MANISTIQUE - It was standing room only in the Manistique City Council Chambers Monday night as residents weighed in on the future of the city's ambulance services.
A private ambulance service agency called Rapid Response One EMS, which has received approval through the Schoolcraft County Medical Control Authority, plans to open its doors in Manistique by mid-February. The private service will be licensed as an Advanced Life Support agency, the highest license available in Michigan, and will be able to provide paramedic services to patients.
Currently, emergency medical services are handled by Manistique Public Safety, which is licensed as a Limited Advanced Life Support agency. Because LALS is the second highest license available, some of the services that an ALS agency can perform are unavailable from Manistique Public Safety even when paramedics are on board. To achieve the higher license and provide paramedic services Manistique Public Safety would need to employ paramedics for all shifts.
"Manistique Public Safety and Manistique EMS has been aggressively seeking Advanced Life Support and will obtain this," said Public Safety Director Ken Golat.
To protect the city's ambulance services and still allow residents access to paramedic services the city council approved an ordinance Monday that would recognize Manistique Public Safety as the primary responder for emergency medical calls unless an ALS agency was available in the city. At the time that public safety becomes licensed as an ALS agency the department would once again become the primary responder.
"The question you have to ask yourself is what kind of public policy is that?" said Terry Burkhart, lawyer for Rapid Response One EMS and principal at Burkhart Lewandowski & Miller PC of Escanaba, who described the ordinance as "a preemptive strike or a warning" to private ambulance services.
While some residents viewed the ordinance as standing in the way of free enterprise, the city noted there may not be enough demand for a second ambulance service.
"With the price of employees, vehicles, insurance, gas, and non-payments, I really find it hard to believe that there is much call for this business in this area," said Councilman Bill Vandagriff.
In 2013 there were 910 ambulance calls answered by public safety. Of those calls, 831 resulted in transporting patients, which results in payment to the department. This averages to only 2.28 calls per day, and on average Upper Peninsula ambulance services can loose as much as 40 percent of their income from these calls to write-offs from insurance companies or patients who cannot pay their bills.
"Are there really enough calls in this community for two ambulance services? Should we the city, who have protected the city and county as a mission for 55 years, just step aside with our four ambulances, 17 EMS personnel - and that number is rising - to make way for a new private service that hasn't been in business yet, that might not be successful in the long run?" asked Public Safety Director Ken Golat.
Burkhart expressed that the cost of operating the ambulance service was a loss for the city and that Rapid Response One would free up that money for other uses.
"This ... $50,000 liability associated with subsidizing a money losing and substandard ambulance service will be gone and the city can make the best possible use of its money which is obviously what everybody in this city needs to be concerned about," said Burkhart.
However, Golat and others noted that Manistique Public Safety provides a number of services free of charge including having ambulances on standby at sporting events and lift assists for residents who fall and are unable to get up.
"The ambulance budget for the City of Manistique pays for salaries and equipment. No tax dollars go towards the support of this ambulance service. We are a non-profit organization. We don't have to make a profit unlike a private business," said Golat.
The council expressed that disbanding the city's ambulance service or liquidating to save costs would be detrimental to residents if Rapid Response One failed.
"We have an obligation to take care of the community, and that's what we do at the city, and what we're being asked to do right now is play Russian Roulette with our ambulance service, and to me that's not acceptable," said City Manager Sheila Aldrich.
Some residents believed the difference in license levels was a concern for residents and the city was not working to achieve ALS status quickly enough.
"It's just not the highest level of service that this community should or could have," said B.J. Rubick, a resident and licensed paramedic.
According to Golat, Manistique Public Safety and Schoolcraft Memorial Hospital had been working with the medical control authority to establish an ALS service as recently as October. However, talks were delayed until Tanya Orr, the new hospital CEO, was officially in her new position and could be be involved in the process.
"In that meantime, a member of medical control, unbeknownst to me, decided to recruit Manistique Public Safety EMS personnel for the new service coming into town," said Golat.
While Golat assured the council that public safety would continue to seek ALS status, he expressed that he welcomed any complaints residents may have with the current service.
"If there are any complaints about any of the service I want to know about it. It will be investigated, discussed, and resolved, and if we are responsible I will take action," said Golat.