By Carleen Wild
Moody County Enterprise

A vote by the Flandreau City Council this week will determine the future of Moody County’s ambulance service — an issue that’s been quietly but intensely debated behind the scenes for months.
Earlier this year, the county offered the city the chance to take over the long-running service after ongoing frustrations over funding. The Flandreau Santee Sioux Tribe has contributed a $10,000 annual stipend for several years. The city has not. With the county-run service operating at a loss, as is common with rural EMS across the country, officials said they could no longer shoulder the cost alone.

What’s now on the table is a proposal for the city to take over and operate a 24/7 emergency medical service for all Moody County residents. The model, presented by City Administrator Cohl Turnquist during a special meeting last week, suggests the creation of a hybrid ALS/BLS department within the city’s General Fund. It would operate with four full-time paramedics, two ambulances, and a pool of part-time volunteers.
The plan comes after months of work by Turnquist, Finance Officer Lori Kneebone, city staff, and an appointed task force. They’ve been working alongside Faber Analytics, a consultant group brought in through a state grant. Their data shows Moody County averages roughly 800 calls a year — a high number for a rural South Dakota department but not surprising given Flandreau is home to a hospital, nursing home, and senior living center. More than a third of calls are for patients over the age of 70.
Most calls come between 9 a.m. and 10 p.m. and are typically for falls, traffic accidents, or respiratory distress. Consultants found the system to be running well, with crews out the door in under three minutes, five-minute average drive times in town, and just 15 minutes in outlying areas. There were no identified coverage gaps, and documentation standards far exceeded state requirements.
To better align with other EMS systems statewide, the model would increase service fees in an attempt to recoup more of the cost — a challenge across the board due to low reimbursements and unpaid bills.
By the time this issue reaches readers, the council will have voted. What happens next will depend on that decision—and how the county chooses to respond.
The full proposal is available at cityofflandreau.com under City Government > Council Meetings.