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Pledge allegiance to the flag of the United States of America and to the Republic for which it stands, one nation under God, 00:00:01
indivisible, with liberty and justice for all. 00:00:07
OK, so today we have a little different setup than normal. Mr. Smith, who is the president of the Highlander Fire Board, is stuck 00:00:17
out of town, was unable to get the flight in, so he has asked his vice chair to step in. So welcome, Mark. We appreciate you being 00:00:23
here today. 00:00:28
Councilman Short is on his way in here and our attorney was unable to make it today as well. So we have Suzanne, if you could just 00:00:36
check the role myself, Mr. Moon, Mr. Hooth for Highlander, Mr. Moody for Georgetown, and Mr. Franklin for New Albany Township. 00:00:43
Doctor Harris wasn't able to make it here today either. So we're going to have two pieces of information we're going to share 00:00:51
today. The 1st is Mr. Smith had requested a presentation from a Firebase DMS service and. 00:00:58
Has reached out to our friends over at Fern Creek, they have a representative here who's going to talk a little bit about their 00:01:06
service and then I'm going to talk a little bit about another option for us to kind of consider so. 00:01:11
I just want to put this out here for Full disclosure and everything. 00:01:17
In my professional capacity, obviously, I work in the fire service. The fire service is pretty tight knit. We know a lot of people 00:01:22
to the surrounding areas. I've been working real closely with the people at Fern Creek as long as well as my excuse me, 00:01:27
consultant. 00:01:32
Jeff Dixon, who's also here. 00:01:37
Who you are and what you're doing. OK, my name is Doug Rex Mold. I am with Fern Creek. Thank you for the kind words of Fern Creek 00:02:10
Fire Department. I've been with Fern Creek just over a year so it doesn't sound like much, but just to give you my background, I 00:02:15
did almost 25 years with the city of Louisville and rose to the rank of deputy chief. I was the cartoon there in the city of 00:02:21
Louisville. While I was on Louisville we had a fire based EMS system for some years and then and then with a merger proposition 00:02:27
over. 00:02:33
County that the EMS was taken out so I have some ground level experience with EMS but more administratively. I moved from the 00:02:40
Louisville Fire Department, left Louisville Fire Department with the Pleasure Ridge Park Fire Department as their Fire Chief and I 00:02:47
brought an EMS system into Pleasure Ridge Park Fire Department and ran that until my retirement two years ago and then and then 00:02:55
since then I've transitioned into. 00:03:02
Creek, which is fully integrated with EMS. So that's my background on EMS. A couple of things I want to introduce you to tell you 00:03:10
about myself that I'm not not a paramedic, I'm not a doctor, I'm not a medical director and I know nothing about Indiana laws when 00:03:16
it comes to fire based EMS. I'm Kentucky through and through when it comes to the law. So I can't I can't advise on what this law 00:03:22
would say or what that law would say if you're in Kentucky, I could help you with that, but I can't do that here but so just so 00:03:28
you. 00:03:34
My background comes from that. 00:03:40
Why do we do EMS the long and the short of the, the EMS system and the sounds really curt, but it's, it's, it's money in Kentucky. 00:03:42
A, a, a department we've called chapter 75 departments. It's how it's the state law. Chapter 75 is how we get our funding for the 00:03:50
department. And if you're a fire department only you get $0.10 on the 100. And if you're a fire and EMS based system, you get 00:03:57
$0.20 on 100. So it's. 00:04:04
Some money proposition and it's not to get rich, it's to make sure you can keep growing your system or maintaining your system. So 00:04:12
it's, I hate to say that it's not out of this great level of honor and duty to our systems, but it, it, it ends up being that we, 00:04:19
we do we're very, we were honored to do that job, but it came out of the need because we couldn't fund ourselves anymore on $0.10 00:04:26
per 100. So it is going to be very, very. 00:04:33
Candid about that. 00:04:41
So when I was I'm going to really start at Pleasure Ridge Park. 00:04:43
When I was the chief at Pleasure Ridge Park, we had roughly 150 employees and very kind of a big area wide, about 60 square miles, 00:04:48
not huge, but not small, about 60 square miles, 105 thousand citizens and a lower socioeconomic area of Jefferson County. And when 00:04:56
I say that that means run volumes high, it's very high. 00:05:05
Our our run volume is really based on socio economic status and age. 00:05:14
And so Pleasure Ridge Park being one of the older portions of the, of the community, one of the things they likes out there. What 00:05:19
do people in the East End call the people in Pleasure Ridge Park? They call mom and dad because all the young folks moved out and 00:05:25
mom and dads are still living there and, and their income, they're, they're the old real blue collar industrial workers and, and 00:05:31
so. 00:05:38
Starter homes, so a lower socioeconomic area that made it very, very busy. 00:05:45
We had three full time ambulances when I left there in 2022 and we were averaging about 13,000 incidents a year for three 00:05:50
ambulances, which is just smoking. That's over 4000 runs per ambulance. So to to make you understand that a lot more runs were in 00:05:58
Pleasure Ridge Park, but we were having to get mutual aid from other departments. We couldn't handle all those runs ourselves. We 00:06:05
had more than 13,000 runs our units made a total of. 00:06:13
Thousand runs, so over 44000 runs a year per unit. Very, very busy. 00:06:20
It at at Pleasure Ridge Park. I fully integrated the system. What does that mean? I had, if I needed six people to run, four 00:06:26
people on a fire truck and two people on an ambulance. That's all I had was 6 people and I rotated those firefighter, the 00:06:33
firefighter level positions, 12 every 12 hours. You were on the ambulance, you were on the fire truck. You were on the ambulance, 00:06:39
you were on the fire truck. Fully integrated. They knew each other's jobs. 00:06:45
If I were king for a day, that's how I would run the entire system. 00:06:53
The problem is I was the only one doing that in Pleasure Ridge Park. So what do you think my firefighters did? They look for jobs 00:06:56
that they didn't have to ride the ambulance on. 00:07:01
And so I kept bleeding out fire trained people to other departments that they didn't have fully integrated. They weren't fire and 00:07:06
EMS together. Again, if the host system ran like that in Jefferson County, that wouldn't have been an issue. I could have been a 00:07:11
pleasure as park firefighter and rode the aimless half time and rode the fire truck halftime and I will try to go to Fern Creek 00:07:17
and become a firefighter there. I would have to do the same thing. That wasn't the case if I was a Pleasure Ridge Park 00:07:23
firefighter. 00:07:29
And I wanted to get off that ambulance. I went to Louisville, who doesn't even have ambulances, or I went to another department 00:07:35
that didn't make you ride those ambulances. So it it, it has been moved my. 00:07:40
My successor is one of my best friends. He's the chief of Pleasure Park. Now he's had to change that. So I'm a grown man. I 00:07:47
understand that didn't work. It would still be the way I would do it if it was, if I were king for a day. But I'm not. I was just 00:07:54
one Fire Chief in a system with 9 fire chiefs. So it didn't didn't work out right. So at Fern Creek, it's fully integrated as EMS 00:08:00
is in our is in our system. 00:08:07
But nobody has to be dual role. 00:08:14
We do train our firefighters to ride the ambulance. If the ambulance is short, we can roll our firefighters over there. And, and 00:08:18
just let me make you understand, it's almost always EMS that's the short it. The firefighters usually are always there in force. 00:08:24
And so you have to roll extras over to the ambulance. There's usually very few times when you got to say how I need that person 00:08:30
from the ambulance to roll over to a fire truck. It's always the ambulance that we're back feeling. And so we do have the 00:08:36
capability. 00:08:42
Doing that because they are trained like that, but it's not mandated that that's the only place they're going to ride every 12 00:08:48
hours. If that makes hopefully that makes sense to you so. 00:08:53
We have 7 different 7 ambulances at Fern Creek. We employ 137 full time folks. Five of those are fire trucks and seven ambulances. 00:09:00
And some of those ambulances are pretty slow and some of them are very busy. Why does that make a difference? And it makes a 00:09:10
little bit of difference in our system. Two of those ambulances are so busy they can't do 24 hours a day we have. 00:09:19
Have 12 hour ride times on those. The other five ambulances are in slower areas, they don't make as many runs. It's palatable to 00:09:29
do a 24 hour shift on. It can be very tiring and you are tired that when you get off the next day but you're not just completely 00:09:36
wiped out. So we're able to ride 24 hour. 00:09:43
Increments on there so that that's we. 00:09:51
The, the balance in our system is we have two very, very busy. And it just so happens, uh, Mr. Feckity and I were talking about a 00:09:57
minute ago, how many runs of hours are into the city and not of our own or they, they into another mutual aid. A good portion of 00:10:03
