Viewpoint: Next step for EMS if strategic plan with community input
By Joyce Hall, chair of EMS Ad-hoc Committee
As chair of the EMS Ad-hoc Committee that was formed by the city council last year, I would like to clarify a statement made by the mayor at the recent debate.
In contrast to what was stated, there has been an active and focused EMS Ad-hoc Committee whose charter is to, "develop recommendations regarding moving St. Croix EMS (SCEMS) toward financial and operational stability while maintaining a community-based service model."
The committee includes myself, Alderperson Jim Webber, Paul Rode (owner of Agave Kitchen), Bill Campbell (owner of Campbell Grants and Research), and John Tremble (former CFO of Hudson Hospital and currently a consultant to hospitals). Our focus is on a process that is transparent to the community and invites all stakeholders to participate. In our process, we are exploring multiple options to allow SCEMS to incorporate those elements that the public has told city council members they value: maintaining the current high quality of service, having public oversight and local public control of the operations, while retaining our EMS team members.
The community expressed objections to both the contract and the process last June. The original proposal was for Hudson Hospital to take over our ambulance service and run it the same way it was being run at the time. During negotiations, the proposal changed to Lakeview EMS providing service to our community. The public objected to the lack of transparency of the process and the decision to only work with one vendor rather than using a bidding process. I heard multiple times that they preferred having personnel who are members of the community and know the patients—an advantage that would have been lost if the contract had been accepted. The public made clear its preference to keep our service locally owned and operated.
The issues that need to be addressed are complex and many other publicly-owned services are facing the same concerns, but there are several key points. First, costs keep increasing, but reimbursement rates from Medicare and Medicaid are staying flat and are not even close to the cost of an ambulance run. Second, Twin Cities employers pay considerably higher salaries to their EMS personnel than the SCEMS pay scale. SCEMS is mainly hiring part-time employees and is competing with employers who are hiring fulltime employees and paying their benefits. Maintaining the current model will cost substantially more money to pay for salaries and benefits for employees. All of the partner municipalities are up against state-imposed levy limits and will have difficulty affording more for the service without going to a referendum.
There are several other models for delivering services besides our current model and the model in the rejected contract and the committee is evaluating them.
One model is an association combining several local services. There are potential savings that could be found with this model and the ad-hoc committee is very interested in it. The other local services each have different staffing models, pay scales, and billing rates, so a uniform model would need to be negotiated. In addition, the association would have to go through the state licensure process. This option is a time-consuming process, but could be a worthwhile effort.
Other communities are using the model of negotiating a contract with a private agency through a competitive bidding process. If this choice is selected, a Request for Proposals (RFP) would need to be carefully written to incorporate the elements that ensure the City of Hudson's oversight of the operation and a strong future negotiation position.
Other models are still under consideration as well.
The next step in our process is to formulate a strategic plan using community input to determine a model that is right for Hudson and the surrounding area. The ad-hoc committee will need everyone's participation to find a solution.
I urge everyone to attend our next meeting at 6:30 p.m. Thursday, March 29 in the City Hall Council Chambers.