CCMSD sourcing new ambulances
January 30, 2020
The latest move in the ongoing and often complicated discussion of Sundance’s ambulance service, Crook County Medical Services District is now sourcing new ambulances for the Sundance ambulance service, with the intention of leasing to buy. The concept would see the district pay for each new vehicle over four to five years and then trade that it in when it comes time to upgrade.
“Ideally, so we don’t keep repeating history, where we have 20-year-old vehicles…we’d take a four or five year lease or purchase and, at the end of five years, it’s the district’s vehicle, we now have the pink slip on it, and we upgrade our equipment again,” said Chairman Mark Erickson at Thursday’s meeting.
Once fully purchased, the vehicle could be traded in for a newer ambulance at the end of the lease, he elaborated, which would allow the service to upgrade on a regular basis rather than wait until an ambulance is defunct. This could be achieved through a capital equipment lease and done on a rolling basis, such that the ambulances did not all need replaced at once.
The board requested that staff and Health Management Services begin gathering quotes after hearing input on what the Sundance ambulance system needs. Anthony Vopat, EMS Coordinator, told the board that he began taking an audit of the department’s equipment when he accepted the role recently.
“Our ambulance situation was in crisis, and I choose that word fairly carefully,” he said. Two of the three ambulances could not safely transport people and keep them warm and cool, which is a “basic, vital thing that we have to have,” while the third ambulance is a four-wheel vehicle that Vopat believes is working well and will continue to do so for at least a couple more years.
This is what led to the contract to lease an ambulance with the Sioux Falls company, he continued, and that’s how things stand at the present time. Answering a question from Trustee Trish Habeck, he stated he feels comfortable using the leased ambulance on Crook County’s terrain.
At Erickson’s request, discussion was held as to what the ideal ambulance fleet would be for the district.
Vopat explained he would like two four-wheel ambulances to navigate the county roads when responding to calls and one two-wheel ambulance.
The board stated a desire to get moving on the process of gathering quotes on the types of vehicles needed. “We can’t keep kicking the can down the road, it’s got to be done,” said Erickson.
As to how the new ambulances should be sourced and paid for, Trustee Connie Lindmier stated that the Crook County Medical Foundation is now working to secure donations for the ambulance fleet. Erickson pointed out that the money now being held by the City of Sundance to purchase a new ambulance is also available, providing additional options.
Lindmier read a message from Judy Hutchinson of the foundation in which she states she may have a source in Colorado to purchase a used, reasonably priced ambulance. Chairman Mark Erickson, however, shared his opinion on purchasing used ambulances.
“The old saying is to never look a gift horse in the mouth. However, if you pick up the horse and it…drops dead the next day, it’s now your problem,” he said. “It’s not that there’s anything nefarious, but there’s a reason why some of these places are getting rid of their vehicles.”
If CCMSD wants to continue being a first-class organization, Erickson said, it cannot be the case that patients are commenting the ambulance crew is great but the ambulance itself is not.
The board expressed concern as to whether or not the City of Sundance plans to hand over the approximately $35,000 that is being stored for ambulance purchase. That money comes from annual contributions from the county towards new ambulances and could be used as part payment or as a grant match.
“I think it’s pretty clear the city wants out, they aren’t going to do any more,” said Erickson. At the first meeting trustees attended, said Erickson, it was said that the $35,000 would just be transferred over to the district.
However, trustees felt the city’s intent in terms of that money is not yet officially confirmed and that Mayor Paul Brooks gave different impressions as to what would be done with it at the two most recent council meetings.
“Until they officially make a motion and say they are doing this, I don’t think we can really count on it,” said Lindmier.
The board also discussed the recent request from the City of Sundance that the district pay rent on the building in which the ambulances are housed.
The board feels that the city’s suggestion of $1000 is more than double what would be reasonable to cover costs. The electricity costs are not particularly high, said Erickson, and mainly involve plugging in the equipment to charge it.
Erickson said he had spoken with Public Works Director Mac Erickson, who had given him a cost estimate of less than $300 per month to heat the whole building, of which the ambulances only take up a portion. Electricity, water and use of the room would also be included.
The chairman volunteered to contact Erickson via phone and offer $400 per month for access to use the building. The board will also investigate whether there could be alternative long-term options to house the ambulances, such as by constructing a new building on district property.
The board will also request direction as to what the city wants done with the two ambulances still housed in the city building that no longer run. Erickson noted that, at the most recent council meeting, Public Works Director Erickson mentioned possibly repurposing one for city use.
County versus city
During Thursday’s meeting, Trustee Sandy Neiman asked for clarification on a point that has been raised several times during meetings of the Sundance City Council. She referred to statements made by Mayor Paul Brooks that the city finds it hard to stomach that a patient out in the county is charged the same rate for an ambulance even though, unlike city residents, they have not contributed to the cost of purchasing and maintaining that ambulance.
CEO Nathan Hough explained that billing is complicated but, in a nutshell, the basic charge is always the same for a patient needing a ride in the ambulance and fluctuates mainly based on the level of care provided. However, he said, a patient far away from Sundance, where the ambulances are stored, could also be charged “loaded mileage”, which applies after the ambulance has traveled one mile.
Whether a person lives in the city or not is “irrelevant”, explained Karl Rude, president of Health Management Services. This is not a city versus county issue; rather, the charge for mileage is based on distance and the ambulance does not travel further than one mile when responding to calls in town.