ours are our mutual aid runs and the two trucks that are the busiest, the two ambulances that are the busiest are those that sit 00:10:10
right on the city border. And so they run a lot up into the city. 00:10:17
Again, so so economic status. 00:10:24
And age and and then the southern parts of our district and Fern Creek, newer, younger, more fluent, just it's just the facts. And 00:10:27
so they're, they're much slower. 00:10:33
And so those were able to put 24 hour personnel on there. Again, they have some days where they're wiped out, but for the most 00:10:40
part they find time downtime. 00:10:44
Uh, if you're familiar with unit hour utilization, it's called, uh, use. It's how much a unit is used during a shift. 00:10:49
The you want to stay around the national average is what you want to stay around 33% of the time. So think about this. We want to 00:11:00
put an ambulance on for 24 hours a day and you say you only want to use that 8 hours of the day. You only want it on runs about 8 00:11:05
hours of the day. You have to, you have to do maintenance, you have to do some downtime, you have to do training, you have to do 00:11:11
all these other things. 00:11:16
That if their unit, our utilization is up above 30%, they're very, very busy. 00:11:22
Our 12 hour units are 65% unit hour utilization, so we have to take those trucks offline to even get them training. We can't. We 00:11:29
could never work training into their system because they're so busy. 00:11:36
So when you're looking at at things about how busy and how, how you have to look at everything, they if you're putting them at a 00:11:44
Firehouse with toilets, the toilets have to be cleaned unless you're gonna hire a janitor. Most firehouses don't right. If you're 00:11:50
putting them if, if they have so many training hour needs, which if they have a national registry, they have to have 72 hours 00:11:55
every so many hours to keep their national registry up, 72 hours of training. You have to think about those things. How are you 00:12:01
going to get them trained? So. 00:12:07
So the, the benefits that I really see in the Firebase EMS and I, I've told you my background is really, really far. So this is 00:12:14
the side that I'm looking at. The benefits are light at the end of the tunnel. There's a place to go. If I'm on an ambulance and 00:12:21
sitting in an ambulance and all I have is a just a single based EMS system, not a fire based EMS system, I have nowhere to go. I 00:12:28
got 25 more years of doing that exact same job. 00:12:35
If I'm in a fire based EMS system, I can switch over or promote out throughout that organization. And to me, that's a little light 00:12:43
at the end of the tunnel, right? So, and I can tell you in the systems that I've worked in, they're so busy that hardly anybody 00:12:50
makes it 20 to 25 years just doing Ms. It's just too hard on the person. And so the fireside is a good, good side to go and, and 00:12:57
learn different things and different. 00:13:04
Models. 00:13:12
The. 00:13:13
Other things that the other light at the end of the tunnel, like I said, if you're 12 hours on ambulance, 12 hours on the fire 00:13:15
truck, that's a daily light at the end of the tunnel. That's a difficult one to do unless everybody around you is doing the same 00:13:19
thing. 00:13:23
And I've already hit that, so I won't hit again. So for the system itself, for the individuals themselves, why do I like Firebase 00:13:27
DMS? If I'm just on a single system, EMS system, I'm going to sit in that truck for 8/10/12 hours, whatever your shift is a day. 00:13:35
Where do I go? Where do I Do I go up to the Circle K and sit there? Is that my strategic landing spot? Do I sit at a headquarters? 00:13:42
Maybe I'm lucky enough, but if I've got more than one. 00:13:50
I've got to go out somewhere and be positioned. That leaves me sitting in a vehicle for 8/10/12 hours a day, whatever my shift is. 00:13:57
That's not good for the individual. If I'm in a fire based system, I have a Firehouse to return to. I have a home quarter to 00:14:05
return to. I can get out of that unit, right? If I'm at a Firehouse, there's a likelihood. I don't know about everybody, but 00:14:12
there's a good likelihood that somebody there is cooking a more healthy meal than a McDonald's or a Captain DS or or something. 00:14:20
Effect So if you're cooking a meal and you can get out and eat a healthy meal rather than a McDonald's or a Captain DS or a 00:14:27
Wendy's, whatever the case may be, it's it's healthier for the person. Most fire houses have workout equipment. I have the ability 00:14:35
to work out, get out of that truck and move around. If if I'm working a 24 hour shift, I have the ability to lay down in a bed or 00:14:42
sit on a couch, even turn on ATV. And I know that's what when you're talking about. 00:14:50
Taxpayers, we don't want to watch on TV all the time. You're not paying that person to watch TV. You're paying them to be ready to 00:14:58
make that run. And in between those runs that you're paying them to make, they have to, if they just sit in the front of an F150 00:15:05
or an F450 all day long, they're not going to be very effective. And, and again, that's, I believe I could find studies on that. 00:15:12
My information is mostly anecdotal because I've I've worked with it, but being able to report back to a fire station is, is a. 00:15:20
Big benefit and then the other benefit that I have seen. 00:15:28
And I think. 00:15:32
My friend back here, Mr. Feckity, would tell me from our time at Louisville, as you bring them into a more structured environment 00:15:34
and you slow down the wrecks that they have, you slow down the disciplinary processes that you put them through because they're in 00:15:41
a more structured, more an environment with more camaraderie, where they're held to account more than with just two partners 00:15:49
working side by side every day, sitting at the Circle K, waiting for the next run, drinking my 32. 00:15:56
Bounce drink right. And so again, those are those are kind of my thoughts on the fire based EMS system. Any questions? 00:16:04
I got just one. You highlighted all a lot of the good stuff in your eyes. What are some of the downfalls? The downfalls are most 00:16:15
of the time in the fire service. There's more promotable sides of the fire department than there are EMS. Fern Creek's dealing 00:16:22
with that right now. We have Sergeant, Captain, Major, Colonel. 00:16:28
For the old Army thing, we have those 4 levels to go to on the fireside. On the Ms. side, we have paramedic and then we have a 00:16:35
jump all the way to a major. And then if you're lucky enough to get into the chief staff and that, that's all appointed. So I 00:16:41
mean, that could be any other side, but there's less promotable spots. So it does cause some friction. We're actually looking at 00:16:47
some of that right now to say how. 00:16:54
We we know we need extra help on the EMS side, not just making runs, but. 00:17:01
Development training, different things like that, where are their promotable spots that we could build into that system? So that's 00:17:07
one of the rubs there. How many, how many calls do you all make at Fern Creek annually? Last year we did just like I said at PRP, 00:17:13
we just did just over her, I think 15,000 with seven trucks. I believe that was the number. I apologize for that. Is that 00:17:20
transports as well or is that just called? 00:17:26
And I, I, I can send you that information and I'll get you, I think actually I think I already have it in my, one of my files in 00:17:34
the office. But so is all your trucks paramedic? No, they are not. We run 3, three different types of trucks. We run just an EMT 00:17:39
truck. 00:17:44
We run an advanced EMT truck and we run paramedic trucks. We try. It's our, it's our goal to have no well, our goal is to have no 00:17:49
less than 5 on a day. Our minimum is 3 paramedic trucks a day out of the four. 00:17:56
Our goal is always 5 and then goal is really 7. I'll be quite honest with you, but but we we like to keep it at 5. We go into 00:18:03
overtime at 5:00 and then we go into mandating overtime at 3. So do you have chase vehicles as paramedics? We only have a chase 00:18:10
vehicle when we have say an EMT or someone calls in sick and we have an odd number and we'll put a paramedic in the chase vehicle 00:18:18
that is not a normally staffed position. 00:18:25
You mentioned that you tend to be short on the EMS side when you're moving firefighters and EMS back and forth. 00:18:37
Is that a nutrition issue or a little bit of it? Is a little bit of it is we overstaff? So in my mind, I got to be real careful 00:18:45
about how I say this, not not because I'm worried about any repercussion. So a normal engine company on the would have four 00:18:52
people. Fern Creek allows it to ride with three. The normal ambulance rides with two, we never ride 3 or 4. So there's always a 00:18:59
cut back on if somebody calls in sick. 00:19:06
Or take that has to leave for an injury or whatever the case may be. We generally have one person on an engine to be able to roll 00:19:14
over to them. So that, that is the main reason why usually we never have extra people on the ambulance side, which might be one of 00:19:20
the what, what's the downside? Well, we ride a little bit extra on the fireside, but we never do on the on the ambulance side. And 00:19:25
sometimes there's some resentment built up. And, and when I talk about what are the main problems, I think the system works 00:19:31
better. 00:19:37
