SIOUX CITY | All is quiet now. But by week's end, thousands of tubes will have traveled the 700 feet from the top of Cone Park's snow-covered hill to the bottom.
Hundreds of people will have entered and exited the brand-new park's day lodge to buy tickets, snack on concessions and heat up between tubing trips.
Dozens of hands will have warmed up near the park's fire pit, some clutching steaming cups of hot cocoa or coffee.
At long last, the all-seasons Cone Park will come to life on Thursday. As the first park-goers enjoy the fresh recreation amenities that the city-owned park has to offer, it will be the payoff of a fundraising and planning process that has stretched for more than a decade.
City staff say they're preparing for big crowds.
"I think you're going to find that the first week in particular, as we work out the kinks, we're going to have huge crowds," Sioux City Manager Bob Padmore said. "That's our hope."
The final week of preparation has included staff training, more snow-making and continued grooming of the tubing hill in the park, which sits in a former field at 3800 Line Drive near Lewis and Clark Park and the IBP Ice Center.
The park's centerpiece is the 150-foot-wide hill, which is more than two football fields long and has an elevation of 83 feet. The park's base of operations is a day lodge that will serve as the hub for admission, skate and tube rentals and concession sales. An outdoor fire pit will allow park-goers to warm up outdoors, and by mid-January, a nearby refrigerated 110-by-50-foot ice skating rink will be up and running.
The park will remain open year-round, with the skating rink transitioning into a free splash pad in the summer. The rest of the park will feature open space and a two-mile trail loop.
Tubing hill tickets are now on sale, and city Parks and Recreation director Matt Salvatore said people have been steadily making reservations online ever since. Some of them are for weeks out.
Salvatore, who has steered the project for the past three years with the aid of two city committees, the City Council and city management, said the end result has exceeded his expectations.
"Everything turned out better than what I thought it would," Salvatore said. "Everyone from Parks and Recreation and those who have been assisting with the project are all very proud of what the project has become."
The park will hold a grand opening Tuesday afternoon, in which major donors and city officials will have the first chance to take the tubing hill for a spin.
The public's first taste will come at 5 p.m. Thursday, when the first four-hour tubing session begins. The park will have special hours over the holidays (see sidebar) then fall into a normal schedule of 5 to 9 p.m. on weekdays and 9 a.m. to 9 p.m. on weekends.
Special "Cosmic Tubing" sessions on Friday and Saturday nights, from 9 p.m. to 11 p.m., will feature music and LED lights.
The city began working toward the prospect of a new destination park in 2006, but the idea is actually a result of a seed planted back in May 1981. That's when the family of the late philanthropist Ruth Cone donated more than $200,000 to invest in a new park.
By the time the bequest became available to the city in 2006, it had grown, with interest, to more than $2 million. It has since increased to $2.9 million and provided the lion's share of funding for the approximately $5 million park.
In 2006, plans originally centered on Sioux City's downtown. The inaugural Cone Park Committee favored a location at 232 Water St. as an ideal space for a park that would include a water feature, performance space and ice skating.
Plans took a hit as proposals for a new casino near that location began to take shape. The city would eventually sell land in the area to the Hard Rock Hotel & Casino Sioux City, forcing the park to relocate.
While the committee eyed other spots downtown, their sights eventually focused on a city-owned field in Morningside east of the IBP Ice Center, near Lewis & Clark Park. A Parks and Recreation survey found 67 percent of public respondents wanted the new park to be winter-themed, and the field was found to have perfect topography for winter recreation events.
"We started with the vision probably about two years ago with that park idea," Padmore said. "We started with the lodge and the tubing hill, and that's now been broadened into a fire pit area and ice skating rink that's cooled."
Craig Berenstein, who joined the project planning team at the outset in 2006 while on the council and is currently co-chairperson on the Cone Park Committee since then, said he has felt public excitement mounting.
"Really, for the last couple of years after we had made the decision to move forward with a winter park that had this kind of concept, people have been very excited," he said. "I think part of it's the visibility in the location of Singing Hills and the Highway 75 bypass."
Co-chairperson Virginia Anderson said the tubing hill now provides the eye-catching feature organizers wanted.
"When we saw it on paper, we knew it looked grand, but seeing it in person just wows everybody that drives by," she said. "Our goal was we wanted an iconic feature that would give the Cone family the recognition they deserved."
The park's unique amenity helped the city land a $300,000 grant from Vision Iowa, a state program that provides financial assistance for major recreational, cultural, entertainment and educational attractions. The award, along with additional private donations, allowed local organizers to meet their final fundraising goal.
With high expectations for attendance, Parks and Recreation staff have recommended reserving tickets in advance. This can be done online at webtrac.sioux-city.org, by calling 712-279-6126 or visiting the Parks and Recreation Office at 401 Gordon Drive.
Tickets will range from $7 to $10, depending on the time of day. The hill has a capacity of 300 users, and usage is on a first-come, first-serve basis for those without a reservation.
