Siouxland Paramedics

An ambulance leaves Siouxland Paramedics for a medical call in early 2016. An agreement finalized Monday has outlined payment received by Sioux City when Sioux City Fire Rescue's EMS Division provides paramedic assistance to the Dakota Valley Fire District, which encompasses North Sioux City, Dakota Dunes, Big Sioux Township and Wynstone.

SIOUX CITY | Facing financial issues, Siouxland Paramedics Inc. has initiated talks with the City of Sioux City to transition the community's medical ambulance services to a "more sustainable model" by January.

The discussions center on a greater involvement from the city's side, leaving the exact future of the 35-year-old ambulance services organization uncertain. Some potential scenarios include formation of a new city division to handle ambulance services or a request for proposals from private companies to take over the services.

"All options are currently on the table at this point," said Karen Van De Steeg, executive director of Health Inc., the governing body of Siouxland Paramedics.

Currently, Siouxland Paramedics jointly responds to emergency medical calls in Sioux City and with regional emergency medical services to provide paramedic assistance. It employs 57 people, 31 of whom are full-time employees, and serves more than 10,000 people each year.

A news release issued Wednesday cited the "increasingly difficult healthcare financing environment" as the cause for the talks. Van De Steeg specified that the organization is facing a rising number of uninsured patients, declining reimbursements from Medicaid and Medicare and increased personnel costs. 

"It's a situation going on nationwide," she said. "Most healthcare reimbursement has been going down fairly significantly over the years. That continues to happen." 

Sioux City Fire Rescue Chief Tom Everett said options under evaluation include creating a new division within the city under Sioux City Fire Rescue, or sending out a request for proposals from private companies that would replace Siouxland Paramedics. 

He said he's not certain at this point how those scenarios would affect current Siouxland Paramedics staff. 

"In either situation, I think, there are some unknowns," he said. "Obviously, there is going to be change."

Under a potential scenario in which the services are put under the city's umbrella, Everett said, the impact on the city's budget remains unknown.

"That’s really early to talk about, and it's part of what we’re analyzing," he said. 

Siouxland Paramedics was conceived in 1982. In 2000, the City of Sioux City and North Sioux City's EMS District entered agreements to provide financial support for emergency medical ambulance services to Siouxland Paramedics. Sioux City currently owns Siouxland Paramedics' ambulances, Everett said. 

To figure out the best move, Siouxland Paramedics has been in discussion with Sioux City Council members, the city manager and Sioux City Fire Rescue about the transition. Everett said the city will continue looking into its options and could have information before the City Council within a few weeks. 

He said the longstanding partnership between Siouxland Paramedics and Sioux City Fire Rescue has worked well over the years, and his goal is to keep the current level of ambulance service intact. 

"The high-quality customer care system itself is good now, and we want to maintain that," he said. "With that in mind, we're looking at those options."

Sioux City Fire Rescue provides paramedic-level first response emergency medical service with 32 paramedics, 24 advanced emergency medical technicians (EMTs), 54 EMTs, 113 total employees and seven fire stations. It is accredited by the Commission on Fire Accreditation International and is a Class 1 Insurance Services Organization department. 

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