In the Firebase system. But I think the resentment and the personnel issues that come from that resentment are probably the 00:19:44
biggest downfall. 00:19:47
Of it all, you have to balance that when they have a boss that's been in the fire service for 34 years and now I have to say, and 00:19:51
I don't have to say it, I'm proud to say I'm in the fire and EMS service, right? But sometimes it's really easy for it to roll off 00:19:58
my lips. I'm a Fire Chief, I'm a fire this, I'm a fire that an EMS never rose off. And when you're an EMS person and you never 00:20:05
hear your name called, there's resentment built in that. So that has to be built into the culture and we're trying to do that. 00:20:12
And and just one example of that was that. 00:20:20
At Pleasure Ridge Park, there is not a firefighter appreciation week, but there is definitely in Jefferson County, State of 00:20:23
Kentucky EMS appreciation week. We made a huge deal of that. That was a big deal for us because it was a way to say, hey, you all 00:20:30
are important and we do want you all to be part of our system so that that's a cultural thing. 00:20:37
When you hire an employee at Fern Creek, are they hired as a firefighter or EMS or how do you do that? We do both, so I. 00:20:46
First off, let me start with. They're currently working on getting a complete. 00:20:55
Their first? 00:21:02
Full time recruit class at Fern Creek's ever put on? 00:21:03
And that's just because of our growth and because the old volunteer system, which used to funnel people into the system doesn't 00:21:08
exist in Jefferson County anymore. And so they're they're doing their first full time recruit class that will start in January of 00:21:12
25. 00:21:17
We have, although we can teach EMT's and advanced EMT's, we have a outside contractor that uses our our facilities to teach EMT 00:21:23
classes and he doesn't charge anything for us to put people in him because he gets free rent from us. So that is how we bring our 00:21:29
EMT's in. 00:21:36
To the system is we, we currently have three EMT recruits coming in and then we'll do our own fire. So we do both and then 00:21:44
paramedics are pretty much laterals or we send them to school while they're in. Of course that depending on what program you get. 00:21:51
But the main one that we use is a 2 year process for that. And so it's tuition reimbursement. It's through the Jefferson Community 00:21:59
Technical College so that it's just like you're going to college and Fern Creek. 00:22:06
Reimburses that as the student goes through and then I know you didn't ask this question, but to give you empts and firefighters 00:22:14
paid the exact same thing. You get an advanced EMT, you get a $4000 raise. You get a paramedic, you get an $8000 raise. So the 00:22:22
paramedic, the paramedic certification holds $8000 worth of value to Fern Creek. Are you union shop? No Sir. OK thank you. 00:22:31
Chief, one more question. I know that I don't think I've ever really talked to you guys about this, but we, we've seen a lot of 00:22:40
departments over in Jefferson County merge and come together. I. 00:22:45
Obviously Fern Creek has gone through that as well. Fern Creek isn't just Fern Creek anymore. It is Fern Creek, but they've 00:22:52
absorbed several. How many districts have you all absorbed? So including Fern Creek, the Fern Creek district, there's four 00:22:58
districts put together, Fern Creek, Highview Mutual and Camp Taylor that that has happened over the last three years, which is 00:23:05
rapid to do that many mergers. And so we we've grown. 00:23:11
Exponentially, let's say over the last three to four years. 00:23:18
One of the reasons I was brought in to the Fern Creek Fire Department was for that my guidance on working with bigger departments 00:23:22
versus a single Firehouse department. And the chief saw that value, and that's one of the reasons I was put on his staff. So. So 00:23:29
do you think in in your mind, was this easier to accomplish because you all came together? Could you imagine doing this as if 00:23:36
every department had their own EMS division? So they did, Yeah. Out of the three, out of the four that merged together. 00:23:44
Three of them had their own EMS separately. And so again, I know state laws, but they had to pick one to go with and Fern Creek 00:23:52
was the one they went with because we got licenses. And so the Fern Creek's license was more, more suitable than the mutual or the 00:24:00
high view license that came with it. So and you all are a certificate in the state over in Kentucky. That's correct. 00:24:07
Can you explain to what just real quickly what that is? So we could so it first goes through. So there's A2 sections, there's the. 00:24:16
I'm drawing a blank now. The House Health and Human Services Division branch of the government of state of Kentucky requires any 00:24:25
medical providers to have a certificate of need. And that means you we map out our our areas and say, hey, we don't have enough 00:24:33
ambulances for this. Or if we wanted to put a hospital in, I mean, that's a whole different thing. But it goes through all any 00:24:40
medical facility that you build over there and you have to prove your need for it. And, and it has. So just as an example, it has. 00:24:47
Anybody that already runs that type of service can, can put their two cents in on it. So it used to be AMR was over there and they 00:24:55
said, hey, we don't, we won't fight your certificate of need as long as you don't do private transports, meaning you don't go pick 00:25:03
up somebody at the at the ambulance, at the ER that's being released or at the hospital that's being released and you charge them 00:25:10
a fee to take them home. That's a private transport. We could only do emergent trans. 00:25:18
And, and so everybody got to sign off on that. And for a long time in the city of Louisville would not sign off on that. And then 00:25:26
they, I believe they finally realized we either got to quit fighting this or we got to do EMS better. And instead of fighting it 00:25:33
and doing Ms. better, they allowed the county to do it. And so the fire departments have it. And so, so we had to get a 00:25:40
certificate of need. And then that certificate of need, you tell what you're going to do. And when I first took over at. 00:25:48
We didn't have paramedics, we had EMTs and so we made it ABLS system. 00:25:56
And part of my hindsight is probably should have kept it a BLS system, just you don't get to charge as much as Medicare, Medicaid, 00:26:02
but there's a abundance of EMTs out there. Paramedics are tough to come by. So anyway, I digress. We, but so, so we, we go back 00:26:10
and, and you have to say what you are doing. And at first, when I was at PRP, we did it. 00:26:18
Basic life support system. And then after we grew a little bit, we did, we went, we moved to a an ALS system. 00:26:28
Which was a little bit easier than the whole certificate of need. Thanks chief. Anybody have any additional questions? 00:26:35
Chief, thank you very much. Appreciate your time. Thank you. Yes, Sir. 00:26:42
Huh. 00:26:48
We'll have public comment at the end. 00:26:51
For him. 00:26:55
About how many fire stations do you have? Fern Creek has 7/7. 00:26:57
All right. 00:27:06
So we're going to move on. I have a presentation I like to make as well, something that we had talked about. 00:27:07
Would be used to deliver EMS in Floyd County versus where the Floyd County EMS Advisory Board was kind of used to identify the 00:27:45
specific needs of what we as a community needed from our EMS service. 00:27:52
So I think in order for us to kind of understand the EMS system and its totality, I think we kind of need to 1st discuss, you 00:28:01
know, the history of emergency medical services here in the United States. So let's go ahead and start from the beginning. So a 00:28:07
lot of people believe that EMS service in the United States kind of started in the 1960s and 70s. Actually the pre hospital care 00:28:13
kind of goes back a lot farther than that, so. 00:28:19
Back in during the Civil War, there's a gentleman by the name of John Letterman. 00:28:27
And he established the US core ambulance court during the Civil War in 1862. And his corpsman basically the the thing that 00:28:31
differentiated his people between the others was is in the past that they would wait for people to go onto the battlefields to 00:28:38
clear the patients off. His people actually go in while the battles were were going. And it saved a lot of lives during that time. 00:28:46
But you know that that ended up being a model that the entire Union army adopted, so. 00:28:53
That's kind of the birth place of United States EMS or with Mr. Letterman and I kind of like to call him the cot father, if you 00:29:00
can kind of get that. 00:29:06
Anyway, so moving on, Cincinnati, OH 1865 established their first ambulance service, and New York City themselves followed in 00:29:13
1868. 00:29:19
You know, even throughout the 20s and, and all the way through the 60s, you had, you had organizations that were all over the 00:29:26
United States that were providing not just transport, but first aid services that would give some pre hospital care to their 00:29:33
communities. As you can see right here, we have Lynchburg Life Safety and First aid crew. 00:29:39
So despite, you know, all the advances that they had made in EMS. 00:29:48
For years it was just really kind of seen more as a transportation agency, and they really kind of offered very minimal patient 00:29:54
care. So in 1972, the National Academy of Sciences and the National Research Committee released an analysis of the United States 00:30:01
