KANSAS CITY, KS — A new era in ambulance service in Wyandotte County began in July, according to the Kansas City Star newspaper. At noon on July 1, the Kansas City, Kan., Fire Department took over the ambulance service for the city and Edwardsville, a service that had been provided by Metropolitan Ambulance Services Trust (MAST) since the mid-1990s. Just a minute into the new order, the first unit was dispatched. “We had a quality service before today, and we will continue to have a quality service in the future,” Fire Chief Thomas DeKeyser said. “This just makes it much more, in my opinion, reliable. It is in the control of the Unified Government. It is a taxpayer-funded service at this point, so there is some direct accountability through our mayor, through our commission, to their constituents, the citizens.” The Unified Government decided to make the switch in December, concluding that it would be required to pay more than $2.5 million for MAST services. MAST, which is struggling financially, claimed that the actual cost would have been about $1.8 million. Either way, those figures are higher than the $1 million to $1.5 million the Fire Department estimates the service will cost the city. In June, voters approved a quarter-cent sales tax to cover the deficit, despite protests from some quarters that the Unified Government had failed to fully explain how the new ambulance service would run. For MAST, the loss of Kansas City, Kan., and Edwardsville means it will no longer have the expenses associated with serving a market with a large number of uninsured patients. It also means MAST will downsize about 20 percent of its work force through attrition, said assistant director Jason White. Kansas City, Kan., and Edwardsville represented about 18 percent of the MAST market. About 10 former trust employees have since signed on with the Unified Government, White added. “We're extremely confident we're going to be able to downsize without any layoffs,” he said. DeKeyser said every effort has been made to provide the same level of service, if not higher, that was offered by MAST. He said he wants to make the switchover as invisible to patients as possible. “The most notable difference, I believe, will be the fact that our ambulances will be red with a white stripe, rather than white with a red stripe,” DeKeyser said. The Unified Government has spent $2.4 million to purchase 11 new ambulances and hire 60 new firefighters/emergency medical technicians and supervisors to operate the new service. The department will have six ambulances staffed 24 hours a day, seven days a week. Two more will operate during the daylight hours, primarily transporting patients on non-emergency runs. However, if needed for an emergency, a paramedic from a fire truck will ride from the scene to the hospital on those ambulances. The three remaining ambulances will be held in reserve, but will be cross-staffed with fire crews so that if they are needed, the staff will move from the fire trucks to the ambulances. Kansas City, Kan., will continue to use fire trucks as first responders. “The first response is critical to patient care,” DeKeyser said. “The earlier the intervention, the more successful the outcome.” Fire officials said that under the city's fire service, the department has been able to average less than a 4-minute response time to get a paramedic into the homes of patients or to accident scenes. “Even if we staffed all 11 ambulances 24-7, it is not the equivalent of the 18 fire stations that we have,” DeKeyser said. “You get better coverage and response by using the fire apparatus.” The ambulances will have a minimum of two emergency medical technicians. David Shost, the medical transport director, said the department's goal is to have an ambulance at the scene in the same time that MAST did, which is less than 10 minutes for life-threatening emergencies and less than 13 minutes for non-life-threatening emergencies. The performance standard is to meet those response times at least 90 percent of the time. DeKeyser said he expects it will cost $4.5 million to $5 million to operate the ambulance service. The department anticipates revenues of $3 million to $3.5 million from private payers, insurance, and Medicare and Medicaid reimbursements. The balance would be covered by the tax passed last month. The department has estimated the average ambulance bill at $460, including mileage and supplies. The highest bill is expected not to exceed $700. Under MAST, the emergency base rate for ambulance service was $615, which did not include medical supplies or mileage. Despite the lower costs, DeKeyser said he still expects that as many as 50 percent of those using the service will not be able to pay.