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Photo ©iStock.com/Chris Bernard Photography Inc.The decision by the Fluvanna County Board of Supervisors to charge a fee for ambulance usage has stirred enough quitting talk among volunteers that Lake Monticello Volunteer Rescue Squad (LMVRS) Captain Joe Orsolini has called a special meeting of the organization, asking that anyone “contemplating making a serious decision about this action by the Board of Supervisors to please hold off until after the meeting.”

Though Orsolini wouldn’t comment on personnel issues, former LMVRS member Lyle Plitt submitted his resignation two weeks ago and said he knew of three other members planning to do the same.

Some rescue volunteers are opposed to cost recovery, or the practice of imposing fees for ambulance transport, because they don’t believe in charging money for a service they pride themselves on providing for free.

Plitt believes that charging a several hundred dollar fee for ambulance use will keep patients from calling 911 or, if they do call, from accepting transport to the hospital. He also takes issue with the fact that he and his fellow volunteers have been asked to collect insurance information from patients. “I don’t feel it’s appropriate for us to ask sick or injured patients for their insurance information,” he said. “My job is to take care of patients.”

Cheryl Elliott, emergency services coordinator, said that providers would “absolutely not” be expected to gather insurance information from someone gasping for breath, for example. “Right now they already ask for some demographic information,” she said. “The only two different things they’ll ask about is the name of the insurance provider and the policy number. If the insurance information isn’t easily available it can be gotten from the hospital – it just makes the process easier if they can get it from the patient. But never will gathering any information impinge on providing any service.”

Supervisors implemented the cost recovery program, which after a year or two may bring in between $754,787 to $791,723 annually, to help alleviate the $2.4 million yearly price tag for rescue and fire services in the county. When considering what sort of billing model to adopt, supervisors rejected an insurance-only model that would charge insurance companies and forgive any remaining balance, opting instead for a “compassionate billing” program that would bill patients for the balance after insurance pays but would refrain from sending unpaid bills to collections.

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Starting Sept. 1, Fluvanna County residents will have to pay for ambulance rides for the first time ever. The newness of the program has left some residents with questions about how cost recovery will work.

Why did supervisors approve cost recovery?
The Board of Supervisors approved fees for ambulance transport plus a billing model and start date for the program on Wednesday night (July 15).

Insurance normally pays when people need ambulance transport to the hospital, Emergency Services Coordinator Cheryl Elliott explained to supervisors. “We have been leaving money on the table,” she said, by not collecting fees for what has thus far been a free service. By leaving that money untouched, Elliott continued, the county is saying it would rather spend tax dollars to fund emergency medical services than take advantage of money that is sitting ready for that purpose.

Fire and rescue in Fluvanna County cost $2.4 million yearly, Elliott said, funded by Fluvanna taxpayers and those who give direct contributions to agencies. “We’d like to see the insurance companies take a little more of that cost,” she said.

How much will cost recovery bring in?
It’ll take a couple years to really get a sense for what kind of return the county can expect on cost recovery. Fees have been set at 125 percent of Medicare’s allowable charge, which right now translates into costs per ambulance ride of $444 to about $762, with mileage charges of $13.78 per mile for miles 1-17 and $9.18 per mile for every mile thereafter.

Based on these figures, Elliott estimated receiving between $368 and $386 per transport, resulting in an annual intake of between $754,787 to $791,723.

What is compassionate billing?
Supervisors settled on compassionate billing as the model for Fluvanna’s cost recovery program.

In compassionate billing, the full amount charged goes to insurance first, Elliott explained. Insurance will likely pay a portion of that amount. Medicare, she said, may pay about 80 percent. The balance of the bill will then go to the patient.

Patients will receive bills, then 30- and 60-day notices from EMS|MC, the billing company hired by Fluvanna. Under a compassionate billing system, unpaid balances are eventually written off rather than sent to collections.

