The switch, which will happen March 9, 2016, was a hard one to make, according to the Board, and it’s left 17 employees currently working the district through CoxHealth with a sense of unease about their futures.
Board President Ken Cielinski said, “Our largest concern through all of this has been the employees. We wanted to make sure that they weren’t thrown to the curb.” He added that the decision to put out a Request for Proposal (RFP) to both CoxHealth and Mercy for the service was made after receiving input from the community.
Cielinski said, “The voters asked for this, and that’s what we’re doing. The constituents of the county asked for us to put the contract out for bid when we asked for our sales tax, and we were doing what they asked for.” The SBCAD Board put a property tax levy rollback and institution of a 1/2-cent sales tax measure on the April ballot, which voters passed.
In light of new funds available, Cielinski said their constituents requested that the district’s ASP contract be put up for bid to better utilize county funds. CoxHealth’s contract was for a $94,500 annual stipend to aid the health service in funding the ambulance service. When Mercy and CoxHealth put in their proposals, both offered to run the service for $0.
Cielinski said, “We were happy with the service that we got from Cox. As far as the service goes, we’ve never had a problem. We know what we have with Cox, but we needed to see what the other options were.”
When the RFP was sent to both CoxHealth and Mercy by the Board, both bid the contract without a stipend, saving the district that large chunk of their annual budget. Both Mercy and CoxHealth claimed that no stipend was necessary due to federal funds being made available to help subsidize local health services. The district will evaluate how the new sales tax money, which is estimated to bring in over $600,000 annually, will be spent once regular collections occur. The first payment to the district was for $4,198.26 on November 10. In the next few months, the Board should have a better idea what their new revenue will be to make a budget plan.
A three-man sub-committee of the SBCAD Board comprised of Ken Cielinski, Tom Rees and Rod Gilreath heard proposals from both CoxHealth and Mercy before making a recommendation to the Board to choose Mercy. The complete six-person board chose Mercy unanimously during a closed session vote on Tuesday night. The Board then voted again during open session, also accepting Mercy’s proposal unanimously.
In a press release from the Board, they stated, “As the District moves forward in an increasingly complex future, they believe that through the competitive bid process, the District will receive from Mercy EMS excellent service, additional resources at a better value for its citizens, along with improved cooperation and interface with all levels of emergency personnel.”
When asked what the driving factors were that encouraged the sub-committee to opt for Mercy instead of continuing CoxHealth’s contract, the Board mentioned a few items, including their “excellent” performance in other ambulance districts, the proximity of other Mercy ambulance districts in Branson West, Joplin and Rogers, Ark., three helicopters in the area, and Instrument Flight Rules, which allows the helicopters to fly during times of low visibility.
Cielinski also noted, “Transparency was a driving issue.” When in conversation with both CoxHealth and Mercy, both stated that Missouri had released additional Federal Reimbursement Allowance (FRA), making it possible to operate the ambulance service without any additional stipend from the district.
CoxHealth said in their presentation that the FRA funds were available for the past 18-months, however, CoxHealth had not offered to remove the current $95,400 stipend until the RFP was sent out. The Board was concerned why Cox was charging over $95,000 and then was able to drop that to no stipend during the bidding process.
CoxHealth media relations coordinator Kaitlyn Connell said, “CoxHealth’s expense reductions over the last two years, as well as market and volume changes, made it possible to eliminate the $94,500 stipend.”
McConnell added, “Federal Reimbursement Allowance (FRA) is something that hospitals providing ambulance services receive, and is largely dependent on government appropriates. It is also an amount that varies year to year, making it impossible to rely on a specific amount for funding.
“CoxHealth supported the sales tax levy because of the need for equipment in Barry County. It was believed that the increase would help provide things like ambulances, costing more than $120,000 each, as well as other equipment necessary in the Cassville and Shell Knob ambulance services. The stipend could’ve helped with such expenses, but additional funding would’ve been a necessity regardless of provider.”
