Both the City and County approved ordinances Tuesday to dissolve the Medical Control Authority (MCA) ordinances and establish the Ambulance Contracting Authority (ACA). This agreement approved by the city and county was not unanimously approved by all commissioners.
City Commissioner Larry Conder provided the only dissenting vote Tuesday night in a 4-1 majority approval. Daviess County Fiscal Court passed its ordinance in a unanimous 4-0 vote.
The new ACA board will be responsible for overseeing ambulance contracts and ensuring American Medical Response (AMR) provides its board-mandated services to the community.
The ACA was formed following a tense period last year wherein Owensboro Health Regional Hospital declined to provide backup ambulance services to the city and county and pulled out of paying its share of a $150,000 annual subsidy that, ultimately, fell completely on the taxpayers instead.
Conder said he voted against establishing the ACA and dissolving the MCA because of the structural changes regarding the new ambulance board. Primarily, Conder said he disagreed with the ACA’s lack of hospital representation on the board.
Previously, the MCA appointed eight voting board members — four each from the city and county — with at least one hospital representative serving as a voting board member. Now, the ACA includes six voting board members, and a hospital representative is not one of them.
“In restructuring the board, now the hospital has one person on the board, but they’re not voting,” Conder said. “What does that do? In my opinion, that takes Owensboro Health out of the equation of ever helping with subsidisation and with services. In my opinion, they should be the ones operating it anyway, period. Basically, the citizens of Owensboro paid to have [Owensboro Health’s] customers delivered to their front door.”
Conder’s opinion is that Owensboro Health should play a role in providing ambulance services to the community it serves, either financially, through providing ambulance service, or both.
When patients are picked up in an ambulance they’re in charge of paying for, then are dropped off at an emergency department for medical treatment they’ll pay the hospital for — Conder believes the hospital receives a financial benefit through the ambulance’s services without having to shoulder any responsibility for those services.
“I think they should do it all,” he said. “What this ordinance basically says — they’re not going to be involved at all. Who’s really getting hurt here? The taxpayers — both the city and county’s. The hospital doesn’t have an opportunity to step up and say, ‘We’ll do it all’ [if they can’t vote.”
City Manager Nate Pagan said the ACA Board will include non-voting members to the board, such as an employee of Owensboro Health Regional Hospital designated by the emergency department director. These members will not have the ability to vote, but they can provide input during meetings, Pagan said.
“They can have some staff participating, even without voting,” Pagan said. “It was decided that the partners paying for the ambulance services would be the ones who have the ability to vote.”
In response to Conder’s concern that the hospital won’t take future responsibility without the ability to vote, Pagan brought up the fact that, even when the hospital had a voting board member last year, they didn’t take responsibility for providing ambulance services.
“They chose not to fund it when they had voting board members,” he said.
