Ambulance service in the City of Platteville may change radically in the next few years.
The City of Platteville and Southwest Health Center are discussing the possibility of the hospital’s taking over and upgrading the city’s EMS service to a paramedic service based at the hospital.
“Part of this was how do we advance the total picture of emergency care as the hospital has advanced emergency care,” said District 3 Ald. Barb Daus.
Southwest Health Center CEO Dan Rohrbach said at the Common Council’s July 9 meeting that a paramedic service would have a net cost of $200,000 to $250,000 annually.
“I think there are certainly advantages to upgrading to a full paramedic service,” said Rohrbach. “We’re certainly interested in this, but we can’t shoulder losses like this … without some sort of support mechanism.
“It comes down to cost and it comes down to adding a higher level of service.”
The discussion is being spurred by a major capital improvement decision the city needs to make. The city’s 2014–18 Capital Improvement Plan includes a tentative figure of $500,000 to build a new EMS facility to replace the EMS garage on Furnace Street under the city’s old water tower. The CIP also includes spending $250,000 for a new ambulance in 2015.
The Common Council discussed EMS services in a work session meeting with Rohrbach earlier this year, and held its second July 9.
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 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.
In addition to the City of Platteville, Platteville EMS provides service by annual contract for all or part of the towns of Platteville, Belmont, Elk Grove, Ellenboro, Harrison, Lima and Smelser.
EMS Administrator Brian Allen said the towns pay 22 percent of Platteville EMS’ expenses, even though 85 percent of EMS calls are within the city limits.
Platteville EMS has one full-time employee, Allen, plus a part-time assistant administrator and 24 EMTs who are paid on call, according to the city’s website.
One issue facing ambulance services in Southwest Wisconsin is available EMTs, particularly during daytime hours. Platteville EMS is advertising for daytime EMTs on the city website.
The problem is more acute elsewhere, however. State officials held a meeting in Boscobel after Boscobel EMS didn’t respond to three calls June 12. According to the Boscobel Dial, only six of Boscobel’s 21 EMTs are able to respond during some daytime hours.
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.
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.
Rohrbach’s cost estimates are based on the hospital’s employing an EMS director, six full-time paramedics and six full-time EMTs. Startup costs would be less if the city turned over all of Platteville EMS assets — namely the building and ambulances — to SHC, he said.
Rohrbach said Southwest Wisconsin Technical College is ready to start a paramedic program, and added, “There’s a lot of EMTs that could go on to make this a career.”
When City Manager Larry Bierke mentioned the annual cost estimate of $254,000, Rohrbach replied, “We’re willing to go less than that.”
Rohrbach said SHC could exchange a lower per-year payment from the city for a longer-term agreement for SHC to provide EMS services. A paramedic service also would be able to generate revenue from patient transports.
“We’d like to know there’s some security,” he said. “If the city’s interested in some level, then we just figure out what makes sense.”
Rohrbach formerly was CEO of Essentia Health in Ada, Minn., whose hospital provided paramedic services for a large area, with first responders handling patients before the ambulance arrived.
For SHC to take over Platteville ambulance services would require approval of the seven towns served by Platteville EMS.
“The towns could choose to go elsewhere,” said Allen.
Rohrbach said that with a number of physician hirings and an expansion in the future, taking over ambulance services is “not our number one priority right now.”
If EMS services stay as they are now, a new EMS garage has been proposed to be separate from the fire station, as now, or combined with a new or expanded current fire station. The 2014–18 Capital Improvement Plan also has $4 million tentatively budgeted for a new fire station in 2017.
Southwest Wisconsin EMS services
EMT–Intermediate Technician: Barneveld, Dickeyville, Dodgeville, Highland, Lancaster, Mineral Point, Platteville, Potosi.
EMT–Basic: Arena, Argyle, Avoca, Belmont, Blanchardville, Blue River, Boscobel, Cassville, Cuba City, Fennimore, Hazel Green, Montfort, Muscoda, Rural Medical (Darlington), Shullsburg, West Grant (Bloomington).
First responders: Bagley, Benton, Cobb, Gratiot, Hollandale, Jamestown, Linden, Livingston–Clifton, Rewey, Ridgeway, South Wayne, Woodman.
SOURCE: Wisconsin Department of Health Services