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| Asking the same question? |
Remember those“Where's the beef?” Wendy's commercials back in 1984 when a dowdy old lady croaked that now iconic line as she looked at her little burger in the middle of a giant bun? Some of our neighbors in the surrounding townships may be thinking or saying that very thing following the meeting on Monday. “What just is the city's beef with the CAAS?” In case you weren't there I'll try and answer that as succinctly as I can.
Prior to 2018, the director of the CAAS was a certified EMT who picked up shifts and was paid an additional monthly stipend of $550 per month for director's duties. The crew chief was paid $12 per hour for 16 hours per week to handle most of the day to day activities which included run review, supply ordering, cleaning, monitoring of training hours, etc. The crew chief also was on call during these hours. The medical billing and the bookkeeping position were handled in house.
Beginning in 2018, a new operational model was introduced and implemented that created one position out of two. Instead of a fire chief and an ambulance director both the Chetek Area Fire Department and the Chetek Area Ambulance Service is now overseen by one individual. This new role became a full-time position. Instead of netting $6,600 annually the new director's responsibilities come with a $55,000 annual salary. In addition to this a Quality Assurance position was created and medical billing is now outsourced as well.
The bottom line: all these “eye-brow raising” administrative expenses were thrust upon the city and the townships with very little discussion about it. While it may now be water under the bridge we feel the commission did not do a good job of communicating ahead of time the particulars of what it was going to cost us. “Buyer's regret”? Perhaps but we weren't really aware at the time just what we were signing off on.
Our next concern is the fact that since the new operational structure was implemented, annual subsidies have gone through the roof from $31K in 2018 to $60K for 2022. That's a 100% increase in a five year span. The other participating townships have seen significant increases as well. So our question to our other partners is are you persuaded that this new operational structure is the one we can live with and afford without having to raise taxes in the not-so distant future?
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| Here's the beef |
What we heard on Monday night – or, at least, what I heard (in so many words) - either from other members of the CAAS commission or the towns was, essentially, 'Quit your whining, City of Chetek. It's the price of doing business. The days of having a part-time director are over. It's a brave new world. EMTs are no longer local folk who have a day job and answer the bell when a page comes in. Given the amount of training involved to acquire and maintain their certification they want and deserve higher pay.' Former CAAS director Sue Gehl, who was at the meeting on Monday night, put it bluntly to all of us: “...if you want to run it like 2018, you find 12 volunteers to run it. Either you pay them, you beg them to come or there’s no volunteers. Volunteerism is dead.”
police officers and fire fighters there are a whole lot less people wanting to become EMTs. At the very same time that ranks are thinning, the State continues to up the anti as to the amount of training that they demand before a person jumps in a rig to respond to a 9-1-1 call. To compete with the shrinking pool of EMTs, ambulance services, our own included, have gone from “on call” pay to a straight hourly rate. Call it supply and demand. Right now only three individuals on the CAAS have Chetek zip codes. That means the remaining pool of our emergency personnel are driving a long way to pick up shifts so that we can keep our ambulance running simply because not enough of us want to do the work.
There are other things that are outside our control. Reimbursement rates from Medicaid and Medicare for example. If an ambulance ride costs (as an example) a $1,000 to get you from here to there, those who are insured pay the bill. If you're on Medicaid or Medicare, the CAAS may see only $300 of it – and that's that. Medical supplies for the rig have increased dramatically in the last few years. And what of those portions of the Towns of Sumner and Stanley that refuse to pay any subsidy at all? We acknowledge that it all affects the bottom line.
The results of the meeting were, in my opinion, a mixed bag. On the plus side, there was good representation from all our partners. What's more, we talked with one another. We didn't yell at each other but listened to what each had to say in turn. While monthly CAAS meetings are open to the public there probably hasn't been that many people to a meeting about our ambulance service for ever. What's more, there were two reporters there, Chief Ambrozaitus of Chetek PD, Sheriff Chris Fitzgerald and several EMTs as well. And the meeting was live-streamed over the net allowing many to watch the meeting from home then or later. All those things are “wins” as far as I'm concerned as we do need to keep talking about these things.
But having said all that, we are a bit surprised that no one seemed overly concerned by the dramatic way subsidies have increased in the last few years. With the exception of the Town of Prairie Lake, what we heard were “crickets.” I happened to catch Sheriff Fitzgerald on the Dryden Report the other day and referencing this meeting he said: “The City of Chetek's council has to decide what they want for a service.” In response I would simply ask the Sheriff are we to just throw in the towel, pony up, pay our fair share and blame our sorrows on all those darn politicians in Madison who set the rules we live by? We think the people we serve deserve better than just collective hand-wringing and annual rate increases.
We've got a couple of ideas. We'd love to keep the conversation going between our partners on how we can provide the most affordable and effective service the people in these parts deserve.
