CUBA CITY — After nearly 50 years in operation, the Cuba City Common Council voted unanimously Wednesday to sign a contract with Southwest Health of Platteville to provide emergency medical services.
That effectively ended the Cuba City Area Rescue Squad. Ald. Nathan Moris, a member member of the CCARS, did not vote.
The vote came at the conclusion of a special council meeting capping off approximately two years of discussions and negotiations between city officials, CCARS, Southwest Health, and attorneys.
The contract is binding until Dec. 31, 2034, which is similar to the contract Southwest Health EMS has with Platteville and other municipalities.
The CCARS is unincorporated and provided emergency services to the City of Cuba City and the towns of Benton, Elk Grove, New Diggings, and Smelser. Southwest Health EMS will now provide 911 coverage for EMS services solely to the city, not including the adjacent townships previously covered by the CCARS.
Southwest Health EMS covers the City of Platteville, as well as the townships of Platteville, Lima, Harrison, Smelser, Elk Grove, Belmont, and portions of Ellenboro Township.
The yearly charge from Southwest Health will change based on the most recently published population of Cuba City from the state Department of Administration. According to clerk/treasurer Jill Hill, Cuba City’s population is currently 2,120, meaning the annual fee would be $33,920. The 2023 charge will be prorated based on the date service began.
In recent weeks, the council has held special meetings that included closed-session discussions about EMS. After last week’s closed session, Ald. Tim Hazen laid out the reasons the council felt it was appropriate to contract with Southwest Health, rather than continue the arrangement with CCARS.
Hazen said the initial issues brought to the council two years ago from the CCARS were staffing and funding needs. Through that process, the city attorney informed the council that the CCARS “was not in proper legal form,” not by the fault of anyone. There were no contracts in place establishing legal duties between the city and the CCARS. At that time, the city attorney suggested four options: he city establish the CCARS as a city department.
The city and local municipalities create an EMS district.
CCARS incorporate and obtain a 501©3 nonprofit status, and surrounding townships enter into an agreement with the CCARS.
The city enter into an agreement with Southwest Health.
Hazen said the council deemed the first two options “not viable.”
“The interesting question that I would have liked to have had a true answer to is, ‘Why did the city choose to not make the Cuba City Area Rescue Squad a city department?’” said Marie Wamsley, president of the CCARS. “That was the number one option on the list, and they ruled that out immediately. That’s how we’ve been operating, basically, for almost the last 50 years.
“When I asked that, the answer that I was given was, ‘It’s just not an option.’” Prior to last week’s meeting, the council received a proposed contract from CCARS for emergency services. The city attorneySteve Zach, from Boardman & Clark reviewed the contract and described it as “subpar,” according to Hazen. “There were issues that our legal counsel felt need to be looked at closer,” he said.
“I have been asking the city attorney for redlines to our agreement, to have a conversation about our agreement, for a very long time,” said Wamsley. “They have given me nothing. We presented this [contract] to them last fall. That’s how long they’ve had this contract and they very easily could have provided us with any type of response.”
Hazen said the council had received a contract from Southwest Health, and upon review from the city attorney, that contract was acceptable.
As for incorporating as a non-profit, Wamsley said they were ready to do that.
“It didn’t make sense for us to form a 501(c)3 until we knew for sure the city was going to contract with us,” she said. “There’s costs, obviously, involved with becoming a 501©3, including legal costs and filing fees, and things like that. It doesn’t make sense to go through that entire process, because we are operating the same way we have been operating since we have been since 1976, why make that change until we know what the city is going to do for sure. So, for them to use that for a reason why they didn’t choose us was not fair. That is something we were planning to do.
“We have all the paperwork. We were ready to put it together as soon as we have support from the city. We haven’t felt that support from the city or the city attorney since this whole process started.”
Ald. Craig Hendrickson then outlined the factors that went into the decision favoring Southwest Health.
The response time from CCARS is 9½ minutes, compared with 10 minutes from Southwest Health. CCARS crews need to be called in, while Southwest Health crews can respond directly.
he level of service is higher with Southwest Health. he CCARS offers EMT care, while Southwest Health offers critical care/paramedic service.
Coverage reliability/ staffing: “Like many, local EMS organizations CCARS is having difficulty fulfilling staffing,” said Hendrickson. "We understand that. That's been a factor across the state, across the Midwest. That is something everybody is facing.”
Wi t h t h e r e c e n t resignation of service director Jennifer Baker, they have utilized Southwest Health to cover those shifts.
Annual costs, including a $10,000 difference in the contracts, with Southwest Health’s offer being less in price. In addition, the contract with Southwest Health would go through 2034, while CCARS would be renewed annually.
Stability: "Staffing issues favor Southwest because they have staff 24/7, with multiple ambulances to run,” said Hendrickson.
It was also noted that by contracting with Southwest Health the city would be saving $160,000 because it would not be allocating that money for the purchase of a new ambulance for CCARS.