EMS system. The analysis clearly just really outlined a complete failure to advance the EMS in the United States. 00:30:09
So in 1973 the EMS services adopted the act Development Act of 1973 was passed. It kind of ushered in a new era of pre hospital 00:30:18
care. And there was a real deep pool of people who were willing to work in this new system a lot because you know, during the 00:30:24
Vietnam War, there's a lot of medics that were trained that were looking for work. So that was one of the reasons that a lot of 00:30:30
people got into it. And then there was ATV show that was really popular back in the day. Some of y'all might remember emergency 00:30:36
any of those. 00:30:41
They worked in EMS. It's kind of a cult classic. It followed up Los Angeles County paramedics Johnny Gage and Roy De Soto, and it 00:30:48
really did kind of capture the attention of the nation and really kind of highlighted what EMS was capable of. 00:30:54
So here in Indiana, we had our very first paramedic class in 1973 and that happened at the General Hospital in Indianapolis. You 00:31:03
know, at the time the paramedic training consisted of about 400 hours of classroom followed by, you know, laboratory rotations and 00:31:08
in hospital clinical rotations. 00:31:13
And about another 100 hours of internship out in the field. 00:31:19
So historically here in the United States where there's been three primary EMS delivery models, we have the municipal style, which 00:31:25
is your city and your county based and also fire based kind of fits in that as well. You have the hospital base and you have 00:31:31
private ambulance. One of the new types of of models that's kind of come out over the years is what they call a public utility 00:31:37
model. It's it's a hybrid model that utilizes private EMS assets that are just managed by an authority that has jurisdiction like 00:31:43
the county, so or. 00:31:49
Fire department even and that was developed by a fellow by the name of the Jack Stout. And there's a reason that there's a 00:31:55
multitude of different EMS models out there because there's not A1 size fits all model. It really kind of depends on your 00:31:59
environment. 00:32:04
Your jurisdiction as far as like the population, I mean, there's a lot of determining factors on which EMS model is best suited 00:32:10
for your jurisdiction. 00:32:15
So when we look at EMS and we look at some of the the top challenges of delivering our different EMS models. So the one of the top 00:32:21
ones is obviously the workforce challenges. There's a real lack of EMS in in the field. It's resulting in about a 65% decline in 00:32:28
applications. And that's system wide that it doesn't matter if it's private, doesn't matter if it's at hospital base or municipal, 00:32:36
They're all seeing a decline in people who want to come. 00:32:43
Serve in that capacity. 00:32:51
So capital and operational expenses have also gone up pretty dramatically, about 11% increase in wages and 12% cost for equipment. 00:32:53
And they're, they're thinking that these costs are going to go up even higher. And I, I forecast them to do that as well from what 00:32:58
I've been researching over the last several months. 00:33:03
Stagnant revenues are also a problem. The cost of providing service versus the return in revenue is not keeping up. Indiana is is 00:33:10
trying to change that right now. They have some legislation supposed to take effect of the first of the year to help speed up 00:33:16
recovery and increase those payments, but yet to be determined, yet to be seen. So we'll have to see how that goes. But this is 00:33:22
resulting basically in a higher subsidies. So this isn't something that's just kind of been unique to Floyd County, we're seeing 00:33:28
this. 00:33:34
All over the United States. 00:33:40
Continuing on, we have also service delivery changes. So people are seeing 49% longer response times, 37% of these different 00:33:46
companies are going to alternative responses to low acuity calls. 28 percent is moving from all ALS to ALSBLS deployments and 00:33:52
about 23% of those are moving away from having dual medics riding in the same e-mail list because there was a lot of agencies that 00:33:59
do that. 00:34:05
Because of the shortage of paramedics are having to go to a single paramedic. 00:34:13
For their deployment, they're also seeing a lot of alternative schedules. So you know, there's there's communities that are kind 00:34:17
of in ponder here. Many of these communities are kind of forced to rethink how these EMS services are being delivered and how 00:34:23
exactly we're going to fund it. So the discussion is being driven by, you know, basically peer reviewed data. I mean, this isn't 00:34:28
just opinion. This is peer reviewed data that highlights the importance of clinical effectiveness, effectiveness in economic 00:34:34
realities. 00:34:39
So according to a fellow by the name of Jonathan Lashko, he's very famous in the EMS world. He says the most significant challenge 00:34:46
in our U.S. healthcare is the lack of delivery of care systems, not the care itself. That's very true. 00:34:54
So in July of 2023, the Floyd County EMS Advisory Board really kind of set off to answer a specific question and that was what is 00:35:07
Floyd County need from his emergency medical services. And after months of meetings and reviewing prior studies in the current 00:35:13
national EMS standards, it was determined by the board that the Floyd County needs between 3:00 and 4:00 ambulances to provide 00:35:18
adequate emergency coverage. After further discussions and recognition of the current EMS shortage, it was determined that 00:35:24
strategically. 00:35:30
3 ambulances in addition to one paramedic response vehicle that are dedicated to emergency calls would ensure that the citizens of 00:35:36
Floyd County are receiving a prompt and professional service. 00:35:42
So I think. 00:35:49
No matter what system that you have or that you're looking at, there's certain benchmarks that you really kind of needed to hit to 00:35:51
be successful. And obviously there needs to be accountability and that and that's from both a clinical level and having the good 00:35:57
appropriate response times and customer service and satisfaction. I mean, the end goal is to have, you know, a good professional 00:36:04
service that's, you know, providing quality clinical care and that you have a happy public that's, that's. 00:36:10
Very satisfied with their service. 00:36:18
Oversight, You know, having a body to monitor service performance with independent, outsized audits. 00:36:20
Accounting for all service costs, multiple jurisdictional approaches optimizes this efficiency, and this includes all billable 00:36:28
runs. 00:36:32
Ensuring the service supply meets the community demand. So what does that mean? That means if if you have a large multitude of 00:36:37
calls and you only have certain amount of ambulances, it's not meeting that need. Well, your, your, your supply is not meeting 00:36:42
that demand. 00:36:46
Stability you need to offer, you know, long term stability for the county and this includes both clinical and fiscal stability. 00:36:52
You know, with all these previous benchmarks of mine. 00:37:07
I'm going to present the following solution that I include several of the items that we've talked about, you know, throughout our 00:37:11
time on the task force. 00:37:14
And through this presentation. 00:37:18
And that's the Floyd County Emergency Medical Services. 00:37:21
So Floyd County Emergency Medical Services would be a standalone county based emergency medical service. It would provide 3 00:37:24
ambulances and a paramedic and a quick response vehicle 24/7 365. 00:37:29
This agency would service all of Floyd County, not including the City of New Albany. 00:37:35
While the initial Floyd County EMS proposals it does not include the city of New Albany, the system itself would be scalable to 00:37:41
accept the city into its coverage area if it were agreed upon by the mayor and the county commissioners. 00:37:47
If the City of New Albany were to decline the Mississippi service, the county would agree, then agreed to pay the EMS subsidy to 00:37:54
the service provider of New Albany EMS services. But this could only happen if there is an EMS lit and it was adopted. If a Public 00:38:00
Safety lit was selected, it would allow the City of New Albany to choose their own pathway for emergency medical services or they 00:38:06
could still opt in to the county service. 00:38:11
If the Floyd County Council. 00:38:20
Dedicated a funding stream such as EMS or a public safety lit. It would provide the necessary funding required to accomplish the 00:38:22
following one. It would provide a sustainable budget for county EMS operations without utilizing the county's general fund. The 00:38:29
funding stream would be utilized to pay for the current system until the EMS contracts expire on December 31st of 2026. It allows 00:38:37
to choose the department head to set policies, protocols, procedure, and procure all necessary equipment and obtain all. 00:38:44
Certifications and inspections. 00:38:52
It would put the newly created agency in a position to assume full EMS operations for the county at the end of the current 00:38:56
contracts. 00:38:59
This is a table that Baker Tilly had presented us on the funding, what it would look like versus an EMS lit public safety Lits and 00:39:06
also the property tax liability impact if we were to do the Max levy for the fire department. And correct me real quick, Mike, 00:39:14
