Getting out of the ambulance business

With the Sundance City Council wanting to get out of the ambulance business and the Crook County Medical Services District (CCMSD) having found a way to take on the responsibility itself, all that remained when the two sides met on Tuesday was for each to inform the other of its stance. All parties appeared to walk away from the meeting feeling that an amicable agreement had been reached.

CCMSD CEO Nathan Hough began the conversation by thanking the city for allowing the district to make use of its ambulances until now. “Moving forward, we’re kind of looking for ideas on what we should do, what we can work together on,” Hough said.

Until recently, the city has purchased, housed and performed major maintenance on the ambulances that make up Sundance’s fleet. However, over the last year, the council has wondered if it should still be doing so now CCMSD is in a more financially stable position than it was when the deal was struck.

Meanwhile, at the most recent meeting of the CCMSD Board of Trustees, it was decided that the district would enter into a contract with a Sioux Falls company to lease ambulances for a maximum of $2500 per month.

The district now had a path to obtain working ambulances, but the board felt a conversation was needed with the city regarding such matters as partnerships for potential grants and use of the city-owned building where the ambulances are housed.

“What can we do to work with you guys?” asked Trustee Sandy Neiman, stating that the city can apply for many grants that the district is not eligible to apply for. Hough elaborated that he is aware of only three grants the district is able to apply for; two require an emergency situation and the third is for a fairly negligible amount.

Mayor Paul Brooks outlined his position on the matter, stating that he would be happy for the clerks to look over any grant applications to the State Lands and Investments Board and would take a vacation day himself to present the application in Cheyenne.

However, he said, the reason that the council would like to extricate itself from the ambulance business is financial in nature. Towns under a population of 2200 are reliant on the state, he stated, but the legislative funding to be distributed among towns and counties has not increased with inflation.

Combine this deflated income with the loss of the sixth cent tax this year and the city is now in “harm’s way”, said the mayor. “Our financials are pinched,” he told district representatives.

However, he said, the city is still willing to offer assistance because the existence of the hospital is an asset for the community in terms of job creation and utility usage.

“I see the value and I understand the value and we’ll do it. We just can’t do everything,” he said, explaining that he is not willing to overload the city’s clerks by asking them to write grants.

“I think we can help you with that stuff – we’re not against you,” he continued, explaining that there is a difference between asking the city to write grant applications and asking the city to sponsor a grant. Previous city-sponsored grants, such as those for the Croell Redi-Mix headquarters and Old Stoney, have been written by a third party, he said.

The concern is not helping the district, according to Brooks; rather, it’s the potential of overworking the clerks and taking away from the work they need to be doing for the city. As far as supporting a grant, he said, the city has no issue with doing so.

The council offered no resistance to the idea of the district continuing to make use of the building in which the ambulances are housed. Neiman asked if the district had at some point paid rent for this service; Clerk Treasurer Kathy Lenz said she was not aware of this ever being the case.

Discussion was held regarding the “fundamental issue of fairness”, as described by the mayor, in which city taxpayers have funded the ambulances but county residents have exactly the same access to them despite not paying that tax.

Brooks stated that he understands Moorcroft and Hulett also have independent ambulance services that are funded by the towns but used by county residents, but there is an important difference. The Sundance ambulances, he said, are the ones used for transfers from the hospital to facilities in places such as Spearfish, Gillette and Rapid City.

While district representatives made clear that they understand the issue, Hough noted that the district is not in a position to be able to charge different amounts to different people.

Traditionally, the county has made an annual contribution of several thousand dollars to the city ambulance fund to partly account for this discrepancy. This money has been set aside to pay for new ambulances when required.

At the current time, said Lenz, the total saved in this fund sits at $32,500. The mayor responded to a query from district representatives, informing them that, yes, it may be possible to transfer that money to the district now it is taking responsibility for obtaining new ambulances.

Later in Tuesday’s meeting, the council passed a motion to monument its willingness to work with the district to open the door to more grant opportunities.