The concession stand will serve a variety of items, with beverages ranging from hot chocolate and coffee to wine and beer and food offerings including pizza, ice cream, pretzels and chicken wings.
When paying on site, staff recommends park-goers use cash. Cone Park will not accept checks, and there will be a $10 minimum on card transactions for on-site sales.
SIOUX CITY | When longtime regional ambulance service Siouxland Paramedics Inc. stops responding to emergency calls on Jan. 1, rural residents surrounding Sioux City likely will notice the change the most.
From Akron to Mapleton, small towns and rural areas across the tri-state region will face a void in paramedic service that could leave some patients with few or no options to receive higher-level care while on their way to the hospital via an ambulance.
The pinch will hurt most during hours of the day or night when paramedics from other area agencies aren't available, meaning patients transported by ambulances who need life support measures beyond what Emergency Medical Technicians can provide may not receive them.
Emergency workers around the region say the void will especially impact those suffering from major medical issues such as strokes, heart attacks and diabetic episodes -- circumstances where seconds count.
In the words of Woodbury County Emergency Services Director Gary Brown, it's a "health care crisis."
"We had an elderly person the other day who we couldn't move until we gave them some (pain medication)," Brown said. "We wouldn't be able to do that now without a paramedic. You're going to just have to tough it out, and that's not what we want to do to our patients."
In some areas, directors say they're aware of a desire among local government leaders and health care professionals for solutions. That includes talks in Woodbury County about how rural cities and townships could share the costs of staffing a 24/7 county paramedic service. But, no matter what is decided, the void will not be filled by year's end.
A solution is further along in northeastern Nebraska, where South Sioux City is working toward putting agreements in place that will allow its paramedics to assist agencies in rural areas of Dakota County and potentially neighboring Dixon and Thurston counties when needed.
But in other areas, there's no stopgap on the horizon. And as year's end draws nearer, some emergency medical professionals say they fear the consequences could be serious.
"Without that paramedic assist, we’re going to be bringing (hospitals) patients that are potentially a lot sicker and a lot harder to bring back to good health," said Lynette Kiger, EMS director for the Akron Fire District, which covers 365 square miles in sparsely populated western Plymouth County, Iowa, and eastern Union County, South Dakota. "It’s recognized by us out here that this just can’t go on without having a detrimental effect."
Mercy Medical Center -- Sioux City, which has the region's highest-level trauma center, also shares an unease that some patients coming from rural areas could soon face longer waits for treatment, said Matt Robins, a hospital spokesman.
"We are concerned about treatment delays that may occur," Robins wrote in an email. "Paramedic care can start some treatments in route that result in quicker care."
What's no longer available
For years, Siouxland Paramedics has provided 911 services to Sioux City and North Sioux City, as well as paramedic assistance throughout the tri-state region. But in August, Health Inc., a joint venture formed by Mercy and UnityPoint Health -- St. Luke's that owns Siouxland Paramedics, informed cities it would no longer respond to emergency calls as of Jan. 1, citing financial difficulties.
The nonprofit will continue a downsized service of non-emergency transports of patients between medical facilities, such as nursing homes and hospitals, which it says provides better insurance reimbursements and a more sensible business model in the current health care industry environment.
The August announcement spurred discussions among local governments about ways to quickly fill the void in the tight window before year's end.
Sioux City Fire Rescue quickly put its own EMS Division in place -- a move expected to cost taxpayers between $600,000 and $1 million in the remaining months of the city's current budget year, which ends June 30. The city also may soon strike a deal to provide paramedic service to the Dakota Valley Fire District, which includes North Sioux City, Dakota Dunes, the Wynstone development and Big Sioux Township.
But those paramedics are not meant to travel beyond their respective boundaries, leaving outlying areas that have traditionally also been served by Siouxland Paramedics without the service.
Siouxland Paramedics responded to 93 paramedic assists in Woodbury County during the fiscal year ending June 30, according to data obtained by the Journal. The agency responded to 40 calls in Plymouth County and a combined 136 calls in Dakota, Dixon and Thurston.
Siouxland Paramedics has traditionally responded to paramedic assists when other nearby paramedics, such as the single paramedic employed by Woodbury County Emergency Services, aren't available.
When more advanced measures are needed, such as pain medication and IVs, local volunteer ambulances carrying patients often meet Siouxland Paramedics rigs along the road to pick up a paramedic, who then administers treatment on the way to the hospital that basic EMTs cant not perform.
"The further away you get, the more critical the paramedic becomes"
Woodbury County Emergency Services is headquartered in Climbing Hill, placing it near the center of the county to offer 24/7 EMS response. The lone paramedic's regular schedule is 7 a.m. to 7 p.m. on weekdays. The paramedic has every other Friday off and has no replacement during sick days and vacations.
Director Gary Brown said last year, 98 percent of patients who needed paramedic care on a 911 call received it either from the county, Siouxland Paramedics or agencies from other counties. In all, those needing paramedic assistance accounted for about 30 percent of transported patients, he said.
