County investigates alternatives for ambulance

The Kimball County Board of Commissioners opened their latest meeting, Tuesday, April 19 to a packed board room, with dozens of citizens and interested parties on hand to hear and discuss the Kimball County Ambulance and the regional ambulance service option.

"The ambulance services that have become regional with you guys," came a question from Kimball County Ambulance Service employee Kim Schildhauer to the CEO of Regional West Medical Center, John Mentgen and Randy Meininger, owner of the Valley Ambulance Service, "can you tell us a little bit about those? Were they lacking? Were they really needing intervention? I just want to get an idea of your history."

Mentgen and Meininger were on the agenda to present regional ambulance program information as an option for the county at the request of Kimball County Commissioners.

Mentgen explained that as the CEO of Regional West Medical Center, he also has a working relationship with Kimball Health Services CEO Ken Hunter, in a joint operating committee. This committee discusses ways to enhance services, staffing and training for Kimball.

"Our roll is to strengthen Kimball Health Services here for the community," Mentgen said. "Our roll at Regional West is to look at how we can enhance an EMS relationship to help ensure that the provision of those services are available for the communities, and how we can enhance the performances. We are the area's only ACS Level II Trauma center."

"KHS has had a joint contract with Regional West Medical Center where we have the opportunity to help each other. If both parties don't benefit - then it doesn't work to do that," Hunter expanded. "Under this contract, Kimball Health Services pays Regional West Medical Center $6,000 monthly. All medications have to reviewed by a pharmacist prior to KHS giving them, and Bemis Drug is not open at night, so we finally went to Regional West."

Hunter added that Regional West medical facilities are more knowledgeable on the distribution of intravenous medications and cancer drugs and that with a facility such as Kimball Health Services and facilities similar in other rural areas, that it benefits the medical facility to have an agreement with a larger medical center that has trauma services.

"It's necessary, because we don't provide everything here," Hunter said. "Last year working with Regional West helped our bottom line about $300,000."

That savings allowed Kimball Health Services to expand local services. Hunter added that Dr. Jamie Broomfield, D.O.N. Richard Harringer, Melissa Prante, CFO of KHS, and he are all employed by the Regional West Medical Center and Kimball Health Services with duel reporting roles.

Valley Ambulance Service owner, Meininger, then offered to the board and public his experience with other nearby communities that they work with as a regional service.

"Ogallala has a department run by the city and they are a full paramedic service, licensed with the State of Nebraska having difficulty with the EMS responders during the daytime."

Meininger then explained that for the community of Ogallala, they were able to help by partnering with them to meet the community's needs and added that the partnership was now at a year's time.

"It's been a very successful model," stated Meininger. "In Kimball you have a critical access hospital; you already have those relationships, so that makes it easier to build on a strong relationship that already exists."

Meininger went on to explain that although Director of the Kimball Ambulance Service, Carla Goranson, is doing an excellent job in her position, he suggested to the board that with a partnership as a regional service our local ambulance service could be even better and costs could be kept down by networking with Regional West and Valley Ambulance.

"You know as well I do, that the costs of these things keep going up and up and up. How do we contain that? And again, the way we do that is through networking and through partnerships,"Meininger said. "Our goal would be to recommend to the County Commissioners that you would be able to put together a task force, or a group, for one-hundred twenty days and the group would begin to explore ways that we could work collectively to enhance the ambulance service here."

Commissioner Tim Nolting moved to proceed with a proposed task force and to sign a confidentiality agreement with Regional West Medical Center for the meetings with the task force for a term of 120 days with prior review by the commissioner's attorney, Matt Turman.

Commissioner Daria Andersen-Faden seconded the motion and questions followed by some of the Kimball ambulance crew members to the regional ambulance staff as most expressed that their futures as EMTs and crew members were uncertain, because of the motion by the county board.

"This (question) is for the board," Kimball EMT Cristy Rowley said. "You have an advisory board that is specifically a liaison between the ambulance and the commissioners. Is that correct?"

"No, we do not," responded Commissioner Larry Engstrom,"We did have, but it's not a functioning board."

Rowley asked if the advisory board had been disbanded or dissolved by the board.

"It wasn't dissolved," replied Engstrom, "It was one of those deals where there was no action taken by the board that was established and some of the board members felt it was a waste of their time. "I guess I thought that as long as it was not doing what we expected it to do, that the best thing was for them not to be meeting."

Engstrom added that technically the board still exists, but is no longer a functioning board.

Rowley then asked the commissioner board to consider having a night meeting for the public to ask questions, since many citizens are unable to attend a morning meeting due to work schedules.

"After 120 days of a task force meeting and getting information together; it would probably be a proper thing at that time," suggested Engstrom.

"So, at the end of the 120 days would be when you (commissioners) would you then discuss what our strengths and weaknesses are and what is going to happen to us?" Schildhauer clarified. "What happens at the end of the 120 days?"

"I think that the task force is going to bring options to the commissioners on their recommendations to strengthen the service and in keeping all the components in perspective," responded the Director of Nursing at Kimball Health Services, Richard Harringer, "Then the task force will hash out all of the options that will be best suited for the EMS here. There are needs in the network too, not just here. So, what can Kimball offer the network and what can the network offer Kimball?"

"I welcome the task force," Goranson said. "Although I know we are doing a good job, there is always room for improvement and we strive to do the best we can!"

The 11:00 am agenda item on the Commissioner's list for the meeting was for the board to go into an executive session where they discussed the payroll audit on the Kimball County Ambulance. No action was taken during the executive session.