On Thursday, August 25, the Monticello Public Safety Committee held an informational meeting at the school in the Rehmstedt Gym. The subject of the informational meeting was the question of which EMS service the village would choose.

Although there were a number of residents who were in attendance, some confusion may have been caused by the changing of the meeting location numerous times. The meeting was first supposed to be held in the school's library, then it was changed to the computer lab, and finally the gym.

Many experts are of the opinion that getting patients transported to the hospital quickly is a priority. Now the Monticello Village Board must consider whether response time or cost to the municipality is most important. The cost for service from New Glarus Area EMS is $18.78 per person, per year. Green County does not charge the municipalities, because with approximately 1,500 runs per year, they are able to operate on run revenue.

For over 40 years, the Village of Monticello has partnered with the New Glarus Area EMS to provide service to the residents of the village. Recently the village has been looking at dissolving that partnership, and going with Green County EMS, out of Monroe. Green County EMS Chief Dan Nufer noted that they may consider charges to municipalities in the future.

Nufer also told the attendees at the meeting that it will most likely take longer for GCEMS to respond to calls in Monticello given the increased distance from the EMS station to the village.

In July the Monticello Village Board reviewed and approved a list of questions that were to be sent to New Glarus Area EMS and Green County EMS. Both services then replied to the request - GCEMS with a two page answer and NGAEMS presented a binder with over 40 page of information.

Before the meeting and after a request by this newspaper, Monticello Village Clerk DaNean Naeger supplied a copy of the answers submitted by the GCEMS. She said at that time that the Public Safety Committee had the NGAEMS binder.

During the meeting it was noted that the answers on the presentation were in some cases drastically different than those that had been submitted. Committee member Steve Scanlan said that he had contacted GCEMS for more information but had not contacted NGAEMS.

Even the questions in the presentation were in two cases different than those that had been approved by the Monticello Village Board and sent to the EMS services.

So to be fair, we are including the original answers from GCEMS and more complete answers from NGAEMS.

Below, the questions from the village board are in italics, the answers presented at the meeting are in bold and the answers from the services actual responses are in plain type.

Those questions are:

1:  We request a copy of your strategic operational plan.

GCEMS: We have none.

NGAEMS: We have none.

GCEMS: Green County EMS last did a strategic operational plan in 2008. We spent an entire weekend on this. The person we hired basically made notes of our discussion and gave us a paper listing things we already knew, and charged us a lot of money to do it. It was not much help. We have not done a strategic plan since, but instead have relied on the expertise of the members and the board of directors.

NGAEMS: A strategic operational plan is still in development by the NGAEMS board of directors, and there is an operating plan on file with the state of Wisconsin.

2:  We request a copy of your capitol and operational budget for the past three years.

GCEMS: Our average operating budget for the past 3 years is about $1 million per year.

NGAEMS: 2013 – income $42,437/net revenue $39,218; 2014 – Income $48,604/net revenue $44,419; 2015 – income $59,339/net revenue $53,604.

GCEMS: The board of directors does not routinely release the details of our budget. Our average operating budget for the past three years is about $1 million per year.

NGAEMS: The amounts shown in the presentation reflect Monticello calls only. The service provided the committee with a full operating budget including capital expenditures for 2016 and projected through 2018.

3:  We request a copy of how many calls, the nature of the calls, and the time to respond to those calls, that have occurred in the Village of Monticello for the time frame of January 2015 through present.

GCAEMS: Approximately 10.

NGAEMS: There were 37 in 2015, and 28 to date in 2016. Types of calls were varied. Response time averages 7 minutes en route to arrival, and 11 min. for unit notified to arrival on scene.

GCAEMS: Records of our calls and response times can be obtained through LifeQuest. (Have the person you talk to at LifeQuest call me for the ok to release the information.)

NGAEMS: In the binder presented to the Public Safety Committee, NGAEMS listed each call and response time.

4:  We request a copy of your present staffing.

GCEMS: 4 paramedics, 19 I-99's, 16 advanced emt's, 13 emt basics.

NGAEMS: 12 advanced emt's, 8 emt basics, 4 emr trainee's, 1 emt trainee.

GCEMS: GCEMS currently has 4 paramedics, 19 Intermediate-99s (I-99), 16 Advanced EMTs (IV-Techs), 13 EMT Basics and 10 non-EMT drivers. Staffing can be viewed on our website: http://www.greencountyems.org.

Our primary ambulance and rapid response vehicle are always staffed at the I-99 level. Our second and third ambulance may be staffed at any level. Of the above, there is a full-time paid chief and one full-time paramedic. We are considering a second paid paramedic, either part-time or full-time.

NGAEMS: The NGAEMS presented a list of officers, staff, board members, executive board members, as well as the membership broken out into EMT Basics, Advanced EMTs, EMR Trainees, EMT Trainees, Drivers and Driver Trainees. The service also provided a list of course work requirements for members.

5:  We request a cost structure for the upcoming 2017 fiscal year.

GCEMS: No fee is charged to the village.

NGAEMS: Contract fee to the village for approximately $23,000.

GCEMS: GCEMS does not charge the municipality for service. We do charge the patient.

NGAEMS: The cost to the municipality is $18.78, per person, per year, for a total of approximately $23,000.

6:  We request a detailed plan on any projected purchases, housing costs and how they are to be paid for.

GCEMS: Purchase of an ambulance and SUV are from the general fund, the new station is being paid for by donations and local businesses.

NGAEMS: No new purchases at this time. A new station is being looked at in or around 2018.

