Do the ambulance ordinance changes do enough?
April 24th, 2007 by 
colson
The Brandon City Council have made some changes to the recently-approved ambulance ordinance that they hope address some of the concerns the public had.
They addressed response time, availability of service, medical oversight and insurance.
It remains to be seen whether those answers all the questions the public has.
Posted in Uncategorized, Ambulance | 
April 24th, 2007 at 10:44 am
I will give the council some credit for closing some of the questions and generally moving in the right direction but the main issue of a response time is still not being addressed. Really 4 minutes and 30 to acknowledge and start a unit on 90% of the calls leaves a lot to be desired considering the nature of the business – remember this is not on scene time this is only starting a unit. (* Actual response times will be addressed at the meeting next Monday to determine the application criteria.) Allowing for drive time to get the scene and having patient contact is then going to be about 8 to 10 mintues (90% of the time)
But wait we are improving the time from the county ordinance which allows up to 11 minutes to acknowledge and get a unit started, What was Rural metro average response time 13 minutes ** That’s pretty darn good 2 minutes from Sioux falls to Brandon.
Since seconds matter, a more realistic time to acknowledge a call is 30 seconds (90% of the time). This would then allow dispatch to send a second call if not acknowledge or dispatch a backup unit. If you have staff at the station and cannot get a rig rolling in under a mintue (90% of the time) is pretty bad considering the actual on scene times of the police (2 mintues) and fire (4 minutes) – These times were on scene with patient contact not leaving the garage.
April 24th, 2007 at 10:49 am
I hope you went to the meeting and mentioned this. One minute to acknowledge, and an additional 90 seconds to be enroute is more reasonable.
Look, citizen person, you need to get over the Sioux Falls rural metro thing. It’s over. There’s no sense in comparing what is was or could be.
There’s a lot of Rural Metro people who posted here, and it’s obvious who they are.
But it’s time to move on. Make the ordinance better, make penalties a part of it, but forget about all the “well rural metro did this and that”
April 24th, 2007 at 1:56 pm
Anonymous, firstly “Acitizen” is different than Citizen. So different person. Secondly, Rural Metro people haven’t posted here, I believe it’s prohibited. I think the reason people are comparing to Metro is because they have served this communtiy for 40 years and done it well. They have set a benchmark. Who else would you compare to? We haven’t had any other provider.
I think the meeting had some benefits and is was a step in the right direction. The one change that concerns me is the item about oversight. The safety committee was taken off the hook, but the new 6-7-14 states: “The city shall be resolution, designate a COMMITTEE, an agency, OR a medical doctor” So if they go the committee route, what are the specifics of this committee? Are we talking about a panel of doctors? Nurses, EMT’s, lawyers, or laypeople? Will they have worked in the EMS field? Do they understand EMS protocols? It really doesn’t guarantee a qualified panel.
In the end, it’s done. Council has made the decisions and only time will tell if it will work well or be a mess.
April 24th, 2007 at 2:44 pm
I am glad the council reviewed the ordinance–they lived up to their word to do so. I think we now need to make sure run times are addressed in the application and that the citizens of Brandon do not end up paying more in taxes to subsidize the chosen ambulance service. We were told prior to the election that there would be no expense, and I think that is what we should insist upon.
April 24th, 2007 at 3:01 pm
I’ll start my response with a disclaimer: When I post to this blog I am posting only my opinions. I do not presume to speak for the other council members.
I’m still listening and I’m still taking your comments to heart. That having been said, I’d ask that you take a step back and analyze this issue of response times. If you were at the meeting last night, you know that the 90 seconds to acknowledge a call and 3 minutes to be “en route” was taken directly from our previous ordinance 286. During the forums and other discussions prior to April’s vote, many people commented that we had a “perfectly good” ordinance in ordinance 286 and that they could not understand why the council repealed it. I also heard many times that Ordinance 381 had been “watered down” from our previous ordinance and from the standards in the Minnehaha County Ordinance. Last night the council adopted one of the strictest standards from Ordinance 286 - the response times - and now I am reading comments on this blog that appear to be claiming that those standards from Ordinance 286 aren’t good enough either.
In a perfect world, every ambulance company in every community would have a crew sitting in the rig at all times, would instantaneously respond to the call, and would be out the door en route to the call at the same time. We don’t live in a perfect world and frankly, mandating that kind of instantaneous response is not practical or reasonable. Can you imagine how much an ambulance company would have to charge per run to cover the costs associated with staffing to that requirement?
