wee willie wrote on Jul 16, 2007 10:38 AM:
" Isn't there a Protocol against Local governments horning in on private business endeavors?? Sounds like an attempt by Hiz Honor and cohorts to set up another Cash Cow, which they have done so smoothly just recently... There is a Commandment stating, Local Government shalt not covet the earnings of private enterprises. Hmmmm, so they just want to improve service??? Just looks as tho' the Money always looks greener on the other side of the City Hall fence... Stop trying to muscle in on private efforts... "
Roger wrote on Jul 5, 2007 10:45 PM:
" The current system works well because fire and ems stations are spread throughout the area. However, with the city expansion to points further south and from there going east, they are eventually going to be forced to erect a new station out that way. The northside will need a new station also. The one station there is what, about 70 years old? Ambulance service? More stations?---Remember, LaCrosse had at one time 5 fire stations. Current staffing level adequate? Alot of decisions to make to try and maintain a good emergency service and still keep the taxpayers happy. "
Thank You wrote on Jun 28, 2007 9:31 PM:
" Thank you very much for your well wishes. Many people here are working very hard here to be good patient advocates and help assure the continuation of the clinical, operational and fiscal excellence the patients and taxpayers enjoy in our community! Thanks again and best of luck in your continued debate in Sheboygan. If we can be of any assistance, please let us know. Thanks, Matt "
To Matt wrote on Jun 28, 2007 3:48 PM:
" I now see why you were so busy expressing your views in the Sheboygan paper over the last couple of monthes. Just I figured you are facing the same thing there. I am sure that you are hoping for better results then you got with your efforts there. "
Roger wrote on Jun 25, 2007 10:58 PM:
" The financial aspect might only be part of the picture as you say it is. And rightly so. The current system seems to be working fine according to history and the mail received in this column. I know the chief at Two Rivers. It is a small city that, like many other smaller cities of its size, supplements its paid staff with that of POC people. We do it here too. It provides a cost savings to its citizens. Fire and Ems organizations, for the most part, seem to work well together. There is some anamosity out there I know that. There are pros and cons to every system. Once again, it might take a "sharpened pencil" to show why the current system needs to be changed. "
TG wrote on Jun 25, 2007 10:35 PM:
" Maybe the Firefighters union would be willing to accept 1% less money on their next contract in exchange for the ambulance service. "
Di wrote on Jun 25, 2007 7:18 PM:
" As a registered nurse, I have had the opportunity to call Tri-State often. Their response time is excellent, the quality of care they provide for different medical problems is very knowledgeable and more advanced. If I needed medical services related to transport to a hospital or medical center, for an illness or accident, I would want Tri-State there for me. "
To: To Matt (2) wrote on Jun 25, 2007 3:10 PM:
" Thanks for your comment. No one is bashing anyone, to the opposite, at the Forum, all the speakers, I included, complemented the fire fighters and all 1st response agencies. Watch the video and see. We have proposed in writing to the Mayor and Fire Chief the following enhancements: EMD, external EMS oversight and governance by an EMS Commission of citizens appointed by elected officials from the entire region, a Community Health Program, system status management of career fire units to reduce response times, and enhanced performance-based contracting. These were submitted to the Mayor and Fire Chief on April 26, 2007 during a face-to-face meeting and provided in writing the day after. If you'd like a copy of the letter, let me know - it was distributed at the Forum. Thanks, Matt "
Carp wrote on Jun 25, 2007 2:52 PM:
" Neither Tri-State or The city of LaCrosse Firefighters have been Status Quo as someone put it. Both have the Best of everything to provide the best for the people they serve, we have strived to stay on the cutting edge as a system. We can improve,and should improve with things like EMD (whoever wants to provide it), joint Incident Command Training and utilization, Closest unit first responder response (not by political boundries), joint system Quality assurance and Improvement ventures, Joint team training for all the types of responses ( hazmat, rescue, medical MCI) these would have much more impact on patient outcomes and efficiency than would another ambulance service. "
Another Tribune opinion? wrote on Jun 25, 2007 2:46 PM:
" How about it Dick? How about the fact that they just might welcome the cash flow. Whether it is profitable or not. 'Profitable' no there is a laugh. TYhese guys are spnding $1.20 and taking in $1.00. They are clamouring for money! -Nestor "
To: 8:25 AM wrote on Jun 25, 2007 12:29 PM:
" Huh? Tri-State exemplifies excellence in health care serivice delivery, both qualitatively and quantitatively. It accomplishes this at no cost to the taxpayers. How in the world would you view this as self serving? It is precisely the opposite. Everyone benefits from the service Tri-State provides if and when when they need it. And, no one pays for it if they don't need it. That's as good as it gets! "
To Matt wrote on Jun 25, 2007 8:25 AM:
" So instead of bashing city and the phantom proposals, why doesn't TSA come up with a list of all the possible alternatives? Provide details of how each could work and what the strengths and weaknesses are to each? So far all TSA has proposed is maintaining and even strengthening the status quo and that is self serving at best. "
mediator mentor wrote on Jun 25, 2007 6:59 AM:
" This is an easy one. "If it ain't broke, don't fix it." Case closed. "
Now You're Talking! wrote on Jun 25, 2007 12:33 AM:
" Matt suggested a county EMS. This is exactly what is needed. We should have full time first responders with medical transport for the entire county, and full time firefighters for the urban areas and paid volunteers for the rural areas. "
joe emt wrote on Jun 24, 2007 8:26 PM:
" Please rest assured that those of us on the streets are getting along and working together for the good of the patient. This will not change. Every time we climb on a rig our personal feelings are put aside, the patient comes first. I believe there is mutual respect for the skills that are possessed no matter what level the training. The dispute will not and can not reach the streets. The working toward a settlement is with the leadership of the organizations. "
Interested Citizen wrote on Jun 24, 2007 7:07 PM:
" My questions are for the Mayor and Fire Chief: Where is your proposal? It seems to me we are wasting time and money having a mediator come when you haven't presented a written proposal.
