By LeAnn R. Ralph
COLFAX — The Colfax Village Board has said “no” to merging the Colfax Rescue Squad and the Boyceville ambulance district.
A year ago, the Boyceville Community Ambulance District Board hired a new director, and on the same evening, 14 Emergency Medical Technicians quit, said Don Knutson, director of the Colfax Rescue Squad, at the Colfax Village Board’s April 25 meeting.
The Colfax Messenger has covered the Boyceville ambulance district board for the Glenwood City Tribune Press Reporter for nearly 10 years.
The new director hired in Boyceville was Wayne Dow, who grew up in Boyceville and is a retired paramedic who served with Dubuque Fire and Rescue in Dubuque, Iowa, for 24 years. He served for 14 years as the EMS supervisor and the ambulance service director.
Dubuque has a population of 60,000, and the Dubuque fire department has a Class 2 Insurance Services Office (ISO) rating. ISO classes range from 1 to 10, with a rating of 10 being considered as having no fire department service at all.
The EMTs, who announced that they intended to resign after the ambulance district board had formally adjourned the April 14, 2021, meeting, said they were resigning because the board had not listened to them and had not hired the director they wanted.
The people who serve on the Boyceville ambulance district board are town board chairs, town board members or village board members in the municipalities served by the Boyceville ambulance service.
Over the past year, the Boyceville ambulance service has struggled to hire new EMTs, although the situation is slowly improving.
Several people in the Boyceville area have taken the EMT classes and will obtain their certification soon, and several others have, or soon will, obtain their Emergency Medical Responder certifications.
An EMR can go out on ambulance calls with an Advanced EMT and can drive the ambulance while the EMT treats the patient.
For more than half of the time over the past year, there has been only one EMT on call at the Boyceville ambulance service, with no second EMT or EMR to assist.
The situation has been so volatile at times that one of the town chairs has received death threats.
Merger
At Boyceville ambulance district meetings, Dow has reported that the Division of Public Health, Office of Preparedness and Emergency Health Care, the state agency responsible for licensing emergency medical services, has recommended that Dow pursue a merger with other ambulance services.
The effort to find EMTs is not a problem unique to Colfax or Boyceville. Ambulance services all over the state, especially in the northern rural areas, are experiencing difficulty finding volunteer EMTs.
In December, Dow asked about a possible merger of the Colfax and Boyceville ambulance services, Knutson said at the April 25 meeting.
Knutson said he had met three times with Lynn Niggemann, Colfax administrator-clerk-treasurer, Dow, and Peter Score, a member of the Sheridan Town Board and chair of the ambulance district board, to discuss a merger and to see if there was a way to make it work.
If the two services merged, Colfax would be one of 16 municipalities in the ambulance district. The merger could be done with no increase to the Colfax Rescue Squad’s budget and with an east district and a west district, Knutson said.
The Village of Colfax currently owns the Colfax Rescue Squad and would have to give up ownership of the ambulance service to become part of a larger ambulance district.
All of the other municipalities would have to approve becoming part of an ambulance district.
The per capita cost for the members of the Boyceville ambulance district works out to be about $86 per person, while the per capita for Colfax is $21, Knutson said.
The Colfax Messenger covered the budget meeting for the Boyceville ambulance district last fall, and for 2022, the Village of Boyceville is paying $37,022 for a standby charge and $93,365 per capita for a total of $132,387.
The Village of Colfax is paying about $24,000 for 2022 for the ambulance assessment.
Debt
The Boyceville ambulance district is carrying debt for an ambulance and for building the ambulance station, Knutson said.
The Boyceville ambulance district has $340,000 in debt, said Jody Albricht, village president.
Each side would be responsible for their own debt, Knutson said.
Boyceville did not have an amortization schedule, Albricht said.
Gary Stene, village trustee, asked for clarification about who holds the Boyceville ambulance service’s debt, and Knutson said it is the ambulance district that holds the debt and not the Village of Boyceville.
