A four-person political action group believes it is time to reform Cape Girardeau County's ambulance system.

Currently, the county has an exclusive contract with the privately funded Cape County Private Ambulance Service. However, the group wants to replace that system with a publicly funded countywide ambulance district.

Made up of medical professionals Randy and Carla Everett, Barbara Mueller and Ron Kiplinger, the Friends of Cape Girardeau County Ambulance District have held weekly meetings throughout the county in hopes that residents sign a petition to place the measure on the April ballot.

As of Tuesday the group had about half of the 3,700 signatures needed. If the required number is collected, voters must then approve a permanent increase in property taxes. The group estimates the increase would raise $2.8 million per year.

Startup costs would include ambulances, facilities, medical equipment, supplies and personnel.

While taxes would increase, the group said that's a small price to pay for improved emergency medical services compared to the current system, which the county has held a contract with since Cape County Private Ambulance Service was founded in 1968.

Friends of Cape Girardeau County Ambulance District hopes to model the proposed service after other ambulance districts. St. Francois County, which has a population of about 4,000 fewer residents than Cape Girardeau County, has had an ambulance district since 1977. While Cole County, with population of about 72,400, has a hospital-based service, Newton County, with about 54,000, and Christian County, with about 61,500, have ambulance districts.

Like St. Francois County's ambulance district, Cape Girardeau County's would be governed by a six-member board of directors and have six to eight ambulances stationed throughout the county. The board and manager would determine the locations and number of ambulances.

Randy Everett said the goal of his service will be for ambulances to arrive anywhere in the county within 10 minutes.

"There are many deficits in the current system, one of which is no coverage in some areas," he said. "Some response times exceed 30 minutes in the county, including Cape city and Jackson."

However, Dr. John Russell, president and principal owner of Cape County Private Ambulance Service since 1983, said response times have been 10 minutes 90 percent of the time in Cape Girardeau and Jackson. Russell said while 70 percent of the county's population lives in Jackson and Cape Girardeau, his fleet of seven ambulances covers the entire county.

Everett said the current ambulance service is financially restricted because it relies primarily on billing income for support.

"There is a fundamental difference between the two, which ultimately results in a completely different approach to addressing the needs of its citizens," he said. "Where the private service is largely profit-driven, a not-for-profit service is patient-driven."

Russell disagrees.

"Our profit margins are very small, and if we were not patient-driven, we would have been out of business many years ago," he said. "We provide a high-quality service at a high value for the taxpayer.

"We are more than just a vehicle that responds in times of crisis," he said. "We do other things, such as sending our vehicles down to help with the recent hurricane response."

Mary Chappius, manager of Perry County's hospital-based ambulance service, said that while both models have attractive qualities, she believes Cape Girardeau County needs an ambulance district and that Everett is qualified to lead the effort. Everett worked on forming North Scott County Ambulance District in the late 1980s and later managed it. He also worked with Chappius in the late 1970s in Perry County.

"We've seen this done throughout the state," Chappius said. "An ambulance district is needed if a county is to have the best staff, equipment and ambulances."

The groundwork for the current ambulance district debate was laid in 2004, when Cape Girardeau Mayor Jay Knudtson met with Russell, city manager Doug Leslie and fire chief Rick Ennis to begin the dialogue of improving ambulance service in the area.

Knudtson said the quality and response time of the private ambulance service was questioned again this year by several individuals. That's when the mayor became aware of the group proposing the ambulance district.

"It was now extremely clear that there was far-reaching discontent with the current service that was being provided," Knudtson said. "To be fair, I do feel they are doing the best they can with the funding and budget they have to work with."

Since then the group has met on a weekly basis.

Hospitals' positions

Southeast Missouri Hospital spokesman Mark Bliss said his institution does not have an official position.

"The hospital is willing to work with first responders to study emergency services options, including the possibility of establishing an ambulance district," Bliss said. "The hospital is not taking a position for or against such an option at this time."

Steven C. Bjelich, president and chief executive officer of Saint Francis Medical Center, supports the group's efforts to find the best solution possible.

"Saint Francis takes seriously the need to envision future emergency care scenarios and plan for them," he said. "We want to ensure there will be sufficient access to emergency care for everyone in our region and are actively working to find the best solution."

Cape Girardeau County Presiding Commissioner Gerald Jones said the group faces a tremendous challenge in passing the measure. He said that with the current economic climate, it may not be the best time to bring the issue before consumers.

"The big question is not will they have enough signatures but will people vote for it," Jones said. "That remains to be seen."

Knudtson agrees the economy may affect the passage of the measure. "While the ambulance district concept is a noble one, it requires that a tax is passed to support it and I have some real concerns about the success of this tax," he said.

Regardless of the outcome, both sides are ready to continue their quest to provide the best ambulance service for the county's residents.

Everett said the group will continue fighting for an ambulance district.

"This county will have an ambulance district eventually to provide timely emergency care to its citizens," Everett said. "Sooner is better than later if it's one of your loved ones."

Russell said he would be willing to discuss ways both groups could work together to improve service.

"Their motivations are OK and not meant to put us out of business," he said. "They're out there to raise questions of whether the system can be better than what it is. I salute them for their efforts and motivation.

"What I don't want to see happen is the emergency medical care system erode in value or service at the expense of the taxpayer," he said. "Are there ambulance districts running good systems? Yes. If that's the direction they want to go, I'm happy to have that conversation. But it's important to keep sight of the large picture."

bblackwell@semissourian.com

388-3628

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