Countywide Emergency Medical Service system will be expedited

Officials say transition will be made by December 1

 SHELBY COUNTY -  After receiving notification from Medivac November 13 asking for an increase in funding, stakeholders for the countywide Emergency Medical Services have decided to expedite the plan, and are now tasked with making the transition by December 1.
 “We didn’t expect this,” said Shelby County Board of Supervisors Chairman Steve Kenkel. “However, we are looking forward and not dwelling on the past.”
 Kenkel announced Jordon Sanders,  Shelby County Emergency Management Agency (EMA) Assistant Director, will be the EMS Director in an interim position until a permanent director can be hired.
 Sanders said he is looking forward to “a unique challenge.”
 “Everyone from the hospital staff, the City of Harlan, the Board of Supervisors, and the volunteers in the county have all had a rallying response to this sudden change. I am confident that with the staff we are bringing on board, and the continued support we have received from stakeholders and citizens alike, we will create a great organization to positively benefit the citizens and travelers of Shelby County,” Sanders said.
 Kenkel praised the cooperative effort of  Sanders, EMA director Alex Londo, and Shelby County Sheriff Neil Gross, who Kenkel said, “all hit the ground running”.  He noted the assistance and support received from the volunteer fire and rescue departments, Myrtue Medical Center, and the City of Harlan. Kenkel said everyone has been doing their part. “No one is backing away from the table.”
 “Without that type of  leadership, we’d really be struggling. There’s a lot of work to do and legal things to put in place, but we can do this. We know we have the support of the entire county,” Kenkel said.
 “We are trying to see this through and make it successful,” Sheriff Gross said.
 “During these discussions, the top priority of the Hospital and Ambulance Commission has always been that we maintain Ambulance services with no gaps in coverage,” said Barry Jacobsen, CEO Myrtue Medical Center.
 “As we transition to the new county run service, we expect the same high level of quality patient care we have had in the past,” Jacobsen said.
  For several decades, the Shelby County Ambulance Commission, comprised of the county, the City of Harlan, and Myrtue Medical Center (MMC) under a 28E agreement, have contracted the privately owned Medivac Ambulance Corp. to provide ambulance service throughout the county. Bob and Nella Seivert have owned and operated Medivac since 2012.
 “Nella and I have enjoyed serving the community and are looking forward to our retirement,” Bob Seivert said.
 A press release read by Board Chairman Steve Kenkel at the Shelby County Board of Supervisors meeting held Tuesday, November 21 stated, “On July 1, 2021, the Shelby County Ambulance Commission signed a 5-year contract with Medivac to provide Ambulance Services to Shelby County.
 “In the past couple years, Medivac has made several requests to increase funding due to the inability to sustain operations financially. The Ambulance commission has continuously shown support of the financial challenges that have presented since 2021, and responded accordingly with significant increases in funding.
 “On November 10th, 2023, Medivac provided notice that without additional increases in funding, they will need to cease operations on December 1, 2023. Considering the already significant increase in funding to Medivac, and the successful vote of the county-wide EMS system, the best approach moving forward is to expedite the county run service,” the press release continued.
 Medivac’s notice was received shortly after a public referendum passed at the November 7 election, allowing the funding of a county wide EMS for 15 years through a tax levy. The measure needed 60% voter approval to pass, and earned 82.29 percent of the votes in favor.
 Under an Iowa law passed in 2021, counties may ask for up to 75 cents per $1,000 of assessed property value to fund EMS, if voters deem it an “essential service.” Earlier this year, an EMS Advisory Council was appointed by the Board of Supervisors to develop a sustainable plan for a county wide EMS. The  council consists of various stakeholders in the county, and includes Chairperson, Tim Plumb, Shelby County ESA; Bryce Schaben, Vice Chair, Board of Supervisors; Alex Londo, Secretary, Emergency Management Agency; Roger Bissen, Fire Chief, City of Harlan; Karen Schlueter, City of Shelby; Janice Gaul, City of Earling; and Jenny Lefeber, Myrtue Medical Center (MMC).
 Once the measure passed, the Advisory Council planned for property tax funding to be collected starting in September 2024.  The 2024-2025 fiscal year was to be dedicated to acquiring a facility, purchasing needed equipment and supplies, and developing the program. When funds were available, a Service Director was to be hired to develop policies and programs, hire staff and apply for necessary licenses. The new county-run ambulance service was originally planned to be in operation July 1, 2025.
  On November 10, correspondence sent to Medivac by the Ambulance Commission stated, “You and Nella were heavily involved in the discussions of the stakeholder group . . . which led to the successful vote to implement a county-run ambulance service on July 1, 2025. This plan relied on Medivac’s commitment to fulfill their obligation up through that date. This would allow Medivac out of their obligation one year early, in line with the Medivac’s owners’ desire to retire prior to the end of the current contract, which is set to expire on July 1, 2026.”
 It continued, “The smooth transition of services to a county-run service is an important aspect of the plan, and the Commission would like confirmation in writing of Medivac’s intention to continue to provide service through July 1, 2025 under the current funding arrangement within the next week.”
 Medivac issued a response November 13, in which they acknowledged their participation in the discussions with the stakeholder group. “At the time of these discussions, Medivac did state its commitment to fulfill its obligation with the expectation of obtaining a transition one year early in 2025,” the response read.
 It continued, “Medivac is currently unable to pay it’s expenses under the current contract. We notified you of this in September 2023. While we would like to continue as your provider, it is impossible for us to do so under the current terms of our contract. We request an immediate re-evaluation of our financial support needs. This must result in allowing Medivac to pay its outstanding bills and continue to pay its bills until a transition can occur.”
 “At this time, Medivac is nearly insolvent. We are unable to pay liability insurance, work comp insurance, and employee health insurance, along with regular operations expenses. These policies will most likely be cancelled for nonpayment December 1, of 2023. At that point Medivac will no longer be able and most importantly, legally able, to continue providing service to anyone,” the letter concluded.
 The county issued press release stated the Ambulance Commission was working diligently with all stakeholders to ensure a smooth transition to the county wide service by December 1, 2023. The County is in negotiations with Medivac over the building and equipment.  The two main ambulances currently used by Medivac are owned by the Ambulance Commission, and will be transferred to the County. Medivac staff will be offered positions with the newly formed ambulance service.
 The referendum stated the Ambulance Commission would still be in place until the county wide service was fully funded in July 1, 2025. Since property tax funding will not be collected until September 2024, funding until then will be provided through the county commission. 
 On Wednesday, November 29 at 9 a.m.,  a special Board of Supervisors meeting will be held to discuss  the amended 28E agreement, purchase agreements, funding agreements, and other  business. A public hearing will be held on December 19 to permit the local option income surtax.
 City of Harlan Administrator Gene Gettys also read the county-issued press release at the Tuesday, November 21 City Council meeting, then noted the plan is now “put in accelerated motion.”
 “The timing was not anticipated,” he said. He credited the Advisory Council for working diligently toward a “smooth transition”.
 “I can’t thank everyone enough for their cooperation,” Gettys said.
 “When we go to sleep at the end of the month, we don’t want things to skip a beat,” Harlan Mayor Jay Christensen said.
 “Fortunately, a lot of good people have stepped up, and helped the community get to where we are with this today.”




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