AMBULANCE SERVICE

First automotive ambulance (1916). Telegraph Herald, June 28, 1936. Image courtesy: Diane Harris

AMBULANCE SERVICE. The first ambulance in the city of Dubuque was a horse-drawn vehicle donated to FINLEY HOSPITAL (THE) by Fannie STOUT. The problem with it was that customers had to hire horses from the Nutwood livery stable, owned by the Stouts. (1)

In 1910 a call from a person in authority had to be made before an ambulance was sent. This led to long waits for the injured and the belief that an ambulance should be sent just as though it was owned by the city. In place of this suggestion, the decision was reached to write a contract between the owners of the ambulance and the City. According to the contract, a fee of $2.00 would be accessed for an ambulance with an extra fifty-cents if an additional man were needed. (2)

In 1916 the city decided to buy its own rig after a man whose legs had been run over by a train had to wait a long time waiting for service. According to the story, the ambulance driver wanted his cash first before starting out. (3)

The first ambulance driver was responsible twenty-four hours daily and three hundred sixty-five days annually. He ate and slept at the 9th Street firehouse, so his supervising offer changed from the chief of police to the fire chief. Although some of the undertakers and hospitals operated their own ambulances, the city responded to ninety-six percent of the cases. The job quickly developed into a two-man operation. (4) In 1954 the two men--Howard Lent and Cyril Behr--had held their jobs of nine and eleven years respectively. (5)

In 1954 the 1951 vehicle used was considered a great improvement. The back area could carry three persons lying flat on the roller stretcher and two portable cots. The new two-way radio meant that emergency calls could be received while attending another accident. In the past, such calls to the firehouse had to wait until the ambulance returned. The per capita cost for twenty-four hour service in 1954 was eight cents annually. (6)

In 1960 Dubuque was the only city in Iowa of its size with a city owned and operated ambulance service. Ambulance service cost the city $10,943.44 with income from call charges being $6,927. (7) People needing an ambulance from any point to a doctor or hospital paid $8.00 with the same charge being made to return the person to their home. Calls outside the city (limited to the county in Iowa) were $15.00 plus twenty-five cents per mile outside the city limits. In addition there was a delay charge of $10.00 per hour or any part thereof for delays over ten minutes not caused by the ambulance driver. (8) Contracts had been signed to provide ambulance service in Jo Daviess County and East Dubuque. The only free ambulance service was given to Dubuque city employees injured on the job. If the call was not an emergency, the driver could collect charges in advance. In emergencies, the person was billed later. (9) Ambulance service was financed from the Public Safety fund. The budget item was expected to rise in 1960 because the city had just received a new ambulance costing $7,529. The old ambulance had been retired after nine years and 75,000. (10) The same drivers were still working.

In 1960 if a second call came in when the ambulance was on an assignment, the call would be responded to with the city police station wagon equipped with an ambulance stretcher. In 1959 the ambulance made 1,304 calls with most requiring the transfer of patients to and from hospitals. (11)

The City of Dubuque received a new ambulance in January, 1970 as a gift from the William S. Sheppley Foundation. The new vehicle could carry one patient and two attendants in the back and was air-conditioned. It also had an outlet for oxygen resuscitation and the capacity to carry at least twice as much oxygen as the older vehicle which became a backup. (12) A new city ordinance provided that when a second ambulance request was received it would be answered by Dubuque firemen in the second ambulance. The second call, however, would only be responded to if it came from within the City of Dubuque. (13)

In March, 1970 the operators of all Dubuque funeral homes announced the end of their own local ambulance service. They cited increased state and federal requirements as reasons why the service was no longer financially possible. In cases where patients had to be transported to out-of-town medical facilities, several of the funeral homes would continue to provide service allowing the city to maintain two ambulances locally. (14)

