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EMS: What To Do Now?

 July 4, 2005 ⋅  Post a comment

The GUARDIAN admits to a cut-and-paste on this one. Here is a copy of the Ada County Commission-appointed EMS task Force report on what to do about emergency services following the defeat of a bond proposal May 22.

We find it interesting the task force is comprised entirely of people who stand to benefit from any decisions and there no citizen/taxpayers who ultimately have to PAY and live (or die) with the decisions. We would like to see a mix with perhaps a banker, accountant, attorney, educator, farmer, engineer, mechanic etc.

Some of the boring lists were edited, but none of the pertinent content. Here is what they say:

1. Consolidate all EMS and Fire services in Ada County. The ultimate goal of this recommendation is full consolidation into a single political jurisdiction with responsibility for all EMS and Fire responses. There are many hurdles to be overcome in moving from today’s multiple-jurisdiction model to a single EMS/Fire jurisdiction, but they must be overcome. In the meantime, while working toward the ultimate goal, there is a need for functional consolidation of services among jurisdictions with existing responsibility for EMS and Fire. This can be accomplished through judicious and thoughtful implementation of Joint Powers Agreements, the first of which could be implemented by October 1 of 2005.

Overall, consolidation appears to the Committee to be the only long-term solution to the financial crisis currently facing Ada County EMS, short of a permanent and substantial increase in local property taxes and/or fees for EMS services. Furthermore, consolidation is preferable to tax and/or fee increases in light of renewed efforts by influential groups to limit property taxes statewide.

Yes, consolidation’s “devil” may lie in the details, as several Committee members noted. Nevertheless, consolidation must be and is the first and highest priority recommendation of the Committee. Nothing short of consolidation will result in the most efficient utilization of taxpayer resources in the provision of Fire and EMS services.

2. Implement a group of six “next-level” recommendations as near -term measures to increase efficiency and reduce expenses. The following six items are in no particular order; all are considered, collectively, to be the second-highest recommendation from the Committee.

a. Establish a medical directorate for the EMS system to include uniform standard written protocols and orders, response standards, QA/QI and training oversight. This recommendation, by itself, incorporates nearly one-quarter of the seventy-eight proposals considered by the Committee. Ultimately, a single group responsible for establishing and administering all facets of Ada County’s EMS standards, protocols, training, evaluation, reporting and certification is essential.

b. Establish an independent 9-1-1 center funding source. This recommendation has the potential to save Ada County EMS nearly $340,000 annually and Fire Departments slightly more than $400,000 annually if an independent revenue source were to be established. Currently only Fire and EMS pay additional dispatching fees into the Ada County Sheriff’s operation of the dispatch center; law enforcement agencies pay no such fees. Including this recommendation in this implementation list underscores the Committee’s unanimous feeling that this is an equally worthwhile use of funds derived from enhanced 9-1-1 per-telephone-line fees.

c. Establish a protocol for radio frequency assignments so all EMS providers responding to the same incident will use the same radio frequency for vital information rather than relaying through dispatch. Having all responding units on the same frequency will provide for greater safety of responding personnel by everyone having immediate access to critical information. The grant that has already been received provides a great deal of assistance to implement this recommendation but this recommendation is still very important as the existing grant does not cover the actual cost of each agency’s new equipment.

d. Implement all remaining high-priority features of emergency medical dispatch. The “alpha” component of emergency medical dispatch has already been implemented (for example, calls identified by the system as non time-critical responses are responded to without the use of emergency lights and sirens). Remaining high-priority items need to be identified, agreed upon and implemented. A Dispatch Steering Committee already exists and should be assigned responsibility to implement this recommendation.

e. Add one Fire Chief to voting membership of EMS Advisory Board immediately, and review the need and desirability for other representation on the EMS Advisory Board. A representative of the Ada County Fire Chiefs’ Association is currently a non-voting member of the EMS Advisory Board. The Committee believes this position should be converted to full voting participation on the Board. In addition, the Committee wants to work with the EMS Advisory Board and the Board of County Commissioners to determine whether other representation should be added to the Board.

f. Develop a single, countywide master plan for EMS and Fire. If money is to be saved in the short-term, this is the single recommendation that will result in the greatest potential cost savings while at the same time maintaining or improving existing levels of service. Furthermore, this recommendation is, in many respects, a companion requirement to functional consolidation that may occur through Joint Powers Agreements.

3. Maintain the existing Committee as the primary group to work on the above recommendations. This group has been working together for nearly four months. Yes, at times members have experienced difficulty in reaching consensus. But collectively, it brings Ada County’s (and perhaps, the State’s) best available technical knowledge of EMS, fire and medical requirements together in a single group. The working relationships that have already been established will go a long way toward making it an effective group through which to seek specific implementation steps for the prior recommendations. This group should stay intact as it is currently constituted and be assigned to initiate implementation of the above recommendations.

COMMITTEE MEMBERSHIP:
The committee was composed of fourteen individuals placed on the committee by the Board of Ada County Commissioners.
Ron Anderson – Chief, Meridian Fire Department
Pam Bernard – Administrator, St. Luke’s Meridian Medical Center
Matt Conklin, M.D. – Co-Medical Director, Ada County EMS
Kevin Courtney – Chief, Star Fire Department
Dan Friend – Chief, Eagle Fire Department
Troy Hagen – Director, Ada County EMS
Doug Kartel, M.D. – Medical Director, Boise City Fire Department
Martin Knoelk – Chief, North Ada County Fire & Rescue
Doug Rosin – Chief, Kuna Fire Department
Renn Ross – Chief, Boise City Fire Department
Ted Ryan – Director of Emergency Department, St. Alphonsus Regional Medical Center
Tom Sanderson, M.D. – Medical Director, Kuna Fire Department
Murry Sturkie, D.O. – Medical Director, Eagle, Star & North Ada County Fire Rescue; Co-Medical Director, Ada County EMS
Darby Weston – Deputy Director, Ada County EMS

Ed note: How about replacing half the members with citizen/taxpayers? This is like having only developers and builders on the planning and zoning commission!

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