EMS funding concerns highlight Lincoln County Commission meeting

The Lincoln County Board of Commissioners met on Tuesday, March 3, in the Lincoln County Boardroom. With all members present, the commission heard agenda items including court scanning, ambulance service, and bid awards. 

Commission Assistant Paul Anderson introduced Carl Thomas, Court Administrator, who requested that the commission consider a motion to split the 50% cost share of the Lincoln County Clerk of Courts’ scanning project with the Unified Justice System. 

“As you might know, there is a grant program available with state funds to fund courthouse security measures and equipment. We anticipate being able to get about $350,000 in state money to fund the security features for that new facility, and we certainly appreciate the county’s cooperation,” Thomas said, showing photos of the files, books, binders, and other court documents, some of which have been accumulating since statehood. 

“We’ve got quite a bit over there, and of course, it’s probably in all our interests to get that cleared one way or another before we go over to the new facility,” he continued. 

Thomas reported that all counties are required to provide court facilities, including physical records storage. 

“We never anticipated that we were going to store large amounts of paper in the new facility, and as you may recall from the register of deeds presentation on scanning a couple of months ago, they’re falling to pieces,” Thomas said. 

Thomas’s goal is to scan all the remaining paper records and clear out the old courthouse. 

“We’re proposing Active Data Systems for a number of reasons. Active Data Systems are local; they’ve always worked with the courts really well. They’re very expert in handling records that are really challenging. Not just books, not just three-ring binders, not just pictures, we’re talking onion skin paper, and litigation over land records with plat maps,” he said. 

The team is charging $305 per box for the 330 boxes, totaling $100,650. The state will cover half the cost of $50,325. All scans will be converted to pdf’s by case number and party names so court staff will be able to access the information. 

Chairwoman Tiffani Landeen opened the floor for public comment. 

Chad Skiles was the first to speak. 

“As I was reading through this agenda item and studying it, why is the county responsible for holding and storing state documents?” he asked.

“It is a state statute and unfunded mandate from our legislature,” Chairwoman Landeen responded. 

Motion was made to approve by Jim Schmidt, seconded by Betty Otten, motion carried 4-1 with Putnam being the nay vote. 

Commissioner Otten requested a commission briefing on ambulance service sustainability. Otten has asked Sharon Santel of Sage Project Consultants to give a presentation on the issue. 

“Thank you for considering options to improve public safety and emergency medical response in Lincoln County. As you know, you have a great weight on your shoulders as lives depend on your leadership. EMTs and paramedics are your first responders on the very worst day of your, your spouse, your children, and your parents’ lives. It is an honorable profession, and I am thankful you are here today to support them and the public safety of Lincoln County citizens. I have a contract with the South Dakota Department of Health EMS to provide technical services to ambulance services in South Dakota at no cost to them. We are not a national firm; we live in Sioux Falls and in South Dakota and are currently working in 35 services across the state,” she said. 

Santel has been working with the Lennox Area Ambulance Service to find solutions for the EMS crisis they are currently facing. The current rate of pay for EMTs is $15 per hour and $23 per hour for paramedics. 

“The value proposition that the city of Lennox has developed is due to increasing call volumes and responsibilities; the existing team members are stretched thin. For these reasons, the Lennox Area Ambulance Service proposes transitioning to a fully staffed model with 24-hour, seven-day-a-week coverage,” she said. 

Santel reported that Lennox is no longer able to shoulder the costs of providing ambulance services beyond city limits without funding from surrounding areas. In South Dakota, there are two funding options: equitable funding within the ambulance jurisdiction, and then there’s an ambulance district option. 

“Calls have been steadily increasing outside of Lennox, and calls inside the city of Lennox have been steadily decreasing over the years,” she said. 

Chairwoman Landeen requested questions from commissioners, and Commissioner Joel Arends was the first to speak. 

“When it comes to private payers, whether that’s cash payer or private insurance, I think most people understand when they get a bill from the doctor’s office that the insurance pays x and then you get a bill from Sanford or Avera for, let’s say $200 and you have to pay that out of your pocket. There’s no legal prohibition on the ambulance service reducing that down to a judgment or a collection as long as it’s private pay, correct?” he asked. 

“That I’m not sure,” Santel responded, stepping aside for Lennox City Administrator, Nate Vander Plaats, to take to the podium. 

“If you’re referring to the difference between what insurance paid and what the patient paid and the difference between that and the amount billed, no, we cannot collect on that, and if we were to do that, we couldn’t bill insurance,” he said. 

“So you’re telling me that insurance companies are saying we will no longer allow you to bill our insurance if you try to collect the remainder from the patient,” Arends asked. 

“Correct,” said Vander Plaats. 

“That’s ridiculous,” Arends responded, asking for more clarity on the whole issue. “I’ve talked to other ambulance providers who send those to collections to get paid. What I’m wondering is, you guys are taking the approach where insurance companies are telling you one thing, but these insurance companies must be telling these other ambulance districts another thing,” Arends said. 

“Or that insurance company isn’t aware they are collecting on that remaining amount,” Vander Plaats added.  

With no action being taken, the commission thanked everyone for their time and effort on the matter. 

Auditor Sheri Lund requested that the commission consider a motion to approve and authorize the Chair to execute the joint agreements for combined elections. 

“Today, we have several agreements presented for the combined elections. These agreements come out of last years SB1130, which requires certain political subdivisions to coordinate and combine or combine elections on the same day. That would be the June primary or the general. We’ve worked since November of last year to come up with the agreements for all the different districts. We have the listing here of who is in agreement and has waited,” Lund said. 

Commissioner Arends asked if Lund was happy with the cost share. 

“We worked really hard to make sure that there wasn’t an additional burden,” she responded. 

Motion to approve was made by Otten, seconded by Arends, motion carried.

Highway Superintendent, Terry Fluit, requested the commission consider a motion to award the Lincoln County Highway roundabout project to BX Civil and Construction in the amount of $1,425,000. 

“There were very competitive bids on this project. The engineer’s cost estimate was about $1.9 million, so we got really good prices on this, and we had 10 bidders. The roundabout will be placed between North County Road 116 and County Road 105, with construction beginning as soon as next month. 

Motion was made to approve by Otten, seconded by Schmidt, motion carried.

Fluit also requested the commission consider a motion to award the Lincoln County Highway surfacing project to Journey Group Companies dba Black-Top Paving Company in the amount of $848,209.89. 

“This is a surfacing project that we’re going to be doing, going through Worthing and on County Road 124. It’s about a five and a half mile project. Cost estimates were about $1.1 million, and again we came in way under. We had eight bidders on this project,” Fluit said. 

Motion to approve was made by Otten, seconded by Arends, motion carried, with Landeen abstaining.