If the two services merged, every member of the district would have to assume the debt because it would be one large district, Albricht said.
The Boyceville ambulance district has $37,800 in annual payments with nine years left, Niggemann said.
Miles
How many miles would be covered in one large district? Stene asked.
There are four ambulances between Boyceville and Colfax, and Boyceville and Colfax would be staffed all the time, while one ambulance would be stationed in Sand Creek and one ambulance would be stationed in Elk Mound, Knutson said.
Several EMTs live closer to Sand Creek and to Elk Mound, so stationing ambulances in those two places would decrease the response time, he said.
Stene also asked about the age of the ambulances.
Boyceville has the newest ambulance in the group, a 2015 model and also a 2006, which are both low mileage. The Colfax ambulances have many more miles on them, Knutson said.
The Colfax Rescue Squad goes out on about 500 runs per year, and the Boyceville ambulance service goes out on 200 runs per year, Niggemann said.
Gains and losses
What does Colfax have to gain from a merger? Albricht asked.
The answer, he said, “is nothing.”
The Village of Colfax would assume some of the debt in the Boyceville district and would have less influence over the ambulance service because the village would be one of 16 members, Albricht said.
Each municipality would have a board member representing the municipality on the ambulance district board, Knutson said.
Boyceville is still maintaining the ambulance service license “and is still operating okay with the state,” he said.
Because there is often only one EMT on call in Boyceville, the Boyceville ambulance district has contracted with Menomonie, Colfax and Glenwood City to cover calls that Boyceville cannot.
Colfax and Glenwood City charge the Boyceville ambulance district $500 for each call.
Menomonie charges more, and when Menomonie responds to a call, the Boyceville ambulance district gets a bill for $1,000 or $1,200, Knutson said.
The Boyceville ambulance district has been paying as much as $4,000 to $6,000 per month for Menomonie to respond to ambulance calls.
Colfax and Glenwood City respond less frequently to Boyceville ambulance calls, with Glenwood City responding more than Colfax.
The Boyceville ambulance district may end up paying for three or four calls per month for Colfax and Glenwood City to respond.
Payroll
Colfax is having problems finding EMTs, too, so why take on more problems? asked Anne Jenson, village trustee.
With a bigger organization, there might be a better opportunity to recruit EMTs, Knutson said.
Boyceville has a larger budget and that has helped to bring the payroll more in line, he said.
The Boyceville ambulance district agreed last fall to increase the wages for EMTs by $3 an hour as part of their effort to recruit more people.
The Boyceville ambulance service pays $11 per hour for an EMR, $12 per hour for a Basic EMT and $13 per hour for an Advanced EMT.
Colfax pays $7.25 per hour for EMR and BEMTs and $7.75 per per hour for AEMTs.
Colfax can raise the per capita to increase the wages for EMTs and will have to address the issue of pay at the next annual meeting in August, Albricht said.
“Making it work” would serve to help Boyceville but would not help Colfax, he said.
Knutson reiterated that a bigger organization might help for recruiting more EMTs.
Merging the two ambulance services would result in more flexibility of the workforce, and bigger organizations also are able to get cheaper insurance, he said.
Service area
The Colfax Rescue Squad’s service area covering nine municipalities serves 8,300 people, and the Boyceville ambulance district’s service area covers seven municipalities with a population of 4,300, Niggemann said..
Colfax’s per capita would have to increase to $30 to get Boyceville’s per capita to decrease to $30, she said.
The state representative for EMS services said the average per capita in Wisconsin for ambulance services is $76, Knutson noted.
The population growth is in Elk Mound, the Town of Colfax and the Town of Tainter, Albricht said.
“I do not see an advantage to us merging,” he said.
Albricht, and village trustees Margaret Burcham and Jeff Prince serve on the village board’s public safety committee, which discussed the possible merger at a meeting on April 13.
Prince said he would not want Colfax to become part of a district that would take on the debt of the Boyceville ambulance service.
