City Council talks smart meters and ambulance subscription

Two major items were tackled at Thursday night’s meeting of the Blackwell City Council where the City Hall building was a full-house of concerned citizens and employees of Stillwater Medical- Blackwell in attendance to voice their concerns over the topic of Blackwell’s new automated meters and a proposed ambulance subscription service. 

The meeting, nearly 2 hours long, had city leaders engaging in conversation with each other as well as with the parties who spoke to their respective causes. 

The first major item was an ambulance subscription service, Ordinance 2025-03. 

The proposed ordinance introduces a mandatory ambulance subscription program requiring all electric utility customers to pay a $5.00 monthly fee to support Blackwell Fire/EMS ambulance operations. This is expected to generate $190,000 annually and potentially fund up to three additional EMS employees to improve response times.

Subscribers will receive emergency and medically necessary ambulance services at no additional cost, with insurance billed and deductibles waived. For uninsured individuals, services will still be provided at no charge. The subscription applies to all residents of a household. Transfer ambulance services, such as transport to or from medical facilities for non-emergency reasons, are not included in the subscription and will incur separate charges.

Service availability will depend on the resources and personnel of the Blackwell Fire/EMS. The City will not reimburse or cover costs for ambulance services provided by other emergency medical services outside of the subscription program.

City Attorney Bryce Kennedy summarized the ordinance stating that the purpose of this ordinance is to generate additional revenue for the Emergency Medical Services (EMS) to improve service quality, primarily by hiring more personnel and acquiring better equipment. 

A secondary benefit is offering no-charge ambulance services for emergencies and medically necessary situations to households paying the mandatory $5 monthly subscription fee (added to their electric bill).

The cost is per household, not per individual, Kennedy noted.

The fee covers both life-threatening and non-life-threatening emergencies but excludes transfer services, which are limited cases.

Landlords or facilities with shared utilities (like nursing homes) have specific subscription rules, and non-electric customers can opt-in for $60 annually.

Revenue from the program will enhance EMS operations, response times, and service capacity.

Ultimately, the goal is to increase EMS resources and efficiency for the community.

Fire Chief Cory Hanebrink then addressed the Council: 

“Our ambulance district is 260 square miles,” Hanebrink said,”And we have to maintain full personnel in town for our emergency calls. If we have a car wreck on the interstate you've got one guy driving an engine to get the rescue tools out to the accident, and you've got one guy driving the ambulance. And then if they transport that patient, now we've got equipment left on the interstate that needs to be moved off once the accident's gone,  So the purpose of this is to hopefully generate enough funding to hire extra personnel so we can move to six men on shift at all times.”

“That way, if we do have a transfer, we could act on that transfer immediately instead of having to try to call personnel back in. Years ago, all the firemen lived within 25 miles of the city limits of Blackwell. We now have only got three guys that live within 25 miles of the city of Blackwell.”

Hanebrink continued: 

“With this, we would theoretically have four personnel in town to supply service to our citizens and respond to any emergency that's needed.”

The add-on ambulance fee would generate an estimated $165,000 if everyone in town participated, Hanebrink estimated, based on the 2,700 residential meters in town.

This fee would apply to residential meters only, noted Hanebrink. 

“It would be just a single-point electric meter on each residence,” He stated. 

BPD currently has four paramedics, seven advanced EMTs,s and six basic EMTs.

“The biggest issue is if we were to have a structure fire and only had two guys on duty- and if it's an unfortunate situation where somebody was in the house- we would not have the appropriate personnel to safely try to make it in and save a life,” Hanebrink said. 

From 2013, BFD had under 1,000 runs- Ambulance runs, and fire runs, altogether. in 2024 BFD had just shy of 2,000. 

The subscription would apply to whomever lives at the listed address. It doesn't matter where the emergency happens if they have an address in Blackwell and the resident pay the subscription, they're covered. 

The person will be taken most appropriate facility for their emergency- Stillwater, Wichita, etc. 

Tammy Parr then addressed the Council on the issue, raising questions of her own regarding what constitutes as “medically necessary” transfers, when the ordinance would go in effect and when the results from the ordinance could be seen. 
Hanebrink clarified that “medically necessary” is determined by the medical doctor who is overseeing the patient from the hospital. If BFD is on the scene of an accident and the patient wants to go to the hospital to be checked out, that's medically necessary.

Dr. Jeffrey Shuart then spoke to the Council regarding the ordinance.

“I think this is a long time coming,” stated Shuart. 

“The whole basis of what I'm concerned about is the people I see. The patients I have to take care of. Medicine has gotten to be insane. I mean, it has changed drastically. The way we take care of people has changed drastically,” Shuart lamented. 

“There was a time when we did everything here. We did surgery. I delivered babies. We did scopes. We did every service that we possibly could. And so the amount of transfers was very small,” He continued. 

“As things have changed and evolved, that has changed drastically. It became even more acute when we became a Rural Emergency Hospital because there is a significant number of patients that need to be hospitalized and we have a hospital here but we don't have a lot of patients. We put them in for a 24-hour observation.”

