Ambulance licenses
April 10th, 2007 by 
Alica
Now that Ordinance #381, the ambulance ordinance, has passed, what is the next step? Presumably the city will start taking applications for licenses. It seems likely that Med-Star will apply. Rural Metro, which has been serving the city, didn’t say before the election if they planned to apply or not (at least not publicly).
Perhaps the Garretson ambulance service will apply for a license in Brandon. A representative from Garretson came to one of the public forums.
Or maybe the Brandon Volunteer Fire Department, or even the city itself, will decide to get into the ambulance business.
What other options can you think of? Which do you think are most likely? Any predictions as to what will happen next?
We’ve been putting our ambulance thoughts under the “All Things Ambulance” thread. But now that the ordinance has passed and we’re looking ahead to the licensing process, let’s start using this thread for our discussions.
Thanks.
Posted in Uncategorized, Ambulance | 
April 11th, 2007 at 5:28 am
Here’s my predictions.
MedStar will be the only applicant.
It will happen very fast.
He will be answering calls before the fine details of the ordinance are ironed out.
Brandon will not have a solid (equal to REMSA, which means 6 laypeople and 5 physicians) quality assurance board to oversee quality control.
Rural Metro has said they will not apply and they won’t. It is proven nationwide that competing services is disastrous. One reason being that a service can “cherry pick” the paying calls and leave the medicare and none pays. Also, the confusion at dispatch is too risky.
My last prediction is that eventally MedStar will not be able to stay in the black financially and ask the city for a subsidy.
April 11th, 2007 at 5:56 am
Citizen is right on the mark Medstar will be answering 911 calls before the you can shake a stick 4 times. But Mr Rubin did set the mark for response times at the second forum, some quick math would put anything over 2 to 3 minutes is unacceptable since If 45 minutes is unacceptable response time for a code 1 call and 33 minutes is unacceptable for a breathing difficulty, Mr Rubin likes to pick numbers with no excuses so hopefully the same rules apply. But it should be easy for Medstar as they are within the city limits of Brandon with staff of paramedics/EMTs on 24/7. one thing I hope the city council will clear up for us is what if medstar is not available but we will find out. The ordinance did state that fire will serve as backup - I guess they will have to become an ambulance service - its in the ordinance
April 11th, 2007 at 6:26 am
How interesting that MedStar has a help wanted ad in the Argus 10 hours after the vote.
Generally is costs 62.00 an hour for 2 staff. (This includes hourly wage, benefits, sick and vacation time, work comp, fica, SS) So that equals 41,000 per month in JUST wages and benefits. This must be paid regardless of how many calls they are going to. Can he really make it with that many dollars being paid out. I think not.
April 11th, 2007 at 7:43 am
Congrats Jay now show us what you have and make it work!!! As far as the comment on “cherry picking” gee I don’t thing that is possible ~ when I call 911 I don’t get asked if I am poor or have insurance!
April 11th, 2007 at 8:40 am
me,
you missed the point. That’s what happens when there is TWO services. But that’s not the case here because Rural Metro won’t be here anymore. There’s not enough calls for 1 service let alone 2. Re-read the above post.
April 11th, 2007 at 10:08 am
Sorry folks I am a little confused about all of this — who is going to provide ambulance serice to the citizens of Brandon. Since the City council is now going to regulate ambulance providers. Only the companies that apply and meet the criteria the city sets will be contracted to serve brandon. Therefore if only one company is granted a contract then only one company will respond, if two or more companies are granted a contract then rotating calls? So what happens if a second or third company don’t apply
April 11th, 2007 at 10:09 am
You can only “cherry pick” on transfers, not 911. Also why wouldn’t Rural continue to come to Brandon, they do not staff, nor do they put any investment into the town. All calls are gravy for them. If anyone is “cherry picking” it is Rural Metro, at least Med-Star pays property takxes and buys gas in town. Rural Metro will not build a bay here or co-locate with our fire dept.
The ordinance is better than 99% of all other towns in South Dakota. The nay sayers need to admit it is a personal problem between them and Jay. Get over it. Also REMSA has not done call records for Brandon for years, so stop comparing that. Besides when they did do it it said nothing and was a waste of money.