With 12,600 people in a merged district and debt of $340,000, that works out to be a one-time payment of about $27 per person, or $3 per person over nine years.
For the Village of Colfax, with a population of just over 1,000, the additional debt would amount to $3,000 per year for nine years.
Burcham said she agreed that it was too much debt to take on.
Some of the municipalities would probably not have capacity in their existing tax levy to absorb an increase for the debt and would probably have to consider a special assessment to pay for any increases.
The state’s levy limit law restricts increases in the tax levy by a formula based on net new construction. If a municipality does not have new homes and businesses being built, the levy remains relatively flat.
New district
Colfax should consider becoming a district at some point so that all of the municipalities would cover the shortage in the budget and not just the Village of Colfax, Knutson said.
Over the past several years, the Colfax Rescue Squad has ended up paying overtime to cover shifts when there were not enough EMTs to go around. The rescue squad budget for 2022 was increased by about $34,000 to cover the overtime as well as a 3 percent increase for line items in the budget, such as insurance, utilities, building expenses and office expenses.
Prior to that, the Colfax Rescue Squad was able to cover its own budget with the revenue coming in.
If the Colfax ambulance service changed into a district, all of the townships would have to buy into the district, Albricht said.
All of the municipalities covered by the Colfax Rescue Squad pay the same per capita assessment, which for 2022, is $22.10.
In addition to the Village of Colfax paying $24,354 in 2022 per capita, the Town of Colfax is paying $28,707; the Village of Elk Mound is paying $19,381; the Town of Elk Mound is paying $42,984; the Town of Grant is paying $8,751; the Town of Otter Creek is paying $11,293; the Town of Sand Creek is paying $12,862; the Town of Tainter is paying $27,094; and the Village of Wheeler is paying $7,646.
The total per capita paid by the municipalities toward the Colfax Rescue Squad budget for 2022 is a little over $183,000.
The revenue budget for 2022 for the Colfax Rescue Squad includes another $264,961 for ambulance calls. The $183,000 in per capita, and the $265,000 for ambulance calls, equals the $448,000 budget for 2022.
Percentages
Since all of the municipalities served by the Colfax Rescue Squad pay the same per capita, it was not clear from the discussion at the Colfax Village Board meeting why the other municipalities would have “buy into” a Colfax ambulance district.
According to the most recent annual report from the Colfax Rescue Squad, the Village of Colfax accounted for highest number of ambulance calls in 2020 at 32.9 percent, which can be attributed to an older population along with the presence of the Colfax Health and Rehabilitation Center.
The Town of Colfax, which pays $4,000 more per year because it has a slightly higher population, accounted for 9.7 percent of the calls.
The Town of Elk Mound, which pays nearly twice the amount as the Village of Colfax ($43,000, compared to $24,000) accounted for 15 percent of the calls.
The Village of Elk Mound, which pays about $5,000 less per year, accounted for 12.4 percent of the calls.
All together, the Village of Colfax, the Village of Elk Mound, the Town of Colfax and the Town of Elk Mound accounted for about 70 percent of the ambulance calls in 2020.
The remaining municipalities accounted for smaller percentages of the calls, with the Village of Wheeler at 3.9 percent of the calls; the Town of Tainter at 6.5 percent of the calls; the Town of Sand Creek at 5.7 percent of the calls; the Town of Otter Creek at 4.3 percent of the calls; and the Town of Grant at 2.4 percent of the calls.
More information
Village board members agreed they needed more information about forming an ambulance district and should seek legal counsel and obtain information from the village’s financial consultants.
Legislators on the state and federal level have realized that emergency medical services are experiencing problems, and there is now more money coming for emergency medical services, such as a 20 increase for Medicaid payments, Knutson said.
New grants also have been announced that did not exist two months ago, he said.
The Colfax Village Board unanimously approved a motion to not pursue a merger of the Colfax Rescue Squad and the Boyceville Community Ambulance District.