Mercy’s executive director of emergency services Bob Patterson said, “When making its proposal, Mercy took a number of factors into consideration. Based on the data provided to us, we believe that sufficient revenue opportunities exist to support operations without a subsidy.”
Cielinski said, “I don’t want any hard feelings. We are here for our constituents and for the county. We are not here for Mercy. We are not here for Cox. We think this will genuinely be better for the county.” Mercy will hold the contract for five-years, and the contract will be renewed annually.
Following the Board’s decision, McConnell released the following statement on behalf of Cox:
“Throughout its operations in the Barry County Ambulance District, CoxHealth has diligently served residents by offering high-quality EMS clinical services and employment opportunities. These relationships make it greatly disappointing that its most recent bid to continue these services wasn’t accepted. However, in line with the current contract, CoxHealth will continue its EMS operations in Barry County through Feb. 29, 2016.”
Patterson also said, “We’ve very excited to be able to serve the people of this community, and with resources like Mercy Hospital Cassville, as well as three Life Line helicopters and three other ground ambulance services in close proximity, we’ll be able to get patients the help they need quickly.”
Now that the decision has been made, the question remains about what the District’s 17 employees are going to choose. With a combined 125 years of experience in the SBCAD, many of the employees feel a loyalty to their present employer and do not plan to leave Cox.
Ricky Savage, western regional manage for prehospital service for CoxHealth, stated, “CoxHealth in South Barry County has provided ambulance service for 27 years. Some of our employees have been with us since the very first day in 1988; they have helped CoxHealth EMS grow into the only high performance system in the area that we operate today.
“Many of our current employees chose to work for CoxHealth for many reasons other than pay. CoxHealth provides the most advanced simulation based training in the region for our EMS providers. We have led the way in many cutting-edge advances in EMS throughout the nation in our 27 years in South Barry County, thus ensuring we provide the best possible care to anyone who uses a CoxHealth ambulance. CoxHealth has some of the best family practice physicians in southwest Missouri whom care for many of our employees and their families. CoxHealth is the only locally governed health system in the Springfield area, which allows the company as a whole to focus on the community and its employees.”
CoxHealth also stated that all employees who wish to remain with Cox will be reassigned to new positions after February 29, 2016, if they choose to stay on.
Some called into question to the pay scale matching by Mercy. With years of service ranging from a few months all the way up to 27 years, the board asked for a direct answer from Mercy about matching their current benefits and pay. Cielinski said, “My point of contact Bob Patterson assured me that he cannot anticipate that anyone would be taking a pay cut, and its possible that they may even get an increase.”
Patterson stated, “Mercy will honor the seniority, paid time off, pay and benefits for the current EMS co-workers who join Mercy.
“We hope current Barry County EMS co-workers will consider working for Mercy. if we can’t fill all the open positions with co-workers who are currently in place, we will begin recruiting. If needed, many of our almost 400 emergency medical personnel would be willing to travel to provide care in Barry County.”
Speaking for Cox employees, Savage said, “Changing your employer is much more than salaries and benefits; it is a life-changing event that will not only impact our employees, but their families as well. CoxHealth understands the importance of this decision, and we are prepared to continue employment with all of our South Barry County Paramedics and EMTs if they choose to accept it.”
During Tuesday night’s meeting, Cielinski addressed employees’ concerns. He said, “At the Board meeting, I said if they believe in the culture at Cox, and they have a place for them, then don’t go anywhere. But if you want to stay with South Barry County, you have that option.”
Cielinski stated, “It’s been one of the toughest decisions I’ve ever had to make, but we really expect a smooth transition from Cox to Mercy.”
Note: There was an error on the dollar amount of revenue from the 1/2-cent sales tax and the start date of the Mercy contract. Those errors have been corrected in the story.
