COMMISSIONERS MINUTES                                             SEPTEMBER 8, 2004


The Elmore County Commissioners met in special session on the above date in the Commissioner’s Room, basement of the Elmore County Courthouse, 150 South 4th East, Mountain Home, Idaho.

Present at the meeting were Chairperson Mary Egusquiza, Commissioners Larry Rose and Calvin Ireland. Also present at the meeting were Clerk Gail Best, Prosecutor Aaron Bazzoli, Karl and Carrie Vogt, and representing Elmore Medical Hospital Greg Mauer, Dr. Karl Olson, Dr. Ashby, Mona Bauer, Bill Ringert, and John Bideganeta.

Prosecutor Bazzoli gave an overview of the background of the issue as he sees it. The main issue is the non-emergency return trips from Boise - or inter-facility transfer returns.

Karl Vogt stated that Northwest Paramedics, Inc. feels their main role here in Elmore County is to provide 911 services to Elmore County. Mr. Vogt stated the question before the group today is on inter-facility transfers, who pays for the return trip? Karl added that there are only three options: the hospital, the county, or NPA. The trips are generally made from the hospital here to Boise or Twin Falls, they could be for tests or procedures that can’t be performed here. The ambulance takes the patient over and then has to wait while the test or procedure is being done and have no control over how long it might take, and then bring the patient back to the local hospital. The time involved in this if the Boise hospital sends the patient back to Mountain Home, if there is no payment to NPA, is a financial burden and not a part of the 911 services they are here to provide.

Greg Mauer stated that Medicare cases are honored by Elmore Medical Hospital for inpatient round trips. Mr. Mauer stated that they want to do what the physician and patient need. Mr. Mauer stated that he wants to know what the Board really wants the Hospital to do because he is unclear about just what the Board wants.

Bill Ringert, Hospital Trustee, stated the hospital does not have any control over these transfers, it is between the patient and the doctor. Karl Vogt agreed that was true.

Karl Vogt stated they are required by law to tell the patient that the return trip will not be covered by insurance and get the patient’s consent. Mr. Vogt added that about 10% of NPA’s finances are these return trips that are unpaid.

Mr. Ringert stated that under the HIPPA regulations and other privacy issues, he does not think the Board had the authority to pay for the return trips. They cannot go beyond the Board’s authority.

There was lengthy discussion about the form NPA wants to have filled out prior to taking the patient on an inter-facility transfer. The hospital has not agreed to sign the form.


Mr. Mauer stated that regarding financial responsibility, we did address it and it was clear at first and then the County took a different view. The hospital feels they need more information.

Carrie Vogt asked why it was alright with the hospital to hire another service for these trips, but would not pay NPA? Mr. Mauer stated they have not excluded NPA. Mr. Maurer stated that in twenty-two months there have been nine 2-way transfers and they would work on gathering more information. It was also agreed that they would work on a form that would be acceptable to both parties.

Commissioner Rose stated that it was clear that communication was the answer to the problem.

Motion by Rose, second by Egusquiza to adjourn the meeting.
EGUSQUIZA - AYE
ROSE - AYE
IRELAND - AYE Motion carried and so ordered.

/S/ MARY EGUSQUIZA, Chairperson
ATTEST: /S/ GAIL L. BEST, Clerk