But he said when Siouxland Paramedics stops its services, it will leave a hole in that chain, meaning one less agency will be on hand to provide that service.
Brown said the care provided by a paramedic on board can affect the length of a patient's recovery time, as well as more generally provide comfort on the ride to a hospital -- a ride that in rural areas can take several minutes or even hours, depending on distance and road conditions.
"You get down to Danbury, and you're talking an hour's drive," Brown said. "The further away you get, the more critical the paramedic becomes."
In Plymouth County, Le Mars EMS director Bill Rosacker said the void will mainly affect the Akron area to the west and the Kingsley area to the southeast. He said Le Mars does have its own paramedics, but some areas of the county aren't geographically feasible for one of those paramedics to respond in time.
Unlike Woodbury County, Plymouth County does not employ a paramedic.
"If they’re having 'the big one,' some of the drugs are not going to be administered until they either get a paramedic on or to the hospital," Rosacker said. "For Akron, that could be a 20-minute drive. You can lose some cardiac muscle in that time during the transport."
Kiger, Akron's EMS director, said Akron received paramedic assistance from Siouxland Paramedics on about 16 percent of its calls last year.
"That doesn't seem like a lot, but when (patients) need life-saving interventions, we need them," she said.
Kiger said it's possible her agency could use Mercy Medical Center's helicopter in certain situations, or transport a patient to Avera Health's Floyd Valley Hospital in Le Mars for stabilization before transferring them to Sioux City.
"We just need to be able to read all the signs, read their condition to figure out what we need," she said.
Monona County Emergency Management coordinator Patrick Prorok said the most affected area in his county will be the northeastern portion of the county near Mapleton, where Siouxland Paramedics responded four times last year.
A paramedic based at Burgess Memorial Hospital in nearby Onawa is available 8 a.m. to 4:30 p.m. on weekdays, but there will be a gap during the other hours of the week, he said.
"It's going to leave a void," Prorok said. "Anytime we can have that advanced treatment for our patients, that's really a benefit."
What's on the table
Brown earlier this fall requested that Woodbury County add three more paramedic positions to upgrade the county to 24/7 response, saying Siouxland Paramedics' absence without more staffing will set county EMS back 30 to 35 years. While none of the five county supervisors argued that point, funding was an issue.
Discussions are now centering on whether other cities can help foot the cost. Brown said Thursday that a Jan. 8 meeting involving local townships, city officials and the board of supervisors will discuss the issue and potential solution.
Regardless of how those talks move forward, Brown said there will be at least a six-week gap between any funding decision and having paramedics on the ground, due to the length of the hiring process.
"If the decision were made today to fund it, I still wouldn’t have anyone on (by Jan. 1)," he said. "But that doesn’t mean we still shouldn’t try and get this resolved."
In Nebraska, local agencies may be able to depend upon a strengthened force in South Sioux City. Fire Chief Clint Merithew said South Sioux City currently provides some paramedic assistance when possible to other cities in Dakota County.
"When they have a patient that is critical with illness or injury, and they need advanced life support, we will be able to assist them with that," he said, then emphasized that the department's primary focus will remain caring for residents within South Sioux City.
Merithew said he is awaiting city approval on agreements that would formally outline the partnership structure and how the city would be reimbursed. He said South Sioux City could also expand the service to Dixon and Thurston. An agreement could be in place sometime in January, he said.
In Homer, Nebraska, which sits 11 miles to the south, Fire Chief Jim Swanson said his department has already received paramedic assistance from South Sioux City, and he's thankful for the upcoming arrangement.
"I can't applaud South Sioux enough in how they stepped up to help us," Swanson said. "The only concern I have is if South Sioux will have the manpower to meet needs outside the city limits to all the rural communities."
Ponca, Nebraska, Fire Chief Brad Krohn said his agency used Siouxland Paramedics about twice a month, mainly for farming accident and heart attack victims. Until he sees something in writing from South Sioux City, he said his crews will either need to call in the Mercy Air Care helicopter for serious events or work with as much speed as possible using what they have.
"Our people, some of them are trained in IV and some are trained for intubation (placing a tube down a patient's throat), so worst case we’ll just have to do that and go," he said. "I guess the bright side of anything on this is we're only 24 miles from the hospital."
Krohn added that losing Siouxland Paramedics is "going to be a bad deal all-around."
For other cities, there's no replacement on the horizon. In Mapleton, Prorok said he doesn't know whether it will be feasible to work with Woodbury County to provide assistance across county lines.
In Akron, Kiger said while she has heard desires from other medical professionals for an answer, she hasn't seen one yet. She described the situation as "frustrating," but she said she is hopeful something will happen.
In the meantime, the volunteer crews will move forward using what they have, she said.
"We’re going to do everything we can with the knowledge, the skills and treatment we can provide to get the best for our patients," she said. "That's all we can do."