“I can do a lot of things in 24 hours. Dr. Allen also puts patients in- We can do a lot in 24 hours. But right now the government has tied our hands and says you've got 24 hours. If they gave us 48 hours, 72 hours, we could do a lot more.”

“But that's not the environment we've been given. So now we have a lot of patients that have to be routinely transferred for what isn't necessarily an emergent situation. They come in, they've got pneumonia, they need to be in the hospital. It's an emergent situation for that patient. It's something that we can take care of here but we don't have the capability. So they have to go to the city, to Stillwater, to Enid, to Oklahoma City, to Wichita, somewhere that they can be cared for,” Dr. Shuart continued.

“That makes the burden on the hospital dramatically greater. It makes the burden on the ambulance service greater. And so now we have this situation where we're becoming adversarial. And that is not functional for us all.”

Dr. Shuart emphasized the urgent need for enhanced ambulance services and advocated for expanding a proposed subscription model to include commercial customers to generate additional revenue. 

Shuart stated that as medicine has drastically evolved, rural hospitals now face significant constraints, including limited capabilities for inpatient care due to regulatory restrictions (e.g., 24-hour observation limits for Rural Emergency Hospitals).

This has led to a sharp increase in patient transfers to larger facilities for non-emergent yet critical care, creating a heavier burden on ambulance services and hospital staff.

Ambulance crews face logistical challenges, including extended waits at receiving hospitals and difficulty finding available facilities for patient transfers, explained Shuart. 

Local EMS struggles with staffing shortages, compounded by reliance on out-of-town personnel and increasing demands from nearby communities.

Dr. Shuart advocated for including commercial entities in the subscription plan, suggesting even small fees could significantly help fund additional EMS staff and expand capacity.

He also highlighted the need to improve billing practices to ensure insurance and government programs (Medicare/Medicaid) adequately reimburse ambulance services.

Dr. Shuart stressed transportation delays and limited capacity to transfer patients jeopardize patient care and overwhelm emergency staff, who spend valuable time coordinating transfers rather than focusing on patients.

The current system forces rural hospitals and EMS to function in a "break-even" model, which is unsustainable given the increasing demand for services.

Dr. Shuart stated the importance of local collaboration between EMS, hospitals, and the community to address these challenges and provide better care for patients.

We've got to work together with this situation,” said Dr. Shuart. 

“I understand everybody's frustrated. I know my staff is just, there are days they're just furious. And they want to spit fire. But this [subscription service] is the only viable solution that I can think of.”

Dr. Shuart stated: 

“An opt-out situation is one of those things that's always difficult. I think it's much cleaner and neater and no-nonsense if there's no opt-out. Tonkawa opted for that and I think that was a wise choice. And for people who say, 'You know, I don't want to pay for somebody else's service because I'm never going to use it.' They will use it sometime.” 

“In our lives, we will all need an ambulance service that's just the nature of being human,” said Dr. Shuart, “and I think it's a good Christian charity if I may say so, to help take care of those who don't have the resources. So if we pay a little extra on our electric bill to provide that for other members of our community, I think that is simply the right thing to do.”

City Attorney Kennedy agreed to hammer out the specifics of the subscription service in further detail. As Thursday night was simply an initial reading, no action was taken. 

The item will be returned at a later date. 

Moving on, the council addressed the “opt-out” for the new AMI smart meters which have been installed through the city as part of an expansive rollout. 

AMI smart meters provide near-instantaneous readings, enabling utilities to track energy consumption in real-time. This allows for more accurate billing and the ability to detect issues such as energy theft or unusual usage patterns.

With automatic and continuous readings, AMI smart meters eliminate the need for manual meter readings, reducing human error and ensuring that bills reflect actual energy usage, rather than estimates.

Utilities can remotely monitor the status of meters, reducing the need for field visits. This can lead to faster response times for maintenance and service interruptions.

AMI smart meters allow consumers to track their energy consumption in real-time, which can help them manage their energy use and reduce bills. Some meters offer apps or online portals to provide detailed usage data, tips for efficiency, and even cost prediction tools.

Many smart meters are compatible with smart home technology, allowing consumers to automate energy-saving actions and get alerts on consumption patterns, further promoting energy efficiency.

The subject of smart meters became a hot-button issue on various social media pages, with many wishing to not have them installed on their homes citing safety concerns.

As such, the City had prepared an opt-out option which would see customers wishing to keep their “manual” meter paying $75 to swap out the smart meters for a manual one and a charge of $35 per month to cover the meter reader’s visit to the customer’s home. 

After some discussion with concerned citizens, the City of Blackwell noted that there would be no $75 charge to “swap out” the meters if said customers did not already have the Smart Meter installed. 

Those with manual meters will still be paying the $35 monthly charge for a person to read the meters.

Citizens who wish to opt-out and to check if their meter has been changed need to contact the Blackwell City Hall at 363-7200