Committee leans away from forming ambulance control board


LEE COUNTY – A push from city officials in Keokuk and Fort Madison to create an oversight board for the future Lee County-owned EMS services met with resistance from the committee overseeing the transition Friday.

The committee comprised of local first responders and county officials has been meeting regularly since Lee County Supervisors voted to move ahead with transitioning into a county-owned ambulance service after failing to approve a third-party vendor.

At Friday’s meeting, the committee took up a discussion on whether or not to create a control board similar to the county’s Public Service Answering Point board.

However, Lee County Budget Director Cindy Renstrom pointed out that the service will be owned by the county and not be an 28E agreement with the service. The PSAB board and the E911 board both operate as part of a combined 28E with the county.

Fort Madison Mayor Matt Mohrfeld and Keokuk Mayor Tom Richardson sent very similar letters to the transition committee asking for a board to be set up to ensure quality of care after the county assumes ownership on July 1, 2021.

Both offered to put their respective fire chiefs, Joey Herren of Fort Madison, and Gabe Rose of Keokuk, to serve on the board.

Committee chairman Jim Steffen, a veteran first responder and instructor at Southeastern Community College, asked whether the city was looking for an advisory board or a control board.

Lee County Auditor Denise Fraise, who sits on the committee, said she thought the cities were looking for more of a control board.

“Board control means (EMS Director) Dennis (Cosby) reports to that board, they have approval of the budget, approval of major purchases,” Steffen said. “Advisory board is more of what we’re doing… and the bylaws we approved when we formed this committee call us an advisory board.”

Steffen said he envisions the committee transitioning into the full advisory board that would measure quality and service metrics.

“I don’t see the difference between what we have and what Fort Madison and Keokuk have asked for,” Steffen said.

Herren and Rose both are on the transition committee.

Herren said the committee has always been looking to the future, but has not addressed how complaints will be handled from the field.

“Where do the complaints go to? Do we go to this board with complaints or would we go directly to the supervisors with it. That’s what we want to know,” Herren said.

Lee County Emergency Management Agency Director Jason Dinwiddie said if there are complaints with the fire departments, they go to the chief and then to the City Council’s if they didn’t get satisfaction. That should be the same with the county-owned ambulance.

Herren said that hasn’t always worked with the current service.

“Going on past history we’ve complained to the ambulance itself and then to the supervisors, and then it went nowhere. So how do we get some meat behind it. How do we do that?,” Herren asked.

“The PSAP board seems to work that way, but now we’re saying we can’t do that because we aren’t a 28E.”

Cosby said he’s been in a lot of those issues in the past working for Lee County Ambulance and would want to handle those issues internally as much as possible.

“This ambulance service is going to have a new director that’s not afraid of that confrontation or disciplining employees when it has to happen. Being it’s not a private service, when you come to the Board of Supervisors they are the operator of the service,” Cosby said.

“I’d like to start this new ambulance service on the right foot. I would welcome everyone’s input and I absolutely think we should continue to have the advisory board.

“As issues come up I would like to discuss those with people and bounce ideas around. I think that’s how we get to where we want to be.”

In an unrelated issue, the committee recommended going to back to companies that build the ambulances and asking for firmed up costs on new ambulances.

The committee was originally looking at buying remounted ambulance boxes, but Cosby said the estimates of that work is very close to buying new. Steffen said with those close estimates it may be better to just buy or lease a new fleet of six.

Steffen said he would recommend Cosby put out a new request for proposal that includes three of the ambulances must be in possession of the county by mid-June to allow for service to start on July 1.

Fraise said that discussion needs to go back in front of supervisors as they were looking at remounts.

The committee also discussed who would assume the roles of Medical Examiner/Investigator for the service. Steffen asked if Lee County Sheriff’s deputies would be able to step into those roles even on a fill-in basis.

Sheriff Stacy Weber said their are different warrant procedures for deputies than medical examiners and he’d rather not have the deputies, who are part of the investigation, also assume medical investigation roles.

Cosby said he had some discussions with Bill Young, a current medical examiner with the private Lee County EMS Ambulance, and said he thinks Young may be willing to stay on and work for the county.

“My suggestion would be maybe he’s still interested in staying involved in doing this, and I would welcome him. It only makes sense to me that we continue to use those folks,” Cosby said.

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