Bethel Queries Ambulance Service
On Reason for Its Budget Increase

The White River Valley Ambulance (WRVA) service held a budget review meeting Tuesday, Nov. 25, to answer questions regarding the 2004 budget that its board had approved Oct. 28.

The WRVA board had sent the budget to the selectboards of its client towns, which are Barnard, Bethel, Braintree, Brookfield, East Granville, Pittsfield, Randolph, and Stockbridge.

The new overall budget of $769,403 represents a 15.6% increase over the current year's budget of $665,754. Bethel's contribution in 2004 will be $59,552, representing a 9.4% increase over the town's contribution this year of $54,432. Recently, the Bethel selectboard raised questions regarding such items as a 13.3% increase in administrative wages, a 39.9% increase in attendants' wages and overtime, and a 63.8% increase in write-offs.

(The Randolph Selectboard was also unhappy with its requested share of the ambulance budget. They first attempted to cut the 11.6% increase to 7% and then to 4% but later relented.)

The Bethel selectboard designated Yaroslav Stanchak to attend the budget review meeting to gather detailed information that would enable the town to exercise closer financial oversight of WRVA operations. The board's action reflects a number of concerns expressed at the last town meeting that the WRVA budget is growing too fast. The total increase from 2000 to 2004 has been 57%.

Earlier, in a letter to the Bethel selectboard, WRVA administrator Amy Estey explained that one of the largest increases in the projected 2004 budget lies in wages and benefits, specifically health insurance which has risen significantly. She also noted that the service has experienced a 25.5% increase in call volume, which has greatly contributed to an increase in wages.

At the budget review meeting, Stanchak said that he had not come to find fault with the WRVA, but noted that since Bethel's contribution to the WRVA budget is included in the town's annual budget, there was a feeling that town management ought to have more of a say in WRVA's own budget, and have access to more detailed information about it.

Stanchak asked for a clarification of the 2004 projected increase in write-offs from $108,775 in 2003 to $178,176. Estey explained that the write-offs represented WRVA's estimate of charges that are uncollectable, mostly because there is a cap on what can be charged to Medicare customers.

"We can set our pricing any way we want," Estey said, "but the law prohibits us from collecting over certain limits from the increasing numbers of our Medicare Medicaid customers." She noted that the percentage of Medicare and Medicaid customers is increasing.

In response to Stanchak's request for more information, Estey pointed to the significantly higher number of calls projected to the end of this year compared to last year. She said that an increase in calls necessitates an increase in backup crews, which in turn requires paying more wages.

"Our full-time staff remains the same," Estey said, "but part-time back up services are up." She also said that if the fees remain constant, and if mandated write-offs increase, any rise in call volume will raise overall costs, and the burden will fall on the towns. Wherever possible, she said, WRVA seeks other modes of funding (such as a recent grant from Homeland Security), and tries to avoid seeking funding from the towns.

"It's important to remember," Estey said, "that ultimately WRVA belongs to the towns."

Stanchak thanked Estey for her clarifications, but pointed out that the budget sheet under discussion presented only the budgeted figures for each of the recent years, not the actual end-of-year revenue and cost figures, so it is hard to evaluate or oversee the WRVA budget from it.

"The sheet that we are discussing is merely a template—a future projection," he said.

For example, Stanchak noted that it could emerge from the actual year-end figures that the revenue-per-call ratio is fairly constant, even with the increase in write-offs, and even when factoring out town contributions. In such a case, if Bethel is to judge accurately its own requested contribution to WRVA, it would be necessary to see and analyze the complete WRVA balance sheet, showing a detailed breakdown of costs as well as revenues. It would also be necessary to see an income statement that would show all sources of income, as well as any carryovers from previous years, he said.

As for actual year-end figures, Estey said their availability is at the pleasure of the WRVA board. Some board members expressed some concern that it might be unduly burdensome to produce and distribute copies of year-end figures. Another member cited restrictions regarding such things as medical privacy when publicizing detailed information.

Nevertheless, the board did agree to make year-end actual budget figures available to the selectboards if requested. It is not clear, however, whether the WRVA board will approve release of its full balance sheet or income statement. Estey later told The Herald that she herself had no objection to releasing the information to the selectboards of the various towns.

Stanchak will now write a recommendation to the Bethel selectboard. Jon Hodgdon, Bethel's representative on the WRVA board, noted that the selectboard had not asked him for any budget information so far, and said the selectboard should channel any official requests for such information through him.

By Chris Costanzo