Wamsley noted some concerns with what was presented by the council members. Southwest Health “ambulances aren’t staffed for Cuba City only,” she said. “They are staffed for a lot of other calls. Platteville is very busy.
“I hope and pray they had all the facts in front of them before making that final decision. What was most disappointing, for me, in hearing everything … there was not one positive thing mentioned about Cuba City Area Rescue Squad, and not once was there a ‘thank you’ to our rescue squad for our years of service that our members have given.”
“We have a great group of core members,” added Wamsley. “It was hard for them to hear those things from the city.”
In an email to the Tri- County Press, Hill said, “although it wasn’t discussed at the meeting, the Common Council would like to express their deepest appreciation to all members of CCARS, past and present. They sacrificed many hours volunteering and did so many good things in our community that everyone is thankful for. It was a very tough decision that took many hours to come to. The council made the decision they believe to be in the best interest of the citizens.”
"There have been a lot of factors involved,” said Hendrickson. “We’re all community members. We live, work; our kids go to school here. That’s why we have taken our time on this, to make sure we are doing the right thing.”
“We’re members of this community also,” said Mayor John Van De Wiel. “It’s not an easy decision, but we have to look at the facts, and those are the reasons why we chose to go this direction.”
A transition plan was to ne put into place following the vote; however, due to the alleged lack of support from the council to the CCARS leading up to the meeting and during the meeting, CCARS members declined to continue.
“I believe, had the city made some more positive remarks about our rescue squad in their speech, that may have gone differently,” said Wamsley. Southwest Health took over immediately Wednesday.
As for response time, Wamsley doesn’t believe the council was appropriately comparing data. The response time submitted by the CCARS was for an entire year, which included rough winter conditions. That time averaged approximately 9½ minutes. The average Southwest Health time per call, was 10 minutes, for the previous six calls to Cuba City, she said.
“And how can they say ‘only 30 seconds,’ when we know seconds and minutes count,” she said. “These response times were on good road conditions. In the winter, that is going to take that average a lot higher.”
Wamsley isn’t sure the outcome could have been changed based on the past few months. She cited the growing confusion of the operational structure between the CCARS and the city as the main problem.
“We have operated kind of as a department of the city for almost the past 50 years,” she said. “It’s never been an issue until we had this fulltime service director position, because we, as on organization, couldn’t employ … them directly through the Cuba City Area Rescue Squad. We had to employ them through the city and the city did an intergovernmental agreement with the municipalities. At that time, it all went through just fine.”
Wamsley said the largest expense is the cost of purchasing and maintaining the ambulances, as well as the upkeep of the fire/EMS facility on South Main Street.
She highlighted the option of incorporating as a 501(c)3 nonprofit organization. That would have allowed the group to apply for its own grant funding, which would drive down the costs for the city and the municipalities.
In addition, Wamsley previously informed the council that they would be going from two ambulances to one in order to save money and provide for a higher salary for a new service director.
The city owns two ambulances, which were used by the CCARS. One has a fair market value of $20,000 and the other has a fair market value of $50,000. The city will transfer title of those vehicles to Southwest Health in exchange for a credit toward the Annual Support Fee payments. The city will be responsible to resolve the equity ownership issues between the city, the CCARS and the townships.
Brian Allen, director of EMS and emergency management at Southwest Health, said the hospital has four ambulances, one of which is used primarily for interfacility transfers, leaving three for service calls. Southwest Health is staffed with 28 personnel and operates from the Platteville facility on a 24/7 basis.
"The Southwest Health team is a great team,” said Wamsley. “I’ve known many of them for a lot of years and I’ve called them my friends. I wish them well with all of this.”
In January 2022, Southwest Health opened a clinic in Cuba City. Allen said at this time there are no plans to add an ambulance bay to the clinic.
Allen has had preliminary discussions with township officials that were covered by the CCARS.
In a press release from Southwest Health Thursday, Southwest Health officials thanked CCARS for its “commitment to high-quality care and service to their community.”
“It was a difficult decision; it took us months to assess the situation to ensure the citizens of Cuba City had quality EMS,” said Van De Wiel, in the press release. “The main reason we went with Southwest Health was the reliability of EMS now and in the future. We want to thank all the volunteers of CCARS who over the years have done an excellent job.”
“We understand emergency medical care and its importance to the community,” said Allen in the press release. “We want the residents of Cuba City to know that they will receive enhanced, high-quality care at the advanced life support level. We are ready to serve and look forward to working with the community members and organizations as the EMS provider for Cuba City and the surrounding area. We also thank Cuba City Area Rescue Squad members for the care they have provided over the years.”
Southwest Health is a nonstock, nonprofit corporation that owns and operates a critical access hospital in Platteville, with rural healthcare clinics in Cuba City, Darlington, Lancaster, and Kieler.