Additionally, why are you holding the EMD program hostage? This is a life saving program that should have been in place long ago. This program should not have to wait until you figure out that going into the ambulance service is not fiscally responsible. "
To: To Matt wrote on Jun 24, 2007 7:01 PM:
" Your concern is appreciated, but I'm just providing factual information about experiences in other systems, including the one’s we were asked to visit by the La Crosse Fire Chief as ‘model’ systems. We feel strongly that the stakeholders need this type of information due to recent examples in WI referenced by the Fire Chief where the time from ‘proposal-to-city-council-vote’ to fragment a county-wide EMS system was 3 weeks. As for responding to phantom proposals, the only thing we have to go on to educate the stakeholders are the comments made publicly by the city, and the 57 page proposal drafted in 2002 by the fire union for 2 ambulances operated in the city by the Fire Department. The same proposal that Asst. Chief Jorgenson spoke publicly about as quoted in the Tribune on July 24, 2002. Thanks, Matt "
To Roger wrote on Jun 24, 2007 6:32 PM:
" The financial aspect is the smaller part of the picture. I am a paramedic with close to ten years experience, (the median experience level at Tri-State). What bothers me the most about the cities "non-proposal" is instead of my loved ones being treated by experienced paramedics, they'll get freshly trained paramedics. To become a paramedic you must get 70% on a national test. In essence you have a governing body saying this person will not make harmful or fatal mistakes more than 30% of the time. Hands on experience and close attention to clinical education and skills development is what makes Tri-State the excellent service it is today. The Lax FD does an unbelievably good job operating at the EMT-Basic and first responder level, but lack the clinical expertise and experience to just take over ambulance duties in the city of La Crosse. "
bad_news.bear wrote on Jun 24, 2007 6:28 PM:
" Do you want the details of your medical situtations to become public record, just like police and fire calls are already?::: maybe they could continue with this and train the parking-ticket writers as Brain Surgeons? "
To: 5:46 PM wrote on Jun 24, 2007 6:23 PM:
" Ever met a shark with a proposal? "
To Matt wrote on Jun 24, 2007 5:46 PM:
" You're comparing apples with watermelons. The fact that some other place has had either success or failure with a particular EMS structure does not mean we will too. We can certainly learn from others, but to draw conclusions on what would happen here without knowing the the details of the proposal is premature. This is precisely what Dick is referring to in his piece. The City hasn't provided specifics yet and TSA is publicly trashing the proposal before it has been been presented. "
To: Roger wrote on Jun 24, 2007 3:00 PM:
" We all visited Two Rivers (WI) FD in December, 2006, a combination paid/volunteer department who has been doing EMS transport since 1953. Their costs were much lower, but the "cash-in-the-door" revenue still did not meet the expenses of having full-time paramedics plus all the capital and related expenses. The Two Rivers chief stated that the paid-on-call system they have makes the biggst cost savings. He also stated that a county-wide system is better than a city-based system. Again, the supporting documents are available if anyone would like them. Thanks, Matt
"
To: Subsidy wrote on Jun 24, 2007 2:42 PM:
" If there are 2 services, both will need a subsidy due to lost operational efficiency. A solely city-based service will not make money, it's been proven in the 3 departments we all visited in December 2006 (visit www.tristateambulance.org tomorrow to view the actual documents from those departments in the information handed out at the EMS Forum last week). That would mean the city residents would be paying a city-tax subsidy for the city department AND a county-tax subsidy to fund Tri-State outside of the city. Also, our paramedics have seen on average 6,500 patients as paramedics, since the city has stated they would train existing personnel and not hire anyone, you'd have brand new paramedics who have never treated anyone outside of an educational setting. That's a reduction in clinical quality. Thanks, Matt "
To Roger wrote on Jun 24, 2007 2:24 PM:
" What's broke are the taxpayers of La Crosse! Anything that can help maintain the levels of service and reduce the costs should be considered. "
LCFD Ambulance User Fees = TAX wrote on Jun 24, 2007 2:23 PM:
" Don't be mistaken...not only will your taxes pay for the ambulances to be there...you'll pay again if you use it. I would consider that an additional tax. "
Roger (part 2 of 2) wrote on Jun 24, 2007 2:01 PM:
" But in this case, where it has already been established that TSA provides an excellent level of care and good service to almost all areas of the coulee region, it might be darned tough to prove why it needs to be changed. After all, the old saying might apply here, "if it aint broke why fix it." If this is the case, the City and the FD might have a more difficult time proving to the public why the current system is "broke and needs fixing" in order to justify the change. "
roger wrote on Jun 24, 2007 1:55 PM:
" It is apparent that the current system is working. LAFD provides first-responder service and TAS does the rest. Providing fire protection is not a service that provides a return in the investment- only certain cases such as highway calls. The City is looking into ways to get into the EMS service because it is a "cash-cow". LaX, like every other municipality is looking for added sources of revenue. The ems portion does pay for itself and then some. Believe me, because I have been on a combo paid/volunteer FD for over 25 years and we have provided ems service for about 35 years to the area. When FDs provide a combo EMS and FIRE service, it does work very well -actually better in some cases- because the service is not split between two organizations. ...more to follow. "
A Subsidy is a Subsidy wrote on Jun 24, 2007 12:18 PM:
" No matter how you slice it, La Crosse residents are subsidizing EMS transport service to the suburbs and rural areas. If the city can save money without a decline in service by having our first class fire fighters provide EMS transport, it is worth exploring. "
Yepper! wrote on Jun 24, 2007 10:21 AM:
" I support government in all of its forms with my tax money. That support takes over half of my income what with income tax, sales tax, property tax, gas tax and estate tax and more. So now the government that takes my money wants to give me a ride to the emergency room? I think not! Let them deal with potholes and burning houses and the criminal element and leave our ambulance service alone. "
Agree with Mial that city needs to be clearer about its reasons for ambulance takeover. wrote on Jun 24, 2007 10:03 AM:
" People in both the City of La Crosse and outlying areas of the county seem satisfied with the service given by Tri State and it's user, not taxpayer supported. If the city cannot clearly explain why its idea enhances service and what it will cost city taxpayers in the short run or how it might gain the city revenue in the future, I don't see much public support beng generated for the mayor's (non)proposal. "
one-way ticket wrote on Jun 24, 2007 8:23 AM:
" Let's help the mayor pack his bags! "
The real world wrote on Jun 24, 2007 7:56 AM:
" I find it offensive that local a government official is trying to interfere with private enterprise. I would suggest that there is an ulterior motive, like maybe helping out the good old boys! I would not be so quick to acuse, but the mayor has a track record in this area. I campaigned hard for Johnsrud, but I am one of those who has learned the hard way that politics comes down to who's back needs scratching. "
bob wrote on Jun 24, 2007 7:55 AM:
" Having Mayor Johnsrud and Chief Cleveland say, "we're just exploring ways to make things better," is like getting the same answer from a hungry shark circling around Tri-State. This is more than frustrating. It is life threatening. And that's before we talk about over-bloated increases -- unecessary and wasteful use of taxpayer dollars. "
To: Richard Mial wrote on Jun 24, 2007 6:58 AM:
" Didn't the city of La Crosse "bring in an outside" person as their new fire chief to criticize the local, already working EMS system? TSA has talked with the city FD Chief and Mayor for the past year on this issue and has only received the same vague non-proposal. Have you asked the firefighters, FD chief, or Mayor if the firefighters were told there would be job cuts if the union did not back this plan by the Chief and Mayor, despite what they think about the current EMS system? It is the city who is asking for "an outside person" to mediate the issue!! Why stick our head in the sand and not benefit from the experience of others! "
Positive Outcome wrote on Jun 24, 2007 6:58 AM:
" Thank you for sharing your views Mr. Mial and I'm glad you had a positive outcome from our wonderful healthcare and EMS System. Your experience is exactly how it is designed to work, quick response and experienced care providers. Hopefully, that will not change in the future. If anyone wants to view Mr. Bayer's comments and judge for yourself how the firefighters and fire union was portrayed, Charter Communications has let us know that they will air the EMS Forum Video on Charter Main Street (ch 8 on the cable dial) at 2 AM and 2 PM every day, M-Th for the next 3 weeks starting Monday, 6/25 at 2 PM. Or, e-mail me at mzavadsky@tristateambuance.org and we'll arrange for you to get a DVD of the program. Thanks, Matt "
Concerned wrote on Jun 24, 2007 6:39 AM:
" The City should contract for more services not get into private sector businesses. Government does not operate efficiently, nor without a degree of corruption. Tri State has done an excellent job! Every time the City gets involved in a new responsibility it ends up costing tax payers. Remember the Doerflinger building, the old LaCrosse Country Club, Market Square ramp as a few examples of poor management. They should work to reduce the size of the Council and there bloated budgets first. "
DB wrote on Jun 24, 2007 12:26 AM:
" Want to make it better? How about continuing to foster the relationship between current providers in the city / county / entire area. Driving a wedge between two entities isn't doing any good. Solidify the bonds between the two sides. Continue to provide the excellent service at the current qualification levels. Get EMD going. Get things back on track. "
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