Dorset will continue to provide approximately $12,000 in municipal aid, along with the other four towns served by the squad.
The rescue squad needs additional revenue to offset costs for new equipment and maintenance of their three ambulances, MRS President Ben Weiss and MRS Chief Operating Officer Mike Casey told the Manchester Select Board at their meeting on Tuesday.
The rescue squad is not a municipal entity, but the town has an agreement with the squad that allows them to request funds from the town.
Weiss explained that last year, the rescue squad operated in the red, or over-budget. For the 2013/2014 fiscal year, he said that they are striving to operate on a budget of $750,000 in expenses through their regular billing, a subscription service, and fundraising.
They are hoping to raise $82,000 through fundraising in order to break even.
Casey said that their regular billing can sometimes be a problem and does not generate as much money as they need.
Patients who require transportation to one of the area hospitals are billed for that service; others provide for that through an annual $95 "subscription" which covers all potential trips to a hospital.
The service is available to anyone regardless of whether the person has private insurance, Medicaid or Medicare. However, if a subscriber has insurance then the subscription cost will cover copays or deductibles; if the subscriber does not have insurance then the $95 is all they will need to pay.
"The program assures no out-of-pocket cost for emergency medical services," read their official request.
When transporting a patient with Medicare, the rescue squad is told how much of the total bill they are allowed to bill. Then, out of that amount, they are only given 65-70 percent of the bill.
"There is a lag time for the [Medicare] billing," Casey said. "It can take anywhere from 90 days to a year for Medicare reimbursement," adding that at any given time, there can be about $2,000 that the rescue squad anticipates receiving but has not obtained yet.
They also see problems when it comes to where the patient is transported; Northshire Medical Center is not considered a "payable" location, because it does not contain at least six in-patient beds.
According to Casey, 60-70 percent of their calls end up being transported to some location, either Southwestern Vermont Medical Center 25 miles away, or the Rutland Regional Medical Center, or to Northshire Medical Center in Manchester. The other calls do not result in transportation, and therefore make no revenue for the rescue squad.
Both Casey and Weiss said that they are unaware of how the upcoming healthcare changes will affect their billing.
They need to purchase a new ambulance every three years, and are currently operating a 2004 model with 150,978 miles of use, a 2005 unit with 101,986 miles on it, and a 2009 unit with 62,510 miles. The trade-in cost for an ambulance of that condition is approximately $6,000, while the cost to purchase a new one every three years falls around $150,000. The annual maintenance on all three ambulances averages to $17,000 a year.
This summer alone, they have replaced two engines on their ambulances because of the age, and the amount of mileage they have taken in. Each time an ambulance needs to transport a patient to a hospital, whether it is in Rutland or Bennington, it puts approximately 60 miles, round trip, on the vehicle.
Manchester is only one of six towns from which the squad is requesting funding - they also provide services to Dorset, Danby, Mt. Tabor, Winhall and Rupert. They are hoping to be able to receive funding from each town. The percentage is determined by what percentage of their calls come from each town.
Weiss and Casey presented a breakdown of how much they would be asking from each town, although the numbers will be adjusted slightly in the future because they were unable to calculate in Winhall and Rupert at the time of presentation.
Manchester will make up 54.4 percent of the request, paying $35,363; Dorset is next at 26.9 percent and $17,495.
"Manchester makes up 65 percent of our call volume," said Casey.
MRS officials have already met with Dorset Town Manager Rob Gaiotti, and he has agreed, in principle, to adding an annual line item for their equipment needs. The item will be submitted to town residents in February of 2014.
There was no decision made at the meeting, and other representatives from the squad are scheduled to meet with other towns in the meantime. The board also discussed an application for a grant of $18,000 to come from the state of Vermont, for a bicycle and pedestrian program.
If the state approves the grant, the town will need to pay 10 percent of the total cost, while the state will cover the remaining 90 percent. The 10 percent, $1,800, will be split between the town and the Manchester School District, $900 each.
The board approved the application and payment of the five percent if the grant is approved.
The select board also tackled an issue involving the revocation of Wood Fired Pizza's liquor license.
Planning Director and Zoning Administrator Lee Krohn explained that, for three years, he had been trying to work with the owners Sam and Kim Johnson to correct what he saw as zoning violations. He said that he had not issued violation notices or tickets, and that each time he told them of an issue they said that they would take care of the problem.
The revocation of the liquor license had been implemented by Krohn because he did not believe that they were going to fix their zoning violations, which were the stipulation of the license.
Both Sam and Kim Johnson spoke to the board to explain that they were unsure of how they were violating zoning regulations, and had frequently been in contact with Krohn and had received no answers to their questions on how they can fix their violations.
The violations stemmed from the amount of seats they were using inside their restaurant; they were permitted for 14 seats inside the building, and 10 outside. The number of seats allowed were counting only seats at tables, not seats without tables, such as couches, or the seats meant for children. They could purchase permitting for up to two more inside seats without having to alter their parking, and the outdoor seating does not affect the parking spaces.
Krohn and Town Manager John O'Keefe said that they had visited the location on multiple occasions and found more than the permitted amount of seats being used inside.
Sam and Kim Johnson both explained that their customers had moved around some chairs to adjacent tables, creating the excess seats, and that seats had been brought in from the outside when it was raining. They said that they didn't know this was a violation because they were not able to receive the answers to their zoning questions.
Select board chairman Ivan Beattie recommended that the item be tabled until the next meeting to give the board time to consider both sides of the story, and he said he was concerned that frustrations from involved parties were clouding their judgment.
The item will be picked up at the next select board meeting in August.
The final item on the agenda was to authorize Homestead Landscaping to maintain the aesthetics of the roundabout.
The agreement would only cost the town the price of annual flowers, and a two-by-two foot sign stating that the roundabout was maintained by Homestead Landscaping.
The board authorized the Town Manager to sign the agreement.