In 1980 Chuck Uskavitch, Ted Pfiffner, and Scott Neyens, all Asbury volunteer ambulance attendants, decided to file a license application to create a transfer service with the City of Dubuque under provisions of a 1974 ordinance permitting private ambulance services. Dubuque Medical Transport would transport patients from nursing homes to hospitals and back for a fee, but would not handle any emergency cases. The private service would cost $10 more than the current $35 per trip, but less than new rates suggested by a city task force that had investigated restructuring city ambulance service for the previous nine months. The rate suggested by the task force would have been $63 per transfer. (15)

Although it was filed, the application was not processed. Court records indicated that the city manager indicated to the city clerk that processing should be delayed despite the ordinance's thirty-day time requirement. (15) The manager took the issue to the city council. In February and March the city defended its right to the ambulance monopoly arguing that only such an arrangement would protect the service. The city also contended that if it lost the transfer of non-emergency patients it would be losing the most profitable part of the business. (16)

Attorneys for the applicants stated that ambulance services were either emergency or non-emergency. Emergency service, like police protection, was an obligation of the city. The non-emergency services were economic. Denying the application, they claimed, was unlawful. The city "had a right to regulate but not to prohibit." (17)

In April 1980 the case was taken to district court. Days later the council amended its ambulance ordinance to state that it did not have to issue a license to a private ambulance operator if the city was already in the business. (18)

In May 1980 the council again refused to issue a license. The three men also amended their original lawsuit to charge that the city had illegally established a monopoly when it amended its ambulance lawsuit to ban competition. (19)

In 1981 the Dubuque County district court ruled that the city had acted improperly under its own ordinance by not issuing a license. The court, however, did not outlaw the new ambulance ordinance. This meant that a license could be issued, but once the three-years expired it could be turned down for renewal. (20)

The district court ruling was appealed by the partnership which proposed to establish Dubuque Medical Transport in June 1981. Shortly thereafter, the United States Supreme Court ruled that cities could be sued under antitrust laws for displacing private business with public monopolies. In November 1982, citing the U. S. Supreme Court decision, the Iowa Supreme Court ruled in favor of the partnership against the city. (21)

In Dubuque, a new ordinance was proposed calling on any ambulance service to respond to all calls--emergency and non-emergency--at all times. Dubuque Medical Transport was only interested in transfer calls during the day. The ordinance was never passed. Attorneys for the partners called the Iowa Attorney General to complain about "city harassment." The Iowa Attorney General called the city with a stern warning. (22)

By July 1983, Pfiffner, the only remaining partner after 1983, was in business. The Dubuque County district court awarded him $75,000 in actual damages and an equal amount in exemplary damages saying that the council and city manager had "flagrantly" violated state law. The court also awarded $102,000 in attorney fees. By the time the debt was paid in April 1986 interest equaling $150,000 had been added making the final amount nearly $400,000. (23) It was expected that the judgment, the largest the city ever lost, would result in a 3% rise in Dubuque property taxes. (24)

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Source:

1. Stevens, Dave. "City Ambulance Costs Only 8 Cents a Year," Telegraph Herald, August 29, 1954

2. "City Fathers' Action Approved," Telegraph Herald, March 5, 1910, p. 3

3. Stevens, Dave.

4. Ibid.

5. Ibid.

6. Ibid.

7. "City Ambulance Service Unique in Iowa," Telegraph Herald, June 26, 1960

8. Ibid.

9. Ibid.

10. Ibid.

11. Ibid.

12. "A Gift for Dubuquers: A Brand New Ambulance," January 30, 1970, p. 15

13. Ibid.

14. "Funeral Homes Ending City Ambulance Service," Telegraph Herald, March 4, 1970, p. 6

15. "Private Firm Seeks Ambulance License," Telegraph Herald, January 3, 1980, p. 8. Online: http://news.google.com/newspapers?nid=aEyKTaVlRPYC&dat=19800103&printsec=frontpage&hl=en

16. Kraske, Steve. "A Costly Irony," Telegraph Herald, March 23, 1986, p. 1

17. Ibid.

18. Ibid., p. 6

19. Ibid.

20. Ibid.

21. Ibid.

22. Ibid.

23. Ibid.

24. Kraske, Steve. "Ambulance Decision Revisited," Telegraph Herald, Feb. 25, 1986, p. 1