Two years after the idea first came up, and two weeks after an agreement appeared on a Platteville Common Council agenda, the Common Council approved the future transfer of Platteville EMS services to Southwest Health.
The agreement was approved 5–2 May 26, with District 4 Ald. Ken Kilian and at-large Ald. Amy Seeboth-Wilson voted against.
Kilian and Seeboth-Wilson said their no votes were due to the speed with which the agreement was considered, and not necessarily being opposed to transferring EMS services to Southwest Health.
Seeboth-Wilson called the proposal a “really good thing in a number of ways,” while adding the proposal moved “relatively quickly when it came to the council level.”
“If it’s a good idea today, it’ll be a good idea in two months,” said Kilian.
Kilian indicated displeasure with the city not having control over EMS services to the extent the city has now.
“We have 15,000 people affected by this change, and I don’t like to see the city lose control,” he said.
At-large Ald. Tom Nall called it a “difficult vote,” adding, “I don’t think it’s going to be a situation where the hospital is out to take away something from the community; I actually think they’re out to help the community.”
The agreement must be approved by the Town of Platteville board to become official. The boards in the other towns in Platteville EMS’ service area — the Grant County towns of Ellenboro, Harrison, Lima and Smelser, and the Lafayette County towns of Belmont and Elk Grove — must either approve the agreement or make alternate arrangements for EMS service, since municipalities are required to provide EMS services under state law.
The Town of Platteville Board is scheduled to meet Monday night, with the EMS vote on this week’s meeting agenda. Town clerk James Lory said the town board discussed the proposal at its May meeting without taking action.
Southwest Health is agreeing to upgrade EMS service to paramedic level, with a combination of paramedics and EMTs staffing the service, within two years. Southwest Health is agreeing to build a new ambulance garage and take possession of Platteville EMS ambulances and equipment.
The condition of the current EMS garage at Furnace Street and Elm Street, and the need for a replacement, was a major factor in the decision to transfer EMS services to Southwest Health.
“Probably for the last six years the city has been grappling with the need for a new EMS facility,” said District 3 Ald. Barb Daus, who called the city “incredibly short-sighted” in building the present EMS garage.
The city and the towns that sign the agreement are agreeing to Southwest Health $100,000 in 2016, and up to 75 percent of costs thereafter, with limits — up to $150,000 in 2017, and from $130,000 to $150,000 per year between 2018 and 2024. Annual reimbursement could increase annually by the Consumer Price Index from 2025 to 2034 at Southwest Health’s discretion.
Southwest Health estimates in the contract that paramedic service would cost about $200,000 per year, including construction and ambulance replacement costs. The annual costs to the EMS district municipalities of up to $150,000 were reduced from initial projections of $200,000 to $250,000 per year when the subject first came up in 2013.
Platteville EMS serves about 17,000 people, with the City of Platteville totaling 77 percent of the EMS district and the Town of Platteville 10 percent. About 85 percent of Platteville EMS’ calls are within the city boundaries.
Much of the discussion at the Common Council meeting was over the timing of the vote.
City resident Jessie Kilian said measures are “proposed at city hall … they give out very little information until it’s voted in, and we’re expected to pay the taxes.”
“If it’s a good idea tonight, it’ll be a good idea in three weeks when the community has more time to learn about it,” said city resident Lana Caywood, who asked what happens if the hospital’s loss on EMS service is “too much for the hospital to bear? I’m concerned about some of the services at the hospital that are no longer there.”
To that, Southwest Health CEO Dan Rohrbach said, “Our intent is going to be to reduce that cost as much as possible” by employing paramedics and EMTs in the hospital when not on calls.
Rohrbach said Southwest Health discontinued hospice services because three other Platteville organizations provided hospice services; five do now, he added.
“We’re committed to not increasing rates” for ambulance calls, he said. “We’re setting the fee. Everything above and beyond that is on us. It’s a risk for us, but that’s what we do’ we’re in health care.”
Basic EMS service calls cost $650 for district residents and $850 for non-residents. Another $100 is charged for advanced EMS calls, which total about 25 percent of Platteville EMS calls.
Platteville EMS administrator Brian Allen said earlier in May that fees are assessed for ambulance calls based on the medical services provided, not on the certification level of the EMTs on the call.
“I’m not opposed to the move,” said Caywood. “I’m in favor of giving people the opportunity to get more information.”
To that, Daus said the proposal was on a council agenda Aug. 26. “It has been on the agenda several times; there was not one but two meetings with the townships” as well as a work session. “I believe this has been publicly discussed a long time before” the past two council meetings.
One person spoke in opposition — EMT Cassandra Woolford, who called it a “horrendous idea.”
“It takes a special kind of person” to deal with patients at such city facilities as Manor Care and Pioneer Ridge Retirement Village,” she said, adding, “We don’t want to become a private entity.”
City resident Tim Jacobson, a Sun Prairie paramedic, had the opposite view, calling paramedic-level service “very important,” noting a patient without a pulse he said Sun Prairie paramedics revived the previous day.
State law requires every municipality to either provide emergency medical service, or contract with a provider for EMS service. In addition to providing basic first aid, EMT–Basic services can provide aspirin, albuterol, Atrovent for asthma or Chronic Obstructive Pulmonary Disease, epinephrine and glucagon to increase blood glucose levels.
Platteville EMS is now classified as an EMT–Intermediate Technician service, which is able to provide IVs and more medications than an EMT–Basic service, including nitroglycerin for chest pain, Narcan for narcotic overdoses, and 50-percent dextrose for diabetics.
According to the Wisconsin EMS Association, EMT–Basics are certified after 140 hours of training. EMT–Intermediate Technicians require another 100 hours of training. EMT–Intermediates require another 335 hours of training, and Advanced EMTs require an additional 170 hours of training beyond that.
Paramedics require 1,000 hours of training to get a license. Paramedics can administer 40 or more medications, and perform some procedures, including sedating a patient to insert a breathing tube.
Platteville EMS currently has 26 EMTs, including three paramedics, after two recent resignations. In 2014 Platteville EMS had 1,165 calls — an average of three per day — but 2015 call volume so far projects to an 11 percent increase over the year.
Allen said May 26 that current EMTs “would be encouraged to apply” for full-time, part-time or on-call positions.
Once the EMS services receives paramedic-level certification, two ambulances will be staffed at first, the second with on-call personnel. When a third ambulance is obtained, two ambulances will be staffed with full- or part-time employees and the third will have on-call personnel.
“It’s going to be a change as to when they work and the name on the ambulance, but until it goes to paramedic service, it’s going to be the way it has been,” said Allen.