Charlea Mills
In a controversial decision last Tuesday night, the South Barry County Ambulance District (SBCAD) opted to change the Ambulance Service Provider (ASP) contract for southern Barry County from CoxHealth to Mercy after 27 years. The switch, which will happen March 9, 2016, was a hard one to make, according to the Board, and it’s left 17 employees currently working the district through CoxHealth with a sense of unease about their futures.
Board President Ken Cielinski said, “Our largest concern through all of this has been the employees. We wanted to make sure that they weren’t thrown to the curb.” He added that the decision to put out a Request for Proposal (RFP) to both CoxHealth and Mercy for the service was made after receiving input from the community.
Cielinski said, “The voters asked for this, and that’s what we’re doing. The constituents of the county asked for us to put the contract out for bid when we asked for our sales tax, and we were doing what they asked for.” The SBCAD Board put a property tax levy rollback and institution of a 1/2-cent sales tax measure on the April ballot, which voters passed.
In light of new funds available, Cielinski said their constituents requested that the district’s ASP contract be put up for bid to better utilize county funds. CoxHealth’s contract was for a $94,500 annual stipend to aid the health service in funding the ambulance service. When Mercy and CoxHealth put in their proposals, both offered to run the service for $0.
Cielinski said, “We were happy with the service that we got from Cox. As far as the service goes, we’ve never had a problem. We know what we have with Cox, but we needed to see what the other options were.”
When the RFP was sent to both CoxHealth and Mercy by the Board, both bid the contract without a stipend, saving the district that large chunk of their annual budget. Both Mercy and CoxHealth claimed that no stipend was necessary due to federal funds being made available to help subsidize local health services. The district will evaluate how the new sales tax money, which is estimated to bring in over $600,000 annually, will be spent once regular collections occur. The first payment to the district was for $4,198.26 on November 10. In the next few months, the Board should have a better idea what their new revenue will be to make a budget plan.
A three-man sub-committee of the SBCAD Board comprised of Ken Cielinski, Tom Rees and Rod Gilreath heard proposals from both CoxHealth and Mercy before making a recommendation to the Board to choose Mercy. The complete six-person board chose Mercy unanimously during a closed session vote on Tuesday night. The Board then voted again during open session, also accepting Mercy’s proposal unanimously.
In a press release from the Board, they stated, “As the District moves forward in an increasingly complex future, they believe that through the competitive bid process, the District will receive from Mercy EMS excellent service, additional resources at a better value for its citizens, along with improved cooperation and interface with all levels of emergency personnel.”
When asked what the driving factors were that encouraged the sub-committee to opt for Mercy instead of continuing CoxHealth’s contract, the Board mentioned a few items, including their “excellent” performance in other ambulance districts, the proximity of other Mercy ambulance districts in Branson West, Joplin and Rogers, Ark., three helicopters in the area, and Instrument Flight Rules, which allows the helicopters to fly during times of low visibility.
Cielinski also noted, “Transparency was a driving issue.” When in conversation with both CoxHealth and Mercy, both stated that Missouri had released additional Federal Reimbursement Allowance (FRA), making it possible to operate the ambulance service without any additional stipend from the district.
CoxHealth said in their presentation that the FRA funds were available for the past 18-months, however, CoxHealth had not offered to remove the current $95,400 stipend until the RFP was sent out. The Board was concerned why Cox was charging over $95,000 and then was able to drop that to no stipend during the bidding process.
CoxHealth media relations coordinator Kaitlyn Connell said, “CoxHealth’s expense reductions over the last two years, as well as market and volume changes, made it possible to eliminate the $94,500 stipend.”
McConnell added, “Federal Reimbursement Allowance (FRA) is something that hospitals providing ambulance services receive, and is largely dependent on government appropriates. It is also an amount that varies year to year, making it impossible to rely on a specific amount for funding.
“CoxHealth supported the sales tax levy because of the need for equipment in Barry County. It was believed that the increase would help provide things like ambulances, costing more than $120,000 each, as well as other equipment necessary in the Cassville and Shell Knob ambulance services. The stipend could’ve helped with such expenses, but additional funding would’ve been a necessity regardless of provider.”