GCEMS: GCEMS is in the process of building a new station. This station is slightly less than 13,000 square feet. It includes 5 garage stalls, 2 classrooms, kitchen, squad area with TV, 10 private sleeping rooms, and general office space. We just purchased a new Rapid Response/Intercept vehicle and we have a new ambulance on order. The building is being paid for with donations from private citizens and local businesses. The SUV and ambulance are being paid for out of the general fund.

NGAEMS: No new purchases at this time. A new station is being looked at in or around 2018.

7:  What is your present level of skills of your EMS staff?  What plans are in place to advance to the next skill set?

GCEMS: (See Q. 4 response) After October 2016, our primary ambulance and rapid response vehicle (SUV) will be paramedic 24/7. (Dan Nufer corrected this statement during the public hearing.)

NGAEMS: (See Q. 4 response)

GCEMS: GCEMS uses EMTs of all levels. We are currently licensed at the Intermediate-99 level. We expect to begin a 1-year phase in period for the paramedic level this month. During the phase in period, our primary ambulance and rapid response vehicle may be staffed at the I-99 or paramedic level. After the phase in period, our primary ambulance and rapid response vehicle will be staffed at the paramedic level 24/7. Our second and third ambulances may be staffed at any level.

NGAEMS: Two Non-EMT Drivers, one EMT Trainee, one EMR, four EMR Trainees, eight EMT Basics and 12 Advanced EMTs.

8:  Has consideration been given to merging the two EMS services, with consideration being given to having said entity being at the paramedic skill set level?

GCEMS: No.

NGAEMS: No.

GCEMS: No.

NGAEMS: Aside from the interest recently expressed by two members of the community, there has been no interest expressed by either entity in merging New Glarus Area EMS and Green County EMS. There are also no plans to add paramedics to the team. As a primarily volunteer EMS service, it would be cost prohibitive to add a full-time staff member with that level of certification and would not statistically improve the outcomes for the patients we serve.

9:  Who is represented on your governing boards?  Has consideration been given to including a Village of Monticello representative?

GCEMS: There are 7 directors elected by the membership of our primary area. The membership votes on 3 non-voting active members who act as liaisons between the board and the membership. At present Monticello is not in our primary area.

NGAEMS: No Monticello resident is on the board at present, we would consider changing the by-laws to add one. There are 5 executive members at present.

GCEMS: The GCEMS board is made up of 7 directors. These people are elected by the membership from our primary service area. The membership elects these board members based on their area of expertise. Each member has a short bio that can be viewed on our website. There are also 3 non-voting, active members that are elected by the membership. These 3 members act as advisors to the board and as liaison between the board and membership. The EMS Chief is not a member of the board or the membership advisors.

NGAEMS: The NGAEMS board is made up of five members, two of which must be service providers and two must be community members. The fifth can come from either constituency. The board would consider amending the by-laws to include additional community representatives.

10:  What is your flat service fee?

*The question presented at the meeting was "What is your billing rate for services rendered?"

GCEMS: The base rate fee is based on residency, and the level of service provided, also on the average of other area ambulance services with the same level of care.

NGAEMS: Basic life support (BLS)/$525; Advanced Life support (ALS)/$625, On scene care (BLS)/$200; On scene care (ALS)/$600, Mileage/$12 (charged from patient to hospital), Oxygen/$60, Spinal immobilization/$150.

GCEMS: The base rate fee for service is based on the level of service provided and the residency of the patient. Anyone that lives in our primary service area is considered a resident for billing purposes, regardless of where they are picked up. Anyone that does not live in our primary service area is considered a non-resident. GCEMS does not routinely release our fee rates, but they are based on an average of other area ambulance services with the same level of care.

NGEMS: NGAEMS also provided a billing analysis from the village of Monticello from 2013 through 2015, including the percentage of calls that were paid for by Medicare/Medicaid and the percentage of calls that went to collections. It should also be noted that travel time is not charged.

11:  What is fee, with services?

*The question presented at the meeting was "What is your basic cost per run?"

GCEMS: Fees are based on an average of other area ambulance services with the same care, supplies and procedures used.

NGAEMS: Personnel cost is $55 per run, ambulance is $100 per run, also for supplies and procedures used.

GCEMS: GCEMS does bill for supplies and procedures in addition to our base rate fee. These fees are based on an average of other area ambulance services with the same level of care.

NGAEMS: Additionally provided samples of itemized supply reports, privacy notices, patient care reports mutual aid agreements. as well as other reports.

At the end of the meeting, attendee Rob Ready requested that a representative of each service give a summary.

Dan Nufer, of Green County EMS, stated that the service was not actively trying to provide service to the Village of Monticello and was not interested in expanding their area, and, in fact, had been approached by the municipality. He added that he thought New Glarus Area EMS did a good job, and also thanked the Monticello Fire Department and First Response. To wrap up, Nufer said that GCEMS would serve the Village of Monticello if asked but warned that response times most would most likely be longer.

Josh Wescott, of New Glarus Area EMS, also praised the Monticello Fire Department and Green County EMS, and added that he believed the network of care, with could continue.

He said that it was not that one service is better than the other, but that NGAEMS can get patients to the hospital the fastest.

"We believe in what we're doing," Wescott commented. "We would like to continue our over 40 year relationship with the Village of Monticello."

Scanlan said that the Public Safety Committee would discuss the matter at their August 30th Public Safety Committee meeting, held at 4:30 p.m., and a final decision would be made at either the September 7th or September 21st regular Village Board Meeting. After that announcement, a member of the audience questioned the 4:30 time of the Public Safety Meeting, commenting that due to many resident's work schedules, they would be unable to attend the meeting. Scanlan replied that that particular committee meeting was traditionally held at that time.

The informational meeting ended shortly afterwards.