Flandreau Council votes to seek extended deadline for ambulance plan

The future of the Moody County Ambulance service remains unclear.
This past week, the Flandreau City Council voted to request an extended deadline from the County Commission to present a comprehensive financial and operational plan for the service.
The Flandreau City Council made a motion to charge the City Administrator with constructing a full ambulance model to present to the City prior to June 1, 2025. The ambulance model should include a complete budget, organizational structure, capital improvement plan, a fee schedule, and all information pertinent to operating a sustainable ambulance service.
Earlier this month, a newly formed Ambulance Task Force recommended that the City take over operations after the county offered all its assets for the service.
The offer follows a series of frustrating meetings in 2023, where the county requested a stipend from the City to support ongoing county services. The ambulance service, largely due to inadequate reimbursement for calls, typically operates at a loss of around $70,000 per year.
To date, the county has not received a stipend for the unmandated service from the City of Flandreau, its largest user. The Flandreau Santee Sioux Tribe has contributed an average of $10,000 per fiscal year to support the countys ongoing services and has recently offered additional support. Avera Hospital has also expressed plans to explore further support for the service, including staffing.
No other communities in Moody County have been asked to support the ambulance service based on the number of calls crews respond to, on average.
On Thursday, the county approved the Citys request for a deferred final response. The City has pledged to provide its final decision on acquiring the ambulance service and extending coverage to the county no later than June 1.
In the meantime, county officials have been presented with the possibility of moving ambulance services to Egan, should the county continue providing them. Egan city officials reached out to the county to explore potential support options, particularly in light of the challenging and inadequate facilities currently available to house ambulance staff and equipment.
A major hurdle in recruiting qualified professionals has been the lack of appropriate accommodations. The ambulance bay currently lacks a full kitchen, along with other much-needed amenities.
Egan is tentatively offering its city building, which includes a large garage, to house the ambulance team. Additionally, Egan is exploring ways to provide better temporary housing for staff.
The issues the county is facing, and in turn, each of the communities, are not unique. Rural EMS agencies across the country are grappling with similar difficulties.
A 2021 report by the National Rural Health Association notes that, challenges in providing EMS in rural areas are directly linked to issues involving reimbursement, financial capital, workforce supply, and training standards.
The financial strain is only compounded by low reimbursement rates and high operational costs. The situation has left countless rural (and urban) EMS agencies at risk of not being able to cover their operating costs.
As as result, another option encouraged by at least one Flandreau City Council member, is the creation of an ambulance district. Under state statute, an ambulance district could be established for all of Moody County, where all property owners would fund the service through taxes, a mill levy, service fees, grants, and possibly fundraising efforts. The funding would be specifically allocated to the ambulance service, with the goal of spreading the cost equally across all users.
While county officials view the creation of an ambulance district as a less viable option, the process could take years, even if voters approve it.
City officials, however, are considering the district idea strongly, as it would relieve any single entity from shouldering the full responsibility of providing services or absorbing potential losses.
Ambulance districts were created to help rural communities establish sustainable services.
Plans are underway for Turnquist to meet with county leaders, ambulance staff, and other communities facing similar challenges, and to explore possible models in the coming weeks and months.
Regardless of the delayed decision, city officials have consistently stated their intention to take over the service.