City, partners still weighing EMS proposals
Discussions on service proposals from St. Croix EMS and Lakeview EMS continued Monday, with uncertainty about what the St. Croix EMS proposals would cost.
A report from Finance Director Brenda Malinowski showed with the proposed 45 percent or 80 percent increase on rates for St. Croix EMS, the service would run out of cash in 2021.
The report also showed the service would need a large per capita increase, up to $41, to generate enough revenue.
Operations Supervisor Josh Olson said he didn't know what numbers were used for that. The company that the service worked with on the proposal did not show any need for a per capita at all with an 80 percent increase, and only a per capita for the city in the 45 percent increase.
Malinowski said the original proposal appears to have transfers in it. She made her calculations based on the run volumes the service knew it had.
Council Member Jim Webber said the suggestion from the last meeting was to validate the numbers the company presented.
Malinowski said she did reach out to the proposal company, but felt more comfortable with the billing company and their numbers.
Olson said he had requested to have the company that helped write the proposal involved again and relook at the financials, something he said it would do for free, but was denied.
"I stand up here at this podium as the head of this service, my hands are tied, I can't answer your questions," Olson said.
City Administrator Devin Willi said he did not understand that it was going to be free, and staff does not have the authority to authorize additional expenditures.
O'Connor said the committee can take more times to get numbers, and Olson would have the approval of everyone on the committee to reach out to the consultant again.
"Lakeview is here to expand upon and explain their proposal," Council Member Sarah Atkins Hoggatt said. "I think it's very reasonable for us to allow the company that wrote this proposal to stand behind it and explain and modify based on new information."
Willi said they will have to figure out the discrepancy in the numbers. Atkins Hoggatt said she wanted both sets of numbers verified. Mayor O'Connor said in the future, any type of request should be done with an email so there is not a misunderstanding of what is requested.
Olson also raised concern that Lakeview EMS is not critical care certified in the state of Wisconsin, as required in one of the first pages of the request for proposals.
Lakeview EMS Supervisor Jon Muller said the service is not currently certified, but will be when it updates its operation plan. That plan has to be updated now that it is serving town of Hudson, but Muller said the service is waiting to see what direction the city will go.
Muller also said elsewhere in the proposal it said the licensing needed to be a paramedic-level certification, which Lakeview is.
Council Member Randy Morrissette asked the city attorney to research for clarification.
O'Connor said he wanted to ensure response times were being compared apples to apples.
Lakeview's response time runs from the time the call comes in to the time the ambulance is on scene. That response time averages 6 minutes, 44 seconds.
Olson said St. Croix EMS response time is from en route to the ambulance arriving on scene. That average time is 7.12 minutes. A paramedic is en route in 90 seconds in a chase vehicle, Olson said. The on-call ambulance crew is in EMS quarters 90 percent of the time and cross the street to ready an ambulance and head to the call.
The chase vehicle is designed to arrive before the ambulance so the paramedic can begin treating the patient. The ambulance arrives first a handful of times, Olson said.
Morrisette said if he was the town of Hudson chair, he would be concerned about the Lakeview response times reported for that area. He said some of those calls are comparable to St. Croix EMS response times, while some are large response times.
Muller said those numbers were from 2018 data. If a call is further out in a service area, Muller said it is not going to have the average 6-minute response time.
Muller presented the numbers from January 2019, when the service became the main provider for town of Hudson. Muller said those calls had an average of 8 minutes, 42 seconds, with the longest response time of 15 minutes.
St. Croix County dispatch
In a presentation to the committee, Lakeview Operations Supervisor Matt Milder said dispatch with St. Croix County has been going well.
Lakeview uses an Allina dispatch, so to answer calls in St. Croix County, the county dispatch receives the initial call and determines its nature, then calls the Allina dispatch that then sends out a Lakeview crew.
Webber said he took exception to the idea that the communication was going well. He said two years ago, when the city was negotiating with Lakeview, concerns were first voiced that dispatch was receiving inadequate information from Lakeview ambulances on calls.
He said in discussion with Emergency Support Services Director Steve T'Kach it appears that they still did not have a solution.
"There's a big gap here, and I think that communication, that's critical," Webber said.
Milder said the service has shared its pulse application, which shows where trucks are and details about its run, with the county dispatch to use. Muller also said a memo will be sent out this week to have crews inform county dispatch when they're en route and when they clear the scene.
O'Connor said T'Kach allowed him to say on his behalf that he believed everything would work out, with compromises on both sides.
New Richmond EMS Association
A third piece of the St. Croix EMS proposal was joining the New Richmond EMS Association. New Richmond EMS Director Matt Melby said the per capita rates of $9.88 for the city, $6.66 for the village of North Hudson, and $6.12 for town of Troy originally put together in November have changed. Losing the transfers from the Hudson Hospital, which will now be handled by Lakeview EMS, has a significant impact on the bottom line, he said.
The new per capita amounts were "ridiculous," Melby said, with city of Hudson paying a per capita of $27.44.
The committee will meet again at 4 p.m. on Feb. 25.