The city of Mauston will be paying a significantly larger contribution to the ambulance association for 2018 and 2019. For 2018, “it’s going to go up by about $43,000,” said Mauston city administrator Nathan Thiel. The city will be paying $136,302 for 2018, a 49.66 percent increase from the $91,074 paid in 2017. The cost will continue to rise in 2019, to $168,080, a 23.31 percent increase from 2018 and an 84.55 percent increase from 2017.

The updated ambulance contribution was the largest budget item change discussed at the common council meeting on Oct. 24.

“The (municipalities) were wanting to change the calculation. So the total ambulance charge, wasn’t changing, but the (municipalities) wanted to change how the distribution and calculation went,” Thiel said.

The total cost of the ambulance service will remain the same at $464,818.

“We have explored lots of avenues as far as trying to be fiscally responsible with the way we run the organization, and I think we’re being true to that,” said Mauston area ambulance operations supervisor and paramedic Michael Peterson. There are no anticipated changes to the overall cost for the ambulance service for 2018 or 2019.

However, the change by other municipalities to how contribution is calculated will result in Mauston paying significantly more for the ambulance service, and several other municipalities paying less. The number of municipalities paying less will increase in 2019. Mauston is part of an ambulance association that also provides services to Lyndon Station, Germantown, Kildare, Lemonweir, Lindina, Lisbon, Marion, Seven Mile Creek, and Summit.

Thiel said the city did not anticipate a change in what they would be asked to contribute for the ambulance service, and noted that the other townships had recently voted to reduce Mauston’s voting power on the matter, shaving the city’s previous four votes down to two.

“We didn’t have a lot of control in this increase,” Thiel said.

Mauston has the highest population of the townships in the ambulance association at 4,499. The next highest is Lemonweir at 1,759. Both towns have two votes.

Originally, the calculation for cost was based on the assessed value of properties within each area. Germantown has a higher assessed value than Mauston.

“Because of that, they were paying a greater share of the cost for the ambulance,” Thiel said.

“I think it’s a more justifiable, more equitable division. Considering, especially the number of calls to the different municipalities,” said Germantown supervisor Ray Feldman, on the new changes to the contribution calculation.

The new formula is based on cap calculation and assessment, which will significantly increase Mauston’s share of monetary contribution to the program. Mauston will replace Germantown as the largest contributor to the program in 2018.

One proposal for recalculating contributions was to base it off of the percentage of calls made to each township. This was ultimately decided against, but if it had been enacted, Mauston would pay $231,637, a 154.33 percent increase from $91,014 in 2017.

Mauston accounts for about 50 percent of the calls made to the ambulance service. Germantown is the next highest at 13 percent. When measuring rate of use per 100 in population however, the difference between Mauston and the other townships is notably smaller. Mauston uses the ambulance service at a rate of 10 calls per 100 people, while Kildare and Lisbon are the next highest at about eight calls per 100 people. Germantown and Lyndon Station come in at about seven calls per 100 people. Summit has the lightest rate of usage at two calls per 100 people.

“I think it’s getting closer to equitable distribution. Maybe we (could) even have to have a provision in the contract where the association could look back at the end of the year and see where and if there was a dramatic increase in any particular location, that that municipality should be responsible for,” Feldman said.

Feldman also observed that Germantown’s population can fluctuate throughout the year, which can make it hard to calculate what its contribution to the ambulance service should be. “To be fair, we have the Buckhorn State Park in our (town) and the Juneau County Park which has a disproportionate number of out of area visitors that the other townships, like Lemonweir, don’t have at all,” Feldman said.

There is also a significant proportion of Germantown residents that only stay there for part of the year.

“We probably go from an average of 1,600 when the school season starts… and then all of a sudden (in spring) it can balloon,” Feldman said.

Thiel noted that Mauston’s close proximity to the ambulance station makes its calls on the service less expensive. “We don’t travel as far,” Thiel said.

Had Mauston anticipated the increase in cost for the ambulance service, it may have fought to lower the overall cost of $464,818. One way to do that would be to have solely EMTs rather than more expensive paramedics.

“To be honest, Mauston’s need for paramedic services is a lot less than a township, because (of) the distance. If you get out far away from the hospital the (need) to get them some immediate ER needs is much greater,” Thiel said.

“I think that the patient benefit is there, regardless of where the location is,” Petersen said on having paramedic services. Petersen said that, in the case of an emergency, “You’re going to want that for your child whether you live in the city here, or you live out (there).”

Mauston did not argue to forego paramedics, but had it known that it would be paying more for the ambulance service, that may not have been the case.

“The big push for paramedics came from Germantown,” Thiel said.

Petersen says the ambulance service has been transitioning towards a career-oriented rather than paid-on-call department. This transition was to help enable a higher level of medical service and employ more paramedics over time, rather than solely EMTs.

“We’re nearing to completion of this swing to make this a career-oriented department,” Petersen said.

Thiel anticipates that this cost increase for the city will have to be accounted for by making changes to city fees.

“One of the concerns that we have is that with these increases in prices on the expenditure side, we qualify for next year for the expenditure restraint program because we kept our expenditures under a certain threshold. Well, with the ambulance association and the increase in cost to the city, it’s going to push us above the threshold, so we won’t qualify for it in 2019. And so the question is how do we combat that?” Thiel said.

For now, the plan is to increase the hydrant rental fee in Mauston. The water utility bill service charge currently pays for Mauston’s contribution to the ambulance service. In 2017, the hydrant rental fee was $3.58. It is currently planned to increase by 46.64 percent to $5.25 in 2018, and increase again by 24.38 percent to $6.53 in 2019, an overall increase of 82.4 percent from 2017.

You can reach Jake Ekdahl on Twitter @JakeaEkdahl