Altenburg’s ax-grinding

“Creating quite a bit of conflict without stating all the facts.”
That was the Emergency Medical Services Regulatory Board’s take, issued in an official report last summer, on the “reporting” by Steve Altenburg in the Tower News. Altenburg, the former director of the Tower ambulance service has used that newspaper for more than two years now to settle old scores in the wake of his dismissal from city employment.
He was at it again, last week, with a rant that stirred up conflict, while leaving out a number of facts. First, we certainly don’t deny that the Tower Area Ambulance Service is struggling financially. We had predicted that the service would face significant financial challenges as a result of a poorly implemented transition to a paid on-call system under Mr. Altenburg’s tenure as supervisor, and that prediction has borne out over time.
Mr. Altenburg, as evidenced by his latest screed, is hoping to place the blame for the service’s troubles at the feet of his successor, rather than accept any responsibility himself. But as last year’s EMSRB’s financial consultant pointed out, it was Mr. Altenburg’s sloppy financial work, adopted by the former city council with virtually no due diligence, that laid the foundation for the current troubles.
At the time, Mr. Altenburg presented the council with financial projections which left out a large number of known expenses, while exaggerating the potential profit from inter-hospital transfers, which he told the council at the time would more than pay for the cost of the switch to a paid on-call model. He later told this newspaper that the service could average $1,000 in profit from such transfers. The EMSRB’s financial consultant pegged those profits at less than $500 per transfer. Since then, the city council has undertaken its own analysis, which concluded similarly to the EMSRB’s findings, and found that shorter transfers tend to be more profitable, while many long transfers actually lose money. That’s the kind of analysis the former city council should have undertaken before it saddled the city with Mr. Altenburg’s costly paid on-call system.
The problem the service now faces is that it is continuing to operate within the same parameters established by Mr. Altenburg, while simultaneously trying to comply with state law. The EMSRB had noted that the service was not in compliance with state law, which requires that all ambulance services maintain a roster of on-call personnel, seven days a week, 24 hours a day. Under Mr. Altenburg, the service was unable to consistently staff that roster more than 40-50 percent of the time. Yet, he has the audacity to criticize the current director for not maintaining a sufficient number of EMTs. He failed to state that the service’s on-call roster is now staffed upwards of 90-95 percent of the time.
This is the foundational issue that Mr. Altenburg avoids mentioning. The only way his paid on-call structure could survive financially was if it was only partially staffed. Once the EMSRB noted that the service was violating state law and the council directed the current ambulance supervisor to bring the service into compliance, the financial burden of the system and pay structure that Altenburg created became unavoidable. The EMSRB had predicted this would happen, which is why it recommended that the city reduce its on-call pay to keep the costs from spiraling out of control. The council has failed to adopt this recommendation, in part because they appear to recognize that it’s hard to reduce pay without impacting morale. It’s just another Altenburg land mine.
Mr. Altenburg claims that the finances can be fixed if only the service undertakes more transfers, but he’s relying on the same fuzzy math as before. While the service could generate more revenue, transfers don’t generate much operational cash flow (which is what the service needs) once the $1.66 per mile allocation to the ambulance replacement account is included in the calculation.
While the EMSRB recommended scrapping that payment, that would require approval from area townships, which is unlikely. In any case, the allocation effectively substituted for another major expense that Mr. Altenburg never calculated, which was the depreciation on ambulances for all those miles driven on transfers. Factor in depreciation, and transfer profits largely vanish.
The real question isn’t why Mr. Altenburg is so fixated on settling scores by stirring up conflict without providing all the facts, as the EMSRB noted. He can’t help himself. What is most troubling is the continued willingness of a newspaper editor and publisher to give Mr. Altenburg free rein to undertake his divisive and destructive ax-grinding, purportedly as “news” rather than the twisted opinion that it is.