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Rumblings in the community of issues at the Fluvanna County SPCA surfaced at the Board of Supervisors meeting Wednesday night (July 15), as eight residents addressed the Board with comments related to recent SPCA troubles including an investigation by the sheriff’s office.
There is a “pattern of disregard for public safety displayed again and again by the Fluvanna County SPCA,” said resident Rose Lemaster to supervisors during public comments. She told three stories, including one of a dog deemed by a behaviorist to be aggressive toward men and children. The SPCA allowed a family with a 5-year-old to adopt the dog, she said, and within three days the dog “ripped half of [the] child’s face off.” The child is now facing at least six plastic surgeries, she said. “Fluvanna County pays the SPCA for pound services,” she said, “but I want to strongly encourage you that it may be time to reconsider that agreement.”
Former SPCA director Tricia Johnson told the Board, “I have fought valiantly, I think, to bring that organization up to the highest standards…and it has frankly broken my heart to see where it has come to in these past three years.” Johnson told a story of dog brought to the SPCA that had been hit by a car. The vet who examined the dog told the SPCA to take it for an x-ray, but “instead of doing that, the Fluvanna SPCA allowed that dog to lay on the cold floor, untreated, with nothing but the canine equivalent of Advil for pain,” Johnson said. “When it finally was pulled after two months…it was found to have a crushed pelvis, multiple fractures of both back legs, and fractures in its tail… The public needs to know what is going on.”
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New home will remain vacant till unapproved road is fixed

Despite a plea to their sense of fairness, Fluvanna County supervisors denied an appeal by Liberty Homes to allow for a final inspection and certificate of occupancy for a new home constructed at lot 24 in Cunningham Meadows, a subdivision off Rt. 53.
In doing so, supervisors upheld the strongest option in the county’s playbook when it comes to unapproved roads – preventing a successor developer or builder from selling a new home until the roads are improved and accepted into the Virginia Department of Transportation (VDOT) system.
The appeal from Liberty Homes was to overturn a decision made by Jason Stewart, Fluvanna’s subdivision agent, that lot 24 – and, in fact, all of Cunningham Meadows – is in violation of the subdivision and zoning ordinances under which the rural cluster subdivision was originally approved, in that its road, Cunningham Meadows Drive, while dedicated to public use, has not yet been accepted into the VDOT system.
Because Cunningham Meadows is in violation, Stewart denied Liberty Homes, an owner of remaining undeveloped lots, the ability to receive final inspections or certificates of occupancy for their new homes under the provisions of the subdivision ordinance, which states that no “permit or other approval shall be issued by any official of the county for any improvement relating to any lot or parcel of land subdivided or transferred or sold in violation of this chapter until such violation shall have been abated.” Liberty Homes, therefore, can no longer sell homes in Cunningham Meadows.
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Confederate ParkSo-called Confederate Park in downtown Palmyra – a tiny park with a monument and cannons honoring Fluvanna residents who died in the Civil War – may be up for a change in name. Or, since the park has never technically received a name, it may finally be christened with a moniker less potentially offensive.
Chairperson of the Fluvanna County Board of Supervisors Mozell Booker suggested the change in name at the Board meeting June 17, and during the meeting on July 15 took a moment to clarify that suggestion.
“I want to make it very clear that the request for the park was to bring more statues of honor into the park,” Booker said. “My request had nothing to do with separating community. It was about bringing Fluvanna history together in one place… That’s all of our history – your history, my history, from the Union army to the Confederate army. There was nothing talked about racism; there was nothing about hatred. This was about honoring Fluvannians.”
“I appreciate Ms. Booker’s intention,” countered Supervisor Bob Ullenbruch. “But it has caused division in this county… Why on earth we’d want to change that [name] at this time is beyond me. It is causing division… We have a lot of serious work to do that’s meaningful to the community that this is just taking away from the focus.”
During public comments, School Board Member Bertha Armstrong addressed supervisors about the park’s name. “Why can’t we move on and include other monuments in the park?” she asked. “Then it will no longer be a Confederate Park. There are Fluvannians who fought in all wars. Let’s honor them all in one place… [If we did,] I’m sure that the African American community, for the first time, would be proud to come to Palmyra and perhaps have lunch in the park.”
Dogs off-leash
In other matters, a seemingly small issue – dogs off-leash at Pleasant Grove park – is stirring intense feelings among Fluvanna County residents, leaving county policymakers scrambling to strike an impossible balance in protecting the rights and desires of two conflicting groups of people.
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