this is a once in every three-year kind of thing for the fire departments. Was that correct? 00:39:22
I believe so, but yeah, I would. I would want to check to make sure. I think so too. 00:39:31
So Highlander, Highlander Fire Department, they're still going to be involved. We still want to use them. So Highlander Fire 00:39:38
Department, it's emergency medical services would be utilized in the system. Highlander would be the primary EMS provider for 00:39:43
their protection district and received a subsidy from the EMS or public safety lit. I think the actual dollar would need to be 00:39:49
negotiated and probably really depends on what type of. 00:39:54
The council would utilize, but All in all, you know, Floyd County, Mississippi and Highlander Fire EMS would have a mutual aid 00:40:00
agreements with one another. We'd be backing up one another and assisting each other on a request. 00:40:07
So. 00:40:17
What are some of the benefits to a system like this? Well, stability, so there's no need to depend on private contractors to 00:40:18
provide necessary service. 00:40:22
We would have a service director that would be chosen by the commissioners to oversee the systems operations. The County Council 00:40:27
will provide the fiscal oversight, ensuring fiscal responsibility. 00:40:32
With a revenue stream in place, we could determine how our citizens are built, which to me is very important because all Floyd 00:40:38
County residents under my system would never personally receive a bill for service. 00:40:43
EMS will build a patients health insurance provider and after that would accept the insurance payment is paid in full. 00:40:49
The Floyd County residents shall never see a bill even if you do not have insurance. 00:40:55
The goal is to ensure that our residents have a very clear return on investment with a system like this and. 00:41:00
Our goal here is to ensure that not only is there a clear return on investment, but we want to reduce the negative outcomes by 00:41:07
alleviating the worry of whether or not that patient can afford. 00:41:12
They Angela's treatment and transport. I can tell you from personal experience that, you know, there's been several occasions 00:41:18
where people have delayed calling for help because they were afraid they couldn't pay for the ambulance ride or you got there on 00:41:25
scene and they didn't want to be transported because they were referred transported by the annual. So put them in some sort of 00:41:31
fiscal hardship and next thing you know, they're they're going into bankruptcy. Well, this route alleviates that. 00:41:38
So what would the future look like? Well, I think setting up the system with the EMS lit at .15 or a public safety tax at its Max 00:41:49
will give the system room to grow. 00:41:55
When billing revenue starts being generated, it's possible that the rate itself could be reduced. If the city was to opt into our 00:42:01
system, that could generate an increased revenue by increasing the amount of billable calls and increase the likelihood of 00:42:06
reducing the rate. 00:42:10
I also see that the system kind of changing. I think that mobile integrated health or the MIH. 00:42:16
Sometimes people call it Community Paramedic is the way of the future. The use of Community Paramedicine reduces the unnecessary 00:42:22
strain that is already being placed on our 911 systems by identifying those callers that are not in need of critical or emergent 00:42:28
services. Community Paramedic can also assist law enforcement with psychological evaluations without committing a transport unit 00:42:33
until necessary. 00:42:39
Lastly, community paramedic can resist those that are underserved here in Floyd County as well by helping. 00:42:45
Those in need of specialized services find those resources that they truly need, and many of those services that they offer in 00:42:51
community paramedicine are available. 00:42:55
We would create a training institution that could help instruct up to the paramedic level. This would help alleviate all the 00:43:00
roadblock of quality pre hospital education that we've seen here at a local level. 00:43:05
There has been no advanced life support training in Clark or Floyd County since 2012. 00:43:11
That's unacceptable. 00:43:17
So just kind of in closing, you know, we have an opportunity here to do something great. We have an opportunity to put an EMS 00:43:20
system that is solely dedicated to emergency calls. It is a system that provides strength, stability and is focused on providing 00:43:26
pre hospital quality, pre hospital care. The dedicated funding system, our stream allows the Floyd County Emergency Medical 00:43:33
Services to bill your insurance only. No resident of Floyd County should personally ever receive a bill, an ambulance bill. 00:43:40
And to me, that's a real clear return on investment for our citizens and they deserve that so. 00:43:47
That's my presentation. 00:43:52
Mr. Chairman. 00:43:56
Yes, Sir. 00:43:58
So you know, we had Putnam County here, we all filled it questions amongst ourselves even afterwards. 00:43:59
Floyd County has always been behind when it comes to EMS service, and it seems that the can has always been kicked down the road. 00:44:09
Your proposal for and this is actually to start conversations. I'd like to make a motion that we accept. 00:44:18
This proposal to be sent to the Floyd County County Commissioners. 00:44:26
All right. I have a recommendation or recommendation. Yeah. 00:44:32
For a proposal. 00:44:37
I can either take a second or we can have further discussions. 00:44:41
I'll second it. 00:44:47
OK, I got a motion in a second from Mr. Moon. 00:44:49
Mr. Moody. 00:44:53
Is there any further discussions? I'm gonna I've got a hard stop here in just a few minutes for another appointment, but. 00:44:55
It's my belief that this model has. 00:45:04
Emerged. 00:45:07
For specific reasons as what fits. 00:45:09
What our county needs, we've had. We've had different presentations and everyone who's presented has said. 00:45:14
None of these work for every county. That's why the counties. Different counties use different methods I. 00:45:23
I think we're at a point where. 00:45:31
We can't be. 00:45:35
Chasing the private providers every couple years and wondering if they're. 00:45:38
What the bill is going to be, what the contract cost is going to be, if they're even going to be around. 00:45:42
So for those reasons I back this this proposal. 00:45:48
I don't think it would be out of order, but I. 00:45:56
Just because there was a motion and a second made, I do want public input here. I would like to hear from the public before we 00:45:59
take our final vote if, if everybody would find that. 00:46:05
Acceptable. 00:46:12
No, OK. 00:46:14
Everybody OK with that? 00:46:16
Is there anybody from the public that would like to comment? 00:46:18
As we move forward. 00:46:22
Yes, Sir, if you can come to the podium, state your name. 00:46:23
Tim Harbison, Edwardsville, Galena Rd. I. 00:46:35
I think your proposal. 00:46:38
In a perfect world sounds great, but I have a question. Does the ability to. 00:46:41
Move this proposal forward, depend on what lit and what level the Council. 00:46:51
Approved. In other words, does the Council have to? 00:47:01
Vote approval. I think there were like last council meeting where they're like three options of lits that would. 00:47:06
Would this proposal be based on? 00:47:13
What the council approved, which one of the lit options the council approved, you understand what I'm saying, like to meet the 00:47:16
financial needs to have a service director or whatever. Well, yes and no. The council needs a recommendation on which way the 00:47:24
commissioners are going to move forward. So we know how to plan for that. We also have a two year window of fixed cost, but within 00:47:31
that two year window if we push forward with. 00:47:38
This proposal we'll need to start acquiring equipment. 00:47:46
And planning for the latter part of that contract to be able to take off on day one. I guess maybe I maybe I'm not getting this or 00:47:50
maybe I'm not making myself clear, but. 00:47:57
But there were three different options that brought in three different amounts of money to the county budget. Wouldn't it depend? 00:48:03
Like if you got the lowest? 00:48:09
Lit would that still be able to be what this proposal still be able to be funded? You could you could fund both proposals with the 00:48:16
the public safety or the EMS let whatever the county. 00:48:22
Thank you. 00:48:29
Mr. 00:48:32
I got to go. 00:48:35
Denise Konko County Council. 00:48:43
I guess the part that's missing for me here is the dollars. 00:48:46
And I would absolutely want to see the dollars that this is going to cost. 00:48:51
On, you know for the next getting ready period and then on a go forward period. So I would need like a five year projection to 00:48:57
understand what kind of lit we would need to put in place and are we willing to really do that? 00:49:06
And what other options we have and what the money would, what the cost would be for those other options? So for me I'm looking at. 00:49:16
Because that's my responsibility. That's what I'm. I'm the fiduciary body and for me to make a decision. 00:49:25
Would have to have some dollars attached to this proposal versus a fire based proposal. So that that's what I would need to see. 00:49:35
Do you have any of those? Well, I think part of the problem is, is that we haven't, we have kind of a rough estimate of what that 00:49:41
budget would kind of look like. 00:49:48
But there's a lot of things that go in there and this is a very volatile market. So for example, depending on the type of 00:49:55