Rural Metro is no better that Med Star, they are just both for profit services and a person either beleives in the little guy or coporate greed. That is the true reason for not wanting two services. The dispatch is all handled by Metro Comm. in S.Falls they know who is responding and who is not. I really resent the scare tactics Rural mentioned the paper. The passing of this is just the first of many growing pains for Brandon……NOT SIOUX FALLS! We are not them, we have 8000 people not 150,000. If you think the Ambulance from S. Falls is better than one in Brandon than you must surely think the police are better. Why not wait for them also? Also if you think that medical personel in Brandon are so important with qualifications than why aren’t you looking into the new doctor at Sanford Health by Jubilee? Stop talking out both sides of your mouth and admit you don’t like the owner and could care less about the requirements.
Everyone knows if you go to Dell Rapids, Garretson, Parker, Worthing, Tea, whatever, you will have LESS qualifications than this ordinance will provide. God forbid you got in a car accident in White, South Dakota. Are you going to ask for their OWNERs REMSA certification? (Paramedics are not REMSA certified only state certified) Or just thank God someone cares enough to take on the profession of a Paramedic and is trying to save your life.
April 11th, 2007 at 11:20 am
I dont care what company serves Brandon, lets just not forget the volunteer EMTs that are the first on the scene. I have never heard anybody thank these guys, for their quick call times.
April 11th, 2007 at 11:52 am
The election is over and the people have spoken! Whether you agreed of disagreed with Ordinance 381 it is now law and the guideline for ambulance service in Brandon! Lets move forward and see how things work for the ambulance service(s) that apply to serve the Brandon Community. Also, I agree with New Resident, “Lets not forget the Volunteer First Responders!” As a team, the first responders, police department, fire department and whom ever the ambulance service is will do their best to serve the citizens of Brandon!
April 11th, 2007 at 12:26 pm
Agreed, Jed. We don’t live in a perfect world, so we can’t expect perfect outcomes to situations.
Ordinance #381 is the law now (or will be once the City Council canvasses the votes), so we have to abide by it. It’s not productive to spend time complaining about what could have been or should have been. Instead, let’s use that energy to figure out how to proceed from this point forward.
My questions now are these:
What if nobody applies?
If more than one provider is licensed in Brandon, will one of them be named the primary provider, or will all licensed providers be considered equal?
Where can the public see a copy of the application?
Will the public be notified if and when applications are made? If so, how?
Since several City Council members said publicly that Ordinance #381 is flawed, how soon will the Council start revising it, and how will that process work?
Will applications be taken during the revision process?
Will the City Council keep close tabs on the progress of the county ordinance, which is being updated? The city Ordinance #381 defaults to the county ordinance on many points. If those points change for the county, then Brandon, presumably, would have to modify its ordinance to maintain the city’s standards.
April 11th, 2007 at 12:26 pm
The city council still needs to “fill in the blanks” on 381. I hope that they put some teeth into it and make the qualifications the same as, or higher than, the current county ambulance ordinance. I want to be sure that whoever gets licensed by the city is a qualified service.
April 11th, 2007 at 5:12 pm
The issue before the voters was not Med-Star versus Rural/Metro. It wasn’t even whether Brandon needed a full time ambulance service. (The City Council made that decision for us last year) The issue before the voters was if the ordinance as written was sufficient. The reality is, it is not. The ordinance was changed, the rules ‘relaxed,’ and promises made to fill in the gaps “down the road.”
Look at any other ambulance ordinance in any other community and it is really quite alarming to see how lax our ordinance is. Speaking only for myself, if I was in need of advanced life support I would like to know that the skill level, experience, and backgrounds of the paramedics working for the local ambulance service have already been checked. I would feel much more comfortable if this new service had access to a Medical Director that was familiar with pre-hospital emergency care.
The information provided by the two council members seemed to be laced with nothing but politics. The Masur family and the family of one of the council members goes back a long, long way. That, in and by itself, appears to be a conflict of interest. In my opinion, this council member should have excused himself from the debate. The statistics quoted about response times were taken completely out of context. The 44 minute response time was a code one and occurred during an ice storm. Check any ambulance services response times in other cities and you will find extended response times during ice storms. Code three and four calls take priority, and on that day, there were many more than normal.
The council member that is allergic to bee stings, was stung by a bee, and then putzed around for 20 minutes before going to the hospital, is nothing short of absurd. Why this played a role in this council member’s defense of the City’s ordinance defies explanation. What does his poor judgment in dealing with his own potentially life-threatening condition and a city ambulance ordinance have to do with each other?
The ’sky is falling’ scare tactics was presented by our council members. The two representatives against the ordinance seemed only to be interested in a smear campaign against Jay Masur. The issue should have been the deplorable sieve of an ambulance ordinance that the City put forth, and a practical determination as to whether Brandon could support a private ambulance service.
