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| | | | 1. Call to Order at 10:03 AM | | | |
Roll call
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| | | | 2. Roll Call. | | | |
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| | | | Appearing:
Ambulance Service providers -
Superior Ambulance Service
Mr. Frederick Hornby
David Hill - CEO
Mary Franco - VP
Kim Godden - VP Legal
Dave Faber
Colin Austin
Austin Chronister
Valerie Bruggman
Bell Ambulance Service - counsel, Joshua Gimbel
Wayne Jurecki
Curtis Ambulance Service
James Baker
Dan Robakowski
Deputy City Attorney - Todd Farris
MFD Chief David Hensly
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| | | | 3. Approval of previous meeting minutes.
Minutes note: Motion by Mr. Fleming moved, seconded by Dr. Weston to approve the December 10, 2022 minutes.
There were no objections. | | | |
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| | | | 4. Certification of Ambulance Service providers.
Minutes note: Asst Chief David Hensley presented the board with the applications of three ambulance service providers: Bell, Cutis and Superior as a new applicant to be considered as a limited provider.
Dr Colella asked if is possible that the packets would be distributed with more time for review.
Mr. Fleming asked the Asst Chief, Hensley what are the factors that go into an affirmative recommendation.
Asst Chief Hensley said that given the service history and work ethics of Bell and Curtis and prior providers working with the Milwaukee Fire Department, MFD recommends affirmative recertification and Superior, as limited provider, for the time being. He continues by saying that bringing a new provider into the mix, may cause disruption in the current flow of the providers. By having them at a limited capacity, it allows for the Fire Dept to be able to monitor the types of calls they could be assigned to (e.i. special events or specific addresses).
Asst Chief Hensley explained that the dead line for providers to submit application is end of September, MPD reviews them and approves any background checks, then they are returned to the MFD.
Chair asked the MFD Asst Chief if things can be move earlier to allow more time for members to review the packets with less pressure.
Mr. Hornsby said that Superior has made great strides in supporting the City, for example they have bought property int he city, to show their commitment to servicing the City of Milwaukee. He also asked why are they only consider as limited providers.
Asst Chief Hensley explained that thanks to the efforts made by Bell And Curtis Ambulance in helping to stabilize the 9-1-1 system (after Paratech dropped out), introducing a new provider at this time, will disrupt the current environment. Having a limited provider can allow for Bell and Curtis the option of subcontracting them to certain areas. MFD would like to work with Superior at a limited capacity and see how the working relationship evolves from now until the next year so they can be consider for a full certification.
Superior's president, Mr. David Hill is appreciative of the opportunity to collaborate with the City in order to develop a working relationship.
Chair Borkowski appreciated the improvement Curtis and Bell have contributed after the hard times the City experienced after Paratech concluded their services.
Dr. Weston asked if their service area reflect the graph they presented. Ms. Franco responded that they service hospitals through private contracts the Menomonee Falls and Oak Creek area.
Mr. Fleming asked how long before considering a third provider.
To answer Mr. Fleming's question, Ald. Borkowski explained that at one point there were four providers. then things happened in a hurry, then the Paratech situation happened. He was personally disappointed with Paratech in that, they decided that they were going to be selective as to what part of the program they were going to participate in; that was not being fair to the other providers nor the community, most importantly. So we went from four to two providers, and then, we are in trouble. We did significant scrambling, as I mentioned. And we got to a very good place. so, your question Mr. Fleming, I say, basically, I don't know if any of us knows what the future holds for EMS, for the private ambulance service or the needs and desires of this community. I think is better to have more, so we don't get to the point we got in the past, which happened rather quickly, said Ald. Borkowski.
Dr Colella said that there a lot of competing issues; we certainly want to make sure that the City is covered and our response time is appropriate, I do appreciate it may require more support either from our team, that on the 9-1-1-1 side, however, I'd like to see a more formal feasibility study, identify where and if there is a gap, what would be impacted since there are operational concerns if adding additional providers.
Dr. Weston asked Superior, based on the different agencies they're working for, Detroit is listed. He asked, are there some of the relationship where a 9-1-1 call would be turn down to your service.