ambulances that you went with, not only what type as far as type one through type 3 or you know, but even when you start talking 00:50:01
about the manufacturer. So buying an ambulance is not like buying a Toyota. It's, it's, there's some of these manufacturers that 00:50:07
are. 00:50:13
Have a service delivery time of out to 2028 depending and that's a spec model now obviously. 00:50:20
Demo models you can get before then, but it depends on what demo model you want what, what brand is it going to be, Is it going to 00:50:26
be gas? It's going to be diesel. And I think those are questions that ultimately the head of an agency needs to answer, not 00:50:30
necessarily. 00:50:34
Us up here trying to to figure out how to operationally run this department, of course, Jason, But what we would need is maybe a 00:50:40
high low number or a media or this is what you know, I think we need some kind of financial number so we know what the tax. 00:50:49
What gave us was 3.24 million. So I'd say about 3.5 million annually. But startup is really going to kind of depend on what type 00:51:00
of equipment these people are going to go with, you know, so we need startup cost and annual cost and the annual cost is 3.5. 00:51:10
You're telling me we're running it now at a $1.3 million. So I, I have, I have a really hard time doubling our current budget. 00:51:19
I, I don't know, I need more information is what I'm saying here, and we'll get it. 00:51:29
This is more to talk about the delivery model as far as more than, but we can't talk about a delivery model if we don't understand 00:51:37
what kind of taxes we need to put in place. 00:51:41
But this is exactly how can kicking keeps us going and going and going because this this market is so volatile, right? And I 00:51:48
respect what you're saying about the fiscal body because it's just so uncertain as far as far as like. 00:51:54
What, what costs are going to be for equipment and so on and so forth. So I'd like to call for a vote because I need to leave. OK. 00:52:01
OK. Thank you. Thank you very much. Thank you. I got a motion and a second motion was made by Charlie. 00:52:08
Yeah, absolutely. 00:52:21
John Shellabear report again, Commissioner. 00:52:29
Couple questions. You said we would have 3 ambulances for the unincorporated. 00:52:31
Where would they be? 00:52:36
Well, the three county ambulances would probably stretch around through New Albany Township in Georgetown, with Highlander 00:52:38
protecting their area. 00:52:42
Decided during the EMS task force or the EMS Advisory Board. But you've got you've got you got 2 townships with a very large 00:53:16
population and geography. Well, I. 00:53:21
I'm going to discuss that. I got to go with. I'm sorry. I mean, this is regardless, this is coming in front of the. 00:53:27
Commissioners anyway, I understand. Well, that's that's why I was getting ready to say this is a recommendation that's going to 00:53:32
the commissioners. Hold on, hold on, hold on, hold on. If I can add, you're taking a vote and you got the medical director. 00:53:38
Doctor Harris is not here. I think his vote is also important. I've also, I've shared the slides with Doctor Harris and we've 00:53:45
talked about this system and he is supportive of this. 00:53:49
Is only a recommendation, Yeah, this is only a voter recommendation. And we can hear that. I just think it's kind of. 00:53:56
Last time you had you had a presentation from Putnam County and then today we had one from this gentleman. And so you see both 00:54:04
sides and all once then you're going to make a recommendation to the commissioner. I think that's kind of premature. Thank you. 00:54:10
Thanks. 00:54:17
Got a motion in a second. Any further discussion? 00:54:19
You gonna do roll call? Yeah, we'll do a roll call vote. 00:54:22
Mr. Huth. 00:54:26
Mr. Moon, Yes. 00:54:28
Mr. Short? Yes. Mr. Moody? Yes. Mr. Franklin, yes. And I know yes as well. 00:54:30
All right. 00:54:39
We have any further business? 00:54:41
Any of our board members? 00:54:44
OK. I will open up the floor back up to public comment if anybody has any further. 00:54:46
Comment. 00:54:52
That's to be determined by whoever sets up the agency, and that will be negotiated between all of those parties. This is just 00:54:56
figuring out the model that we're going to recommend to the Commissioner. 00:55:00
Which is important because they have a vote coming up. 00:55:07
Soon, as far as the funding stream, yeah. 00:55:09
I got something. Yes, ma'am. 00:55:13
I I just want to. 00:55:21
Go ahead with my thought about the fiduciary responsibility there had. I have never seen a plan. 00:55:23
Without dollars associated with it, there has to be some dollars associated with this plan before it moves forward, even to the 00:55:32
commissioners in my mind, so. 00:55:38
I'm just going to stop there. There has to be some dollars associated with this plan. 00:55:44
It makes absolutely no sense for our constituents to enter into any kind of plan without an understanding the consequences to 00:55:50
their tax dollars. 00:55:55
Yeah, if you don't mind your address, please. 00:56:05
Jeff Dixon I live in Clark County, Indiana, 5610 Scarlet Oak Rd. I have vested interest in Floyd County. My mother-in-law lives at 00:56:12
3025 Plantation Drive in Southern Estates. It's in Sellersburg, but it's in Floyd County. 00:56:18
She's elderly, she's widowed, and I'm her power. 00:56:25
So. 00:56:28
Charlie, I think said just a second ago, this is how he kicked the can down the road. Well, here's the thing with EMS And so, and 00:56:30
for you, for those of you all don't know me, I'm on my 25th year in EMS. 00:56:35
Been a paramedic for 25 years. I've worked private service, I've worked municipal service, I've worked for the federal government. 00:56:41
I've done all three. I've seen good, I've seen bad. The thing with EMS is this. You can have good, you can have fast, and you can 00:56:46
have cheap, but you can only have two of the three. So to sit here and say that you know, well, I understand cost and I understand 00:56:52
fiscal responsibility, I totally get it. I respect that. 00:56:58
But just taking the cheaper option every time gets you right back to where you're at right now, because that's what's always been 00:57:04
done. 00:57:07
As far as the deployment model goes. 00:57:11
You know. 00:57:14
There is no one-size-fits-all approach. 00:57:15
A countrywide service employee in Clark County won't work, period. 00:57:18
Countrywide service in Floyd County would work. 00:57:23
But I'm also saying I'm not saying that a fire department based service won't work. 00:57:25
But all the presentations have been for one prior to today. And one of the questions that was always raised was is there was 00:57:30
always somebody that was going to be left out coverage wise. There was always going to be somebody that was going to be left out. 00:57:36
And with with at least what was proposed today, nobody's left out. 00:57:43
And anyone who's providing a ServiceNow is not being kicked to the curb. 00:57:48
You're basically building a hybrid service is what you're doing because. 00:57:53
You're going to have other services that are going to continue to function. 00:57:57
So you're still going to have two different services providing coverage and that's actually going to put 4 ambulances on the 00:58:01
street. 00:58:04
Plus parameter chase car instead of the current 3 plus plus parameter chase car. So you're going to have more coverage. The 00:58:08
biggest problem is look around. You have no mutuality. 00:58:13
Current, the previous provider left. 00:58:19
You have no mutual weight. Maripro is busy. They're going to be busy regardless of what happens in the county. They're going to be 00:58:22
busy in the city. You have no mutual aid, so you have to build the system from the county's perspective. 00:58:28
To have enough fluff in there, I guess you could say enough resources in there for that bad day because. 00:58:34
You know it. 00:58:42
Look around at both counties, there's not a whole bunch of ambulances anywhere. And I'm not saying anything bad about either one 00:58:43
of these delivery models. I think both of them have their pros, they have their cons, But I think it would be foolish if anyone, 00:58:49
regardless of which model they support, to completely turn their back on the other. You've got to look at both options. 00:58:55
So and I think that's what. 00:59:03
The position today was. 00:59:05
He's just presenting an option. 00:59:08
So I mean to me. 00:59:11
You know, you, you can't make an informed decision without having all of your information. So put all the information out there 00:59:12
and let let the commissioners and the council make the decision on what they want to do and. 00:59:17
The way I've understood it, I think that's what you all were trying to accomplish today. That's correct. 00:59:22
So thank you. 00:59:26
Thank you. 00:59:29
All right, so if there's no more further public comment. 00:59:31
Does anybody have any closing comments? 00:59:36
Can I get a copy of the presentation? 00:59:39
The slide presentation, yes. 00:59:42
You know, I think that this task force. 00:59:45
Has gave. 00:59:49
Or will be given the county commissioners enough to go off of? 00:59:52
You know, we've all discussed and we've had acclement amount of time to get presentations from other areas which I think all of us 00:59:56
pretty much touched out to other other local. 01:00:01
Fire or county wide EMS services kind of brought it back and kind of picked it through where no, that's not going to fit our 01:00:08
