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Beginning Jan. 1, the town of Summerset will need to contract with a new ambulance service after receiving notice recently that the Piedmont Ambulance District will no longer serve the community for no charge.

On Sept. 26, the tax district board overseeing Piedmont Ambulance voted to discontinue the life-saving service for the 13-year-old community of around 2,400 residents near Rapid City.

David Weeks, president of the Piedmont Ambulance District, sent a letter last week that informed Summerset the service will end Jan. 1.

"Years back I briefed the Meade County commissioners and one commissioner told me he threw us (Piedmont ambulance) a bone by giving us this response area (Summerset). Well now I'm tired of dragging this bone. I want to cut it loose, because this bone has been growing."

Nearly two years ago, Summerset residents voted down joining the taxing district that provides for over half the operational costs for Piedmont's two ambulances and staff, which receives a small stipend. Piedmont pays $41,000 a quarter and costs are rising. But Summerset residents south of Interstate 90 are not contributing to the ambulance service, Weeks said, leaving the cost mostly to residents in and around Piedmont. 

Last month, the Piedmont Ambulance District formally decided it would no longer pick up the tab for another town's ambulance bill, which led to Weeks delivering the news to Summerset.

"We just wanted to get out ahead and tell people what is happening," he said. "We don't want to be the bad guy in this." 

An official with the city of Summerset declined to comment, but officials with the Rapid City Fire Department said Tuesday they were meeting with the mayor of Summerset, George Mandas.

Finding a new ambulance provider — and one that wouldn't ask them to be in a taxing district — is something the mayor promised in 2016 when voters went to the ballot box to decide whether to allow the expansion of the Piedmont ambulance's taxing district to portions of southern Summerset.

Prior to the election in a letter sent to city residents and obtained by the Journal, Mandas urged a "no" vote, anticipating the 27 cents per thousand dollar property tax levied on residents in Sun Valley would translate to an annual $50 increase in property taxes on a $200,000 home. He argued for any increased cost the city should opt to hire "full-time paid service professionals," such as those maintained by Rapid City Fire Department Ambulance.

"Piedmont Ambulance is licensed to provide Basic Life Support," Mandas wrote in the 2016 letter. "The ambulance service is staffed by volunteer EMTs with a few Paramedics that work on the ambulance but the ambulance is not licensed to provide Advanced Life support." Whereas BLS support entails stabilizing a patient, an ALS-certified ambulance crew can initiate emergency medication and administer IVs.

While the Rapid City Fire Department Ambulance, which serves an area stretching from the Wyoming border to the Badlands, takes advantage of economies of scale and does not charge residents any additional property taxes, Piedmont does. To support the rural ambulance service, Piedmont ambulance's tax board increased property taxes last year. Weeks said his property taxes nearly tripled.

It's a price worth paying, he said.

"If we fold or go under that means Sturigs or Rapid will have to respond to this area," he said. "I would think that people in Rapid would ask, 'Why should I pay my city taxes for someone who lives in Black Hawk or Rapid Valley and only has to pay the county taxes?' "  

Piedmont Ambulance owns two ambulances and it pays the fire hall in Piedmont to house them. Weeks said the board also makes payments to the bank on one of the ambulances — which cost $148,000 unfurnished. After adding iPads, new defibrillators and a power-lifter, the costs increase.

"People are getting heavier," Weeks said. "So we can't just use two people to safely lift them into the ambulance anymore."

Rapid City Fire Department Chief Rod Seals said that separate meetings took place Tuesday with Mayor Mandas and Piedmont ambulance. Seals discussed what a relationship with Summerset might look like between the two communities.

"We wouldn't form a (tax) district, but there might a flat rate up front, which would come out of their general fund," Seals said. "That's taxpayer money to secure us and help us offset costs."

Seals said the Rapid City Fire Department already contracts with Piedmont Ambulance to serve Summerset for ALS response calls. He also added that when no tax district exists, ambulances pay for their services through medical insurance or what Seals called a "pay-as-you-go" model. Larger ambulance services and private providers with higher call volume can, in a sense, self-fund, he said. Seals said Rapid City currently assesses a flat fee to Custer County to partially cover ambulance runs down around Hermosa.  

"We'll have a better idea what's going to happen in Summerset in the next 30 days," he said.

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