A Timeline of The EMS Transition
The Jefferson County Commission voted to hire Fitch & Associates in May of 2021 to analyze the County’s EMS (emergency medical services) system. Out of the public eye, the consulting firm spent the next several months collecting and analyzing data from the county’s dispatch system. The consultant met frequently by video conference with Stephanie Grove (the County Administrator at that time) and other Commission staff and had limited email exchanges with the county’s emergency services staff. The consultant did not visit the county or speak with any of the volunteer fire companies.
Feb 2022 — Commission Shares Plan To Restructure Ambulance Service
The County Commission scheduled a special meeting on February 17 2022, with a cryptic notice: “The Purpose of the Special Session will be held for presentation and consideration of report regarding analysis of public safety issues.” When the Fitch & Associates’ report was later posted publicly and then discussed at the March 3 2022 County Commission meeting, the reaction outside of the Commission ranged from dismay to anger, particularly among the many volunteers who expressed concern that they had not been invited to share their local experience and expertise.
May 2022 — Commission Asks For Plans
After several months of meetings and discussions about the questions raised by the Fitch & Associates’ report, the Commission asked John Nissel, the new County Administrator hired in February 2022, to develop a plan to create a County Ambulance Service, which would include the County owning and operating all ambulances. The staff of the county’s Emergency Services Agency (ESA) presented several options to the Commission in July 2022. These proposals were based on internal analysis and did not reference the analysis or recommendations presented in the report from Fitch & Associates.
July 2022 — Commission Purchases Ambulances
A July 2022 vote by the County Commission authorized the purchase of 10 ambulances and related equipment, funded by $2.5 million allocated from federal money received by the County as part of the pandemic-related American Rescue Recovery Act (ARPA). The Commission also voted to reorganize the ESA as a county-run department to manage all ambulance staffing and EMS operations (shifting from the current hybrid of county-paid staff operating volunteer-owned ambulances). The staffing option accepted by the Commission proposes an increase in the full-time paid-staffing for EMS compared to the current staffing and would require hiring 12 additional EMS personnel.
The County completed the purchases from the volunteer companies by August 2022, acquiring 9 previously-owned vehicles and 1 new vehicle already scheduled for delivery. The target date for the County department to begin operating the ambulances is March 2023. Until the transition is completed, the County is leasing the ambulances back to the respective volunteer companies and the county-wide EMS services are being provided under the existing paid/volunteer structure.
December 2022 — Updates on the EMS Transition
Bob Burner, Director of the ESA, provided an update to the County Commission at its December 3 meeting, noting that several tasks of the transition had been completed, most notably the state licensing required for the county department to transport patients. Burner noted that establishing billing arrangements with multiple state and federal reimbursement programs, along with insurance company agreements, is complicated and will be a much more time-consuming process for his staff.
Technology and equipment investments were the big-ticket items discussed at the meeting. The Commission approved $209,000 for the county’s IT department to upgrade its systems that support the ambulance services and $35,800 for an inventory management system to track drugs and medical supplies — described as a necessity not only to ensure the paramedics have the material they need to treat patients, but a requirement of federal law to maintain control over the narcotics and other drugs stocked in each ambulance.
Burner also reported on other key issues he highlighted as concerns, particularly the expense of equipment maintenance and the difficulty in recruiting paramedics.
The County Commission will receive another update in January 2023.
Page revision: Dec 7 2022 (Dec 3 County Commission meeting discussion).