scenario. 01:00:12
You know, I think throughout these meetings and I don't want to speak for for Mr. Moody or Chief Franklin or Mr. Mills, but you 01:00:17
know, there's two departments here that really isn't really keen about doing EMS. They want to stick to fire. 01:00:25
And if they want to speak on that or if I'm wrong, please call me out on that. But you know, that's what I've got through through 01:00:33
these several meetings. 01:00:36
You know, we had the presentation done from Putnam and it was really good. 01:00:41
And she or from Clown Creek, I mean, we thank you for coming, but I really still didn't get a full picture of a fire base EMS. 01:00:46
You know what does a Firebase EMS look like? We actually have one here, employee county, but I don't think anybody can tell us 01:00:58
what it actually looks like right now, so. 01:01:03
Fire based part. So fire based team has by definition is. 01:01:09
You're you're basically serving the whole world. 01:01:15
Are civilian paramedics need increased the stat to staff? 01:01:17
There's different benefits, different benefits, different jobs are working. 01:01:24
If you want to just actually, we're getting ready to close the meeting up, but if you hang out for a minute, we'll be happy to 01:01:32
chat with you. 01:01:37
I want to take this direct involved for coming because he pretty much told you that it wasn't fire based you were. 01:01:43
Problems retaining people because there was no way to do but even even though maybe the. 01:01:52
I appreciate you being here. 01:02:00
Is that what you're trying to say, Mr. Reckon Wall? I'm sorry. 01:02:04
Just for clarification for the committee, were you trying to say that if we're not doing a fire based system and then that 01:02:08
there's. 01:02:11
One of his benefits? 01:02:15
There was no problem. 01:02:19
Ocean within the system if it wasn't a power based system. 01:02:20
Is that what you're trying to say, Mr. Right? 01:02:25
Vulnerable position for them. 01:02:29
OK. 01:02:33
OK. All right. We got a motion and a second. Any further discussion? 01:02:37
All right, all things in favor signify by saying aye aye. 01:02:42
Thank you. 01:02:47
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Pledge allegiance to the flag of the United States of America and to the Republic for which it stands, one nation under God, 00:00:01
indivisible, with liberty and justice for all. 00:00:07
OK, so today we have a little different setup than normal. Mr. Smith, who is the president of the Highlander Fire Board, is stuck 00:00:17
out of town, was unable to get the flight in, so he has asked his vice chair to step in. So welcome, Mark. We appreciate you being 00:00:23
here today. 00:00:28
Councilman Short is on his way in here and our attorney was unable to make it today as well. So we have Suzanne, if you could just 00:00:36
check the role myself, Mr. Moon, Mr. Hooth for Highlander, Mr. Moody for Georgetown, and Mr. Franklin for New Albany Township. 00:00:43
Doctor Harris wasn't able to make it here today either. So we're going to have two pieces of information we're going to share 00:00:51
today. The 1st is Mr. Smith had requested a presentation from a Firebase DMS service and. 00:00:58
Has reached out to our friends over at Fern Creek, they have a representative here who's going to talk a little bit about their 00:01:06
service and then I'm going to talk a little bit about another option for us to kind of consider so. 00:01:11
I just want to put this out here for Full disclosure and everything. 00:01:17
In my professional capacity, obviously, I work in the fire service. The fire service is pretty tight knit. We know a lot of people 00:01:22
to the surrounding areas. I've been working real closely with the people at Fern Creek as long as well as my excuse me, 00:01:27
consultant. 00:01:32
Jeff Dixon, who's also here. 00:01:37
Who you are and what you're doing. OK, my name is Doug Rex Mold. I am with Fern Creek. Thank you for the kind words of Fern Creek 00:02:10
Fire Department. I've been with Fern Creek just over a year so it doesn't sound like much, but just to give you my background, I 00:02:15
did almost 25 years with the city of Louisville and rose to the rank of deputy chief. I was the cartoon there in the city of 00:02:21
Louisville. While I was on Louisville we had a fire based EMS system for some years and then and then with a merger proposition 00:02:27
over. 00:02:33
County that the EMS was taken out so I have some ground level experience with EMS but more administratively. I moved from the 00:02:40
Louisville Fire Department, left Louisville Fire Department with the Pleasure Ridge Park Fire Department as their Fire Chief and I 00:02:47
brought an EMS system into Pleasure Ridge Park Fire Department and ran that until my retirement two years ago and then and then 00:02:55
since then I've transitioned into. 00:03:02
Creek, which is fully integrated with EMS. So that's my background on EMS. A couple of things I want to introduce you to tell you 00:03:10
about myself that I'm not not a paramedic, I'm not a doctor, I'm not a medical director and I know nothing about Indiana laws when 00:03:16
it comes to fire based EMS. I'm Kentucky through and through when it comes to the law. So I can't I can't advise on what this law 00:03:22
would say or what that law would say if you're in Kentucky, I could help you with that, but I can't do that here but so just so 00:03:28
you. 00:03:34
My background comes from that. 00:03:40
Why do we do EMS the long and the short of the, the EMS system and the sounds really curt, but it's, it's, it's money in Kentucky. 00:03:42
A, a, a department we've called chapter 75 departments. It's how it's the state law. Chapter 75 is how we get our funding for the 00:03:50
department. And if you're a fire department only you get $0.10 on the 100. And if you're a fire and EMS based system, you get 00:03:57
$0.20 on 100. So it's. 00:04:04
Some money proposition and it's not to get rich, it's to make sure you can keep growing your system or maintaining your system. So 00:04:12
it's, I hate to say that it's not out of this great level of honor and duty to our systems, but it, it, it ends up being that we, 00:04:19
we do we're very, we were honored to do that job, but it came out of the need because we couldn't fund ourselves anymore on $0.10 00:04:26
per 100. So it is going to be very, very. 00:04:33
Candid about that. 00:04:41
So when I was I'm going to really start at Pleasure Ridge Park. 00:04:43
When I was the chief at Pleasure Ridge Park, we had roughly 150 employees and very kind of a big area wide, about 60 square miles, 00:04:48
not huge, but not small, about 60 square miles, 105 thousand citizens and a lower socioeconomic area of Jefferson County. And when 00:04:56
I say that that means run volumes high, it's very high. 00:05:05
Our our run volume is really based on socio economic status and age. 00:05:14
And so Pleasure Ridge Park being one of the older portions of the, of the community, one of the things they likes out there. What 00:05:19
do people in the East End call the people in Pleasure Ridge Park? They call mom and dad because all the young folks moved out and 00:05:25
mom and dads are still living there and, and their income, they're, they're the old real blue collar industrial workers and, and 00:05:31
so. 00:05:38
Starter homes, so a lower socioeconomic area that made it very, very busy. 00:05:45
We had three full time ambulances when I left there in 2022 and we were averaging about 13,000 incidents a year for three 00:05:50
ambulances, which is just smoking. That's over 4000 runs per ambulance. So to to make you understand that a lot more runs were in 00:05:58
Pleasure Ridge Park, but we were having to get mutual aid from other departments. We couldn't handle all those runs ourselves. We 00:06:05
had more than 13,000 runs our units made a total of. 00:06:13
Thousand runs, so over 44000 runs a year per unit. Very, very busy. 00:06:20
It at at Pleasure Ridge Park. I fully integrated the system. What does that mean? I had, if I needed six people to run, four 00:06:26
people on a fire truck and two people on an ambulance. That's all I had was 6 people and I rotated those firefighter, the 00:06:33
firefighter level positions, 12 every 12 hours. You were on the ambulance, you were on the fire truck. You were on the ambulance, 00:06:39
you were on the fire truck. Fully integrated. They knew each other's jobs. 00:06:45
If I were king for a day, that's how I would run the entire system. 00:06:53
The problem is I was the only one doing that in Pleasure Ridge Park. So what do you think my firefighters did? They look for jobs 00:06:56
that they didn't have to ride the ambulance on. 00:07:01
And so I kept bleeding out fire trained people to other departments that they didn't have fully integrated. They weren't fire and 00:07:06
EMS together. Again, if the host system ran like that in Jefferson County, that wouldn't have been an issue. I could have been a 00:07:11
pleasure as park firefighter and rode the aimless half time and rode the fire truck halftime and I will try to go to Fern Creek 00:07:17
and become a firefighter there. I would have to do the same thing. That wasn't the case if I was a Pleasure Ridge Park 00:07:23
firefighter. 00:07:29
And I wanted to get off that ambulance. I went to Louisville, who doesn't even have ambulances, or I went to another department 00:07:35
that didn't make you ride those ambulances. So it it, it has been moved my. 00:07:40
My successor is one of my best friends. He's the chief of Pleasure Park. Now he's had to change that. So I'm a grown man. I 00:07:47