Mercy’s executive director of emergency services Bob Patterson said, “When making its proposal, Mercy took a number of factors into consideration. Based on the data provided to us, we believe that sufficient revenue opportunities exist to support operations without a subsidy.”
Cielinski said, “I don’t want any hard feelings. We are here for our constituents and for the county. We are not here for Mercy. We are not here for Cox. We think this will genuinely be better for the county.” Mercy will hold the contract for five-years, and the contract will be renewed annually.
Following the Board’s decision, McConnell released the following statement on behalf of Cox:
“Throughout its operations in the Barry County Ambulance District, CoxHealth has diligently served residents by offering high-quality EMS clinical services and employment opportunities. These relationships make it greatly disappointing that its most recent bid to continue these services wasn’t accepted. However, in line with the current contract, CoxHealth will continue its EMS operations in Barry County through Feb. 29, 2016.”
Patterson also said, “We’ve very excited to be able to serve the people of this community, and with resources like Mercy Hospital Cassville, as well as three Life Line helicopters and three other ground ambulance services in close proximity, we’ll be able to get patients the help they need quickly.”
Now that the decision has been made, the question remains about what the District’s 17 employees are going to choose. With a combined 125 years of experience in the SBCAD, many of the employees feel a loyalty to their present employer and do not plan to leave Cox.
Ricky Savage, western regional manage for prehospital service for CoxHealth, stated, “CoxHealth in South Barry County has provided ambulance service for 27 years. Some of our employees have been with us since the very first day in 1988; they have helped CoxHealth EMS grow into the only high performance system in the area that we operate today.
“Many of our current employees chose to work for CoxHealth for many reasons other than pay. CoxHealth provides the most advanced simulation based training in the region for our EMS providers. We have led the way in many cutting-edge advances in EMS throughout the nation in our 27 years in South Barry County, thus ensuring we provide the best possible care to anyone who uses a CoxHealth ambulance. CoxHealth has some of the best family practice physicians in southwest Missouri whom care for many of our employees and their families. CoxHealth is the only locally governed health system in the Springfield area, which allows the company as a whole to focus on the community and its employees.”
CoxHealth also stated that all employees who wish to remain with Cox will be reassigned to new positions after February 29, 2016, if they choose to stay on.
Some called into question to the pay scale matching by Mercy. With years of service ranging from a few months all the way up to 27 years, the board asked for a direct answer from Mercy about matching their current benefits and pay. Cielinski said, “My point of contact Bob Patterson assured me that he cannot anticipate that anyone would be taking a pay cut, and its possible that they may even get an increase.”
Patterson stated, “Mercy will honor the seniority, paid time off, pay and benefits for the current EMS co-workers who join Mercy.
“We hope current Barry County EMS co-workers will consider working for Mercy. if we can’t fill all the open positions with co-workers who are currently in place, we will begin recruiting. If needed, many of our almost 400 emergency medical personnel would be willing to travel to provide care in Barry County.”
Speaking for Cox employees, Savage said, “Changing your employer is much more than salaries and benefits; it is a life-changing event that will not only impact our employees, but their families as well. CoxHealth understands the importance of this decision, and we are prepared to continue employment with all of our South Barry County Paramedics and EMTs if they choose to accept it.”
During Tuesday night’s meeting, Cielinski addressed employees’ concerns. He said, “At the Board meeting, I said if they believe in the culture at Cox, and they have a place for them, then don’t go anywhere. But if you want to stay with South Barry County, you have that option.”
Cielinski stated, “It’s been one of the toughest decisions I’ve ever had to make, but we really expect a smooth transition from Cox to Mercy.”
Note: There was an error on the dollar amount of revenue from the 1/2-cent sales tax and the start date of the Mercy contract. Those errors have been corrected in the story.