This is as factual as it can be:
-Rural Metro transported approximately 90 patients from Brandon to Sioux Falls hospitals in 2006. At $1000 per transport (this is an estimation only) that is $90,000 per year in revenue. Payroll and benefits for six full-time paramedics would exceed $200,000 per year. The numbers do not add up.
-A Medical Director with ER privileges is of the utmost importance. The cost for this type of medical direction is not $10,000, or whatever crazy statistic was quoted. It is probably closer to four or five times that amount. The city will have to pick up this tab.
-Competing ambulance services is a disaster. The City of Sioux Falls already has experience with that nightmare. Ask around at the two hospitals and someone will be glad to tell you the horror stories. And yes, ambulance services have been guilty of ‘cherry picking.’ If a call comes in from an address that didn’t pay the last time they needed 9-1-1, the service could and will recognize the address and may choose not to show up.
The reality is, the residents of Brandon are now going to be serviced by a private ambulance company that cannot possibly earn enough revenue to support a full time staff and facility. Paramedics that may or may not have experience, that may or may not have ethical violations in their background, that may or may not have the skill level to treat critically injured or sick patients, are going to be servicing our city. The reality is, this new service may be getting their medical direction from a doctor that treats the flu, bunions, chronic back pain, and other non-life-threatening conditions, instead of someone practiced in emergency care. But, hey, at least the response times will be 2-3 minutes.
April 11th, 2007 at 7:28 pm
For a progressive growing community, Bradon has taken a step backwards, Just a thought, Med-Star couldn’t meet the qualifications under REMSA but were quoted as stating that they wouldn’t have any trouble meeting the new ordinance. This is only because he helped write it and made sure its water dowh to his standard. All anyone kept talking about was response time but keep in mind that you can have the quickest response but if you have incompetent staff who don’t know what they’re doing -people will still die just as quickly. Is there an out for anyone who prefers higher standards with an active practising medical director who is up on current medical standard??
April 11th, 2007 at 9:59 pm
Yes Dee hopefully we do have an out - Fill the city halls every Monday that they meet and force the councilmember’s and mayor to be held accountable to the citizens of Brandon not just themselves or select few. When they dodge the questions - ask again and again until you are satisfied with a reasonable answer and do not let them get away from it.
Now I’m going to get bashed because I was against this ordinance and that is ok because I just cannot understand how after 2 plus years in the works - so many matters where never addressed or need to tweaked. But I am going to keep asking as all of us need to do including the supporters — What is criteria for the ambulance, staff training? financial stablity? Staffing to cover 24/7? Backup service? and yes response times.
Mr Rubin loved the story of how a 44/45 response time for a code one call was unacceptable (no Excuses -no details) just unacceptable. Since Mr Rubin set the standard for unacceptable response time * 4 to 5 minute respond time for that same call that will be less then 2 miles from the station is not acceptable either remember No EXCUSES and no details — just unacceptable.
I hope the citizen understand that since the council has decided to revise the standards, The City will be at the top the list if proper care is not provided. This city council has decided they can guarantee quality care. Remember Jays comments a lawsuit is the best quality control. Our Mayor does need to address a few things in order to protect the city of Brandon investigate the possible conflict of interest between Mr Rubin and jay and take appropriate actions. Issue refunds for illegial /inflated fees for prior ambulance application(Thank you Mr Karber for bringing that up)
PLEASE All of us need to remind the members of this council that they represent he city of brandon and all its residents whether they agree with them or not. And to Jay Good luck hopefully this will work because good quality care by experienced medics in addition to a faster response times will saves lives.
April 12th, 2007 at 10:19 pm
I did not vote for the ordinance to go through but now that it has..I ask Mr Beesley and his council to carefully review all applicants. I believe there are reasons Mr Masur has been around the state so long and has failed at trying to set up an ambulance service before. I hope Med-Star has competition and that the job is not handed to them on a silver platter. Seems like that is how the ordinance was written..with Jay in mind. I am sure there is a reason Jay is not in Sioux Falls, Huron, Aberdeen or any other city in S.D. Also, I have to wonder why he does not have a medical back-up that has previlages at Sanford or Avera? I hope this is taken into consideration when the council takes a vote on the best interest for our city!
Also, I do agree..the wonderful volunteer service we have deserves a hugh THANK YOU for all they have done for this community!!