Ms. Franco said that they have been working with the city of Detroit for about ten years; City of Detroit model is very similar to Milwaukee; Superior have created different models suited for the specific needs of each community.
Dr. Weston asked for call-backs Data for Detroit for the MFD and the Ambulance Service Board considers the possibility of adding another provider. He also ask about their medical direction.
Ms. Franco said that they have four medical directors that are affiliated with Aurora set up in different parts of the state; for Milwaukee the medical director is with Aurora St. Luke's Medical Center.
Dr. Colella moved, seconded by Mr. Zollicoffer to approve the recertification for Bell, Curtis and accept Superior as a limited provider and refer the packet to the Common Council for final approval.
There were no objections.
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| | | | 5. Private provider report.
Minutes note: Report submitted by Asst Chief Hensly
The report gives a breakdown of call-backs for 2023, the number of calls serviced and their turn-back;Hensley said that the percentages of overall calls that are turn-back are pretty low. Curtis and Bell have done a great job of handling these calls and taken the burden off the MFD.
Mr. Baker said that after Midwest medical left, both Curtis and Bell made serving the City of Milwaukee their primary focus and just within the last year, Curtis, has handled over 25% higher volume of calls than a year ago. Mr. Baker complimented the MFD for their efforts to help during the difficult times.
Mr. Jurecki said that Bell has made a structural change to their organization to focus on the City of Milwaukee and its 9-1-1 system. Since October 2022 Bell has not had a single call that was not handled; as a matter of fact, Bell has handled, as back-up calls all the calls that Curtis was not able to handle, therefore removing the pressure on the MFD ALS units. As part of the negotiation discussion the number one priority was, that the fire Department's unit be available for their use. Doing much less calls with Aurora and Ascension and all Hospital system and focusing on 9-1-1. This relationship has worked out very well for us and are in the process of opening another station on the north side of Milwaukee to further improve response time and service to the residents. Mr. Jurecki continued by saying that providing service to the residents, in time of need is something very dear to Curtis Ambulance providers. He thanks the Milwaukee Fire Department.
Dr. Weston asked, based on the report, there have been 0% unable to handled calls by either provider.
Mr. Jurecki said that Curtis has had unable to handled call that, Bell has handled. There have been no calls that Bell and Curtis collectively, could not handled and therefore had to turn back to MFD. The report may look unclear because they are attributed to previous providers, therefore some of the numbers are what would have been a Paratech number, but because of the way Bell and Curtis are handling it, they're handling it and not gone down to the MFD. It's working from some legacy reporting.
Dr. Weston asked about the response time of 20-40 minutes, it looks like is higher for Bell than for Curtis, is Curtis more willing to turn down a call than Bell. Mr. Jurecki responded that the report as created, does not take into account appropriately, the lowest acuity call that, now have a 60 minute response time. It is not broken down into a separate category. Dr Weston asked if there are different "unable to handled" criteria. Mr. Jurecki said that it is a contractual obligation of 60 second to make the determination and return it. Bell is substantially larger than Curtis; we have other vehicles that we can rearrange for a non emergency facility to be able to meet the obligation of the 9-1-1 system. It is very rare that 100% vehicles that are on duty are actually, on calls.
Mr. Baker adds that is it a decision on the part of the dispatcher to balance resources and demand.
Dr. Colella ask the providers how they manage to determine the acuity of the calls. Mr. Baker said that Curtis allows the MFD to let them know the acuity level of the call. Bell, on the other hand, is certified Emergency Medical Dispatch (EMD) center so on their call back they are able to confirm the EMD determinate that MFD has ascertain on the first call to make sure the situation has not change and if,it had change, to escalate the response.
Mr. Fleming moved, seconded by Dr. Weston to receive and place on file. | | | |
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| | | | 6. Changes to Ch 75
Minutes note: MFD reviewed Chapter 75 relative to the consumer price index to see if there should be any price increase based off that number, health care CPI was flat, so MFD makes the recommendations of no increase at this time. Motion made by Dr. Culvert, seconded by Mr. Fleming. There were no objections.
