The uncertain future of Siouxland Paramedics Inc. has sent a ripple throughout the region. After the nonprofit ambulance service notified Sioux City and North Sioux City that it will cease providing 911 emergency ambulance services to the two cities after New Year's Eve, both cities have begun weighing options and counting the cost of staffing up their rescue squads to fill the void. Those in outlying communities and rural areas who benefit from the organization's assistance are also waiting to see what arrangements they may need to make if SPI discontinues its services entirely. Sioux City Fire Rescue Chief Tom Everett said his department is continuing to work with other city departments on plans to put before the City Council as early as this month.