The 3 minute “en route” requirement approved by the council last night is significantly more stringent than the Minnehaha County ordinance, which allows an “en route” time of 10 minutes after acknowledging the call. It is also significantly more stringent than state law, which allows 15 minutes to “en route” status.
It may be true that Rural Metro had an average response time of 13 minutes to Brandon. What does that tell you? To me, it points to the logical conclusion that, even though Rural Metro is allowed 10 minutes to be en route, they don’t stand around looking at the clock when a call comes in - waiting for 10 minutes before they get in their rig and leave. Why should we assume that a service licensed for Brandon will act any differently? We are talking about medical people who are being called to assist someone with a medical emergency. Does anyone really believe that the provider we chose as our 911 provider will sit and listen to the phone ring for close to 90 seconds before answering it - just because the ordinance allows it? Does anyone really believe that our 911 provider will sit in their ambulance barn for 3 minutes before going en route - just because the ordinance allows it? I don’t.
At some point, we have to be reasonable. There’s a difference between having tough, stringent standards, and having standards set so high that no ambulance company, Rural Metro or otherwise, will be willing or able to apply for a license in our town. Is that what we really want?
ACitizen proposes 30 seconds to acknowledge and one minute to be en route. Anonymous proposes 60 seconds to acknowledge and another 90 seconds to be en route. Although I can’t honestly say I’ve researched this point nationwide, I’d be shocked if you could find a single jurisdiction in the country that mandates, by ordinance, a total acknowledgment and en route time of 1 1/2 or even 2 1/2 minutes. Please understand, I don’t mean to say that the provider shouldn’t be trying to get out the door as fast as they can on every call. I just think the 90 seconds to acknowledge/3 minutes to be “en route” sets the standard pretty high already - certainly higher than any current standard in this region.
As for how long it takes for a provider to get to the scene of an incident, again, if you were at the meeting last night, you heard that there is no state law or any requirement in the Minnehaha County ordinance, that mandates that a provider actually show up “on the scene” in a given period of time. Nor was there any such requirement in Ordinance 286. Does that mean we shouldn’t require some mandatory “on scene” response time of our contracted 911 provider? As I stated last night, in my opinion we should. I believe that it is an issue the council should address by contract when it chooses a licensee to be the contracted 911 provider. However, to mandate an “on scene” response time in the ordinance would, in my opinion, discourage many potential applicants from even applying. We have to consider whether Rural Metro, or Garretson, or Jasper, or any other County-licensed ambulance service, would ever consider applying to serve Brandon if we required an “on scene” response time of, for example, 8 to 9 minutes. As “ACitizen” pointed out, Rural Metro’s average response time is 13 minutes. Why would they apply for a license - knowing that we have an ordinance provision that they cannot meet?
I, for one, hope we end up with more than one applicant for a license. I know there is a good chance we won’t. While I am working as hard as I can to make this ordinance better than it was, I certainly don’t want to be adding language that no provider can meet.
If we don’t get any applicants, we will end up being served by the County, just as we are now. I know there are some out there who would prefer that. But remember, in that case, we go back to the 10 minutes “en route” requirement and NO mandatory “on scene” response times (which Brandon still has the option of putting in its contract.) I question why, on the one hand, some would be willing to go back to having county coverage where these easier “en route” standards exist, yet, on the other hand, take the position that the more strict standards approved by the Brandon Council last night are “not good enough.” This type of contradiction makes it appear that there are some people who simply will never be satisfied - no matter what changes the council makes to this ordinance.
I will keep pushing to make positive changes to this ordinance and to the application because I believe its the right thing to do. I will also push to have meaningful requirements in any contract with our chosen 911 provider.
I commend the rest of the council for diligently working through these issues and voting unanimously on every postive change that was made last night. I’m hopeful we’ll make the same progress next Monday. We may not end up with an ordinance that everyone in town thinks is perfect - but I do believe the council is seriously trying to address the concerns that were raised and make it the best ordinance we can.
April 24th, 2007 at 3:17 pm
By the way, I apologize that my previous response was so long winded!
April 25th, 2007 at 12:29 pm
understandable, your an lawyer, right? We don’t mind.
April 25th, 2007 at 12:55 pm
ouch!