Mr. Jurecki said that historically, the rates had been adjusted by CPI Urban for the Milwaukee Area. The Bureau Labor Statistics discontinued that specific CPI, prior to COVID the MFD was in search of Consumer Price Index (CPI) to use to set our rates, at that time it became an average of the Chicago and Minneapolis CPI on medical care and that's the rate that has shown as flat over this past year. It doesn't necessarily meet all of the changes that have happened.
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| | | | 7. Updates on the EMS system.
Minutes note: MFD Chief Hensley, recommended to consider Midwest Medical and Event Medical Solutions for possible consideration for certification for service, in the future.
MFD is preparing for next year's RNC convention and looking to improve the system and everything MFD does. Considering adding paramedics into the dispatch system and working with the community of paramedics Mobile Intergrated Health (MIH) programs to take care of everyone the best way possible.
Commissioner Totoraitis recommended a feasibility study be done with the intent of doing research as to the need of additional providers to the system, CPI, seconded by Dr. Colella.
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| | | | 8. Public Comments/ Announcements.
Minutes note: Mr. Fleming thanks the Chair, Ald. Borkowski for his leadership in the board.
Dr. Weston need representation from the VA, take into account
Dr. Reipenhoff no longer with Ascension Columbia St Mary's. VACANCY
Dr. Weston part of ground breaking ceremony for the Center for Protective Medicine and Forensic Services located at the medical College grounds; it will house the County Medical Examiner, the Co. Office of Emergency Management, Varsity Blood Center, and the State Crime Lab. This facility will open in about two years.
Chief Hensley thanks Ald. Borkowski for his service, he will be truly miss!
Dr. Totoraitis wishes Ald. Borkowski best wishes!
Dr. Colella said that he has a long history with Borkowski. wishes him well!
Mentioned that last week was the 50th anniversary of Co. EMS system and the Medical College of WI. which prides itself on the their research. of the support of the City of Milwaukee for all of the research they do.
Just received a grant for resilience and EMS providers space.
Ald. Borkwoski said that Milwaukee County continues to be one of the best in the country!!
Dr. Culvert Aurora, thanks Ald. Borkowski for his service.
Mr. Jurecki honored to work with Ald. Borkowski and from Bell's prospective, he looks forward to working with the City of Milwaukee for their 47th year!
Mr. Baker celebrates his 51st year as a EMT. Family business since 1959; he thanks Ald. Borkowski for his dedication and leadership in leading the board these years.
Mr. HIll from Superior thanked the Chair for being invited to the meeting.
Chair Borkwoski thanked the board member for the opportunity to work together.
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| | | | 9. Adjournment.
Minutes note: Meeting adjourned at 11:15 AM
Joanna Polanco
Staff Assistant | | | |
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| | | | In the event that Common Council members who are not members of this committee attend this meeting, this meeting may also simultaneously constitute a meeting of the Common Council or any of the following committees: Community and Economic Development, Finance and Personnel, Judiciary and Legislation, Licenses, Public Safety and Health, Public Works, Zoning, Neighborhoods & Development, and/or Steering and Rules. Whether a simultaneous meeting is occurring depends on whether the presence of one or more of the Common Council member results in a quorum of the Common Council or any of the above committees, and, if there is a quorum of another committee, whether any agenda items listed above involve matters within that committee’s realm of authority. In the event that a simultaneous meeting is occurring, no action other than information gathering will be taken at the simultaneous meeting.
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| | | | Upon reasonable notice, efforts will be made to accommodate the needs of persons with disabilities through sign language interpreters or auxiliary aids. For additional information or to request this service, contact the City Clerk's Office ADA Coordinator at 286-2998, (FAX)286-3456, (TDD)286-2025 or by writing to the Coordinator at Room 205, City Hall, 200 E. Wells Street, Milwaukee, WI 53202. | | | |
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| | | | Limited parking for persons attending meetings in City Hall is available at reduced rates (5 hour limit) at the Milwaukee Center on the southwest corner of East Kilbourn and North Water Street. Parking tickets must be validated in the first floor Information Booth in City Hall. | | | |
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| | | | Persons engaged in lobbying as defined in s. 305-43-4 of the Milwaukee Code of Ordinances are required to register with the City Clerk's Office License Division. Registered lobbyists appearing before a Common Council committee are required to identify themselves as such. More information is available at http://city.milwaukee.gov/Lobbying. | | | |
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