The Tower City Council, on Monday, had little choice but to discharge Steve Altenburg from his duties as fire chief and ambulance director for the city. While Mr. Altenburg has been an asset to the community as an EMT and firefighter over the years, he, unfortunately, lacked the temperament and the organizational skills to serve as an effective leader of either of the city’s emergency services.
That mismatch, particularly when it came to the Tower Area Ambulance Service, has been the focus of our reporting in recent years. While Mr. Altenburg portrayed our reporting as an attack on the TAAS itself, we focused our actual attention solely on Mr. Altenburg’s decision-making and struggles to manage the finances of the service. The concerns we raised were widely shared among city and township officials, most of whom had lost confidence in Mr. Altenburg in recent months. They were also confirmed by the investigation of Mr. Altenburg, which we report on this week.
It wasn’t so much Mr. Altenburg’s failing as it was the fault of the previous city council, which chose to elevate him to these positions of leadership. It was a misjudgment which negatively impacted the TAAS.
Given the current council’s decision, it’s now best to turn our attention to the future of the ambulance service. What Mr. Altenburg seemed unwilling to acknowledge was clear to many— the shift to a 24-hour paid on-call service has been a huge financial burden. The TAAS, which regularly posted $100,000 operating margins before implementation of the paid on-call program, has struggled to break even since. A major change is desperately needed to ensure that TAAS survives.
The city council plans to review the paid on-call program— which is certainly appropriate given the impact it has had on both TAAS’s profitability and morale. While some paid on-call staffing may be warranted at times, the TAAS should consider models used in other small, neighboring communities, like Cook and Orr, where paid-per-call staff who already live in town or within minutes of town, are offered hours during peak times and are paid much more modest wages for agreeing to be available, if needed, during those hours.
The TAAS also needs to immediately discontinue allowing paid on-call staff to rack up huge amounts of overtime. As recently as February, one of the paid on-call staff was allowed to work a 90-hour shift, which means 50 hours of accrued overtime. The fact that the city hasn’t been paying the required overtime is no excuse to continue this practice. For the city, it’s a financial ticking time bomb, as we’ve repeatedly warned in the past. The council should act on this issue as soon as possible.
The TAAS also needs to refocus on its core mission— emergency calls. Non-emergency inter-hospital transfers may appear to be lucrative at first glance, since they pay considerably more than emergency transports. Yet these transfers typically involve putting many more miles on costly ambulances, longer hours for staff, and time when key personnel and equipment are outside the service area. When all those costs are factored in, it’s not clear that transfers are all that profitable or beneficial for TAAS. And it was never realistic to triple the TAAS payroll, as Mr. Altenburg did, believing that profits from transfers would pay for it all.
In the end, it was a breakdown in confidence that ultimately forced the city to act. The TAAS needs the contributions that the townships provide to the ambulance replacement fund. When area townships began asking questions and pressed for more financial information and business planning, Mr. Altenburg was unable to respond in a forthcoming manner. By all accounts he’s a good EMT, but those skills don’t necessarily make one qualified or appropriate to provide the administrative and personnel leadership that TAAS requires.
The TAAS has done well under prior leaders. There’s no reason it can’t rebuild and emerge stronger in the future under new leadership. That’s certainly our hope moving forward.