understand that didn't work. It would still be the way I would do it if it was, if I were king for a day. But I'm not. I was just 00:07:54
one Fire Chief in a system with 9 fire chiefs. So it didn't didn't work out right. So at Fern Creek, it's fully integrated as EMS 00:08:00
is in our is in our system. 00:08:07
But nobody has to be dual role. 00:08:14
We do train our firefighters to ride the ambulance. If the ambulance is short, we can roll our firefighters over there. And, and 00:08:18
just let me make you understand, it's almost always EMS that's the short it. The firefighters usually are always there in force. 00:08:24
And so you have to roll extras over to the ambulance. There's usually very few times when you got to say how I need that person 00:08:30
from the ambulance to roll over to a fire truck. It's always the ambulance that we're back feeling. And so we do have the 00:08:36
capability. 00:08:42
Doing that because they are trained like that, but it's not mandated that that's the only place they're going to ride every 12 00:08:48
hours. If that makes hopefully that makes sense to you so. 00:08:53
We have 7 different 7 ambulances at Fern Creek. We employ 137 full time folks. Five of those are fire trucks and seven ambulances. 00:09:00
And some of those ambulances are pretty slow and some of them are very busy. Why does that make a difference? And it makes a 00:09:10
little bit of difference in our system. Two of those ambulances are so busy they can't do 24 hours a day we have. 00:09:19
Have 12 hour ride times on those. The other five ambulances are in slower areas, they don't make as many runs. It's palatable to 00:09:29
do a 24 hour shift on. It can be very tiring and you are tired that when you get off the next day but you're not just completely 00:09:36
wiped out. So we're able to ride 24 hour. 00:09:43
Increments on there so that that's we. 00:09:51
The, the balance in our system is we have two very, very busy. And it just so happens, uh, Mr. Feckity and I were talking about a 00:09:57
minute ago, how many runs of hours are into the city and not of our own or they, they into another mutual aid. A good portion of 00:10:03
ours are our mutual aid runs and the two trucks that are the busiest, the two ambulances that are the busiest are those that sit 00:10:10
right on the city border. And so they run a lot up into the city. 00:10:17
Again, so so economic status. 00:10:24
And age and and then the southern parts of our district and Fern Creek, newer, younger, more fluent, just it's just the facts. And 00:10:27
so they're, they're much slower. 00:10:33
And so those were able to put 24 hour personnel on there. Again, they have some days where they're wiped out, but for the most 00:10:40
part they find time downtime. 00:10:44
Uh, if you're familiar with unit hour utilization, it's called, uh, use. It's how much a unit is used during a shift. 00:10:49
The you want to stay around the national average is what you want to stay around 33% of the time. So think about this. We want to 00:11:00
put an ambulance on for 24 hours a day and you say you only want to use that 8 hours of the day. You only want it on runs about 8 00:11:05
hours of the day. You have to, you have to do maintenance, you have to do some downtime, you have to do training, you have to do 00:11:11
all these other things. 00:11:16
That if their unit, our utilization is up above 30%, they're very, very busy. 00:11:22
Our 12 hour units are 65% unit hour utilization, so we have to take those trucks offline to even get them training. We can't. We 00:11:29
could never work training into their system because they're so busy. 00:11:36
So when you're looking at at things about how busy and how, how you have to look at everything, they if you're putting them at a 00:11:44
Firehouse with toilets, the toilets have to be cleaned unless you're gonna hire a janitor. Most firehouses don't right. If you're 00:11:50
putting them if, if they have so many training hour needs, which if they have a national registry, they have to have 72 hours 00:11:55
every so many hours to keep their national registry up, 72 hours of training. You have to think about those things. How are you 00:12:01
going to get them trained? So. 00:12:07
So the, the benefits that I really see in the Firebase EMS and I, I've told you my background is really, really far. So this is 00:12:14
the side that I'm looking at. The benefits are light at the end of the tunnel. There's a place to go. If I'm on an ambulance and 00:12:21
sitting in an ambulance and all I have is a just a single based EMS system, not a fire based EMS system, I have nowhere to go. I 00:12:28
got 25 more years of doing that exact same job. 00:12:35
If I'm in a fire based EMS system, I can switch over or promote out throughout that organization. And to me, that's a little light 00:12:43
at the end of the tunnel, right? So, and I can tell you in the systems that I've worked in, they're so busy that hardly anybody 00:12:50
makes it 20 to 25 years just doing Ms. It's just too hard on the person. And so the fireside is a good, good side to go and, and 00:12:57
learn different things and different. 00:13:04
Models. 00:13:12
The. 00:13:13
Other things that the other light at the end of the tunnel, like I said, if you're 12 hours on ambulance, 12 hours on the fire 00:13:15
truck, that's a daily light at the end of the tunnel. That's a difficult one to do unless everybody around you is doing the same 00:13:19
thing. 00:13:23
And I've already hit that, so I won't hit again. So for the system itself, for the individuals themselves, why do I like Firebase 00:13:27
DMS? If I'm just on a single system, EMS system, I'm going to sit in that truck for 8/10/12 hours, whatever your shift is a day. 00:13:35
Where do I go? Where do I Do I go up to the Circle K and sit there? Is that my strategic landing spot? Do I sit at a headquarters? 00:13:42
Maybe I'm lucky enough, but if I've got more than one. 00:13:50
I've got to go out somewhere and be positioned. That leaves me sitting in a vehicle for 8/10/12 hours a day, whatever my shift is. 00:13:57
That's not good for the individual. If I'm in a fire based system, I have a Firehouse to return to. I have a home quarter to 00:14:05
return to. I can get out of that unit, right? If I'm at a Firehouse, there's a likelihood. I don't know about everybody, but 00:14:12
there's a good likelihood that somebody there is cooking a more healthy meal than a McDonald's or a Captain DS or or something. 00:14:20
Effect So if you're cooking a meal and you can get out and eat a healthy meal rather than a McDonald's or a Captain DS or a 00:14:27
Wendy's, whatever the case may be, it's it's healthier for the person. Most fire houses have workout equipment. I have the ability 00:14:35
to work out, get out of that truck and move around. If if I'm working a 24 hour shift, I have the ability to lay down in a bed or 00:14:42
sit on a couch, even turn on ATV. And I know that's what when you're talking about. 00:14:50
Taxpayers, we don't want to watch on TV all the time. You're not paying that person to watch TV. You're paying them to be ready to 00:14:58
make that run. And in between those runs that you're paying them to make, they have to, if they just sit in the front of an F150 00:15:05
or an F450 all day long, they're not going to be very effective. And, and again, that's, I believe I could find studies on that. 00:15:12
My information is mostly anecdotal because I've I've worked with it, but being able to report back to a fire station is, is a. 00:15:20
Big benefit and then the other benefit that I have seen. 00:15:28
And I think. 00:15:32
My friend back here, Mr. Feckity, would tell me from our time at Louisville, as you bring them into a more structured environment 00:15:34
and you slow down the wrecks that they have, you slow down the disciplinary processes that you put them through because they're in 00:15:41
a more structured, more an environment with more camaraderie, where they're held to account more than with just two partners 00:15:49
working side by side every day, sitting at the Circle K, waiting for the next run, drinking my 32. 00:15:56
Bounce drink right. And so again, those are those are kind of my thoughts on the fire based EMS system. Any questions? 00:16:04
I got just one. You highlighted all a lot of the good stuff in your eyes. What are some of the downfalls? The downfalls are most 00:16:15
of the time in the fire service. There's more promotable sides of the fire department than there are EMS. Fern Creek's dealing 00:16:22
with that right now. We have Sergeant, Captain, Major, Colonel. 00:16:28
For the old Army thing, we have those 4 levels to go to on the fireside. On the Ms. side, we have paramedic and then we have a 00:16:35
jump all the way to a major. And then if you're lucky enough to get into the chief staff and that, that's all appointed. So I 00:16:41
mean, that could be any other side, but there's less promotable spots. So it does cause some friction. We're actually looking at 00:16:47
some of that right now to say how. 00:16:54
We we know we need extra help on the EMS side, not just making runs, but. 00:17:01
Development training, different things like that, where are their promotable spots that we could build into that system? So that's 00:17:07
one of the rubs there. How many, how many calls do you all make at Fern Creek annually? Last year we did just like I said at PRP, 00:17:13
we just did just over her, I think 15,000 with seven trucks. I believe that was the number. I apologize for that. Is that 00:17:20
transports as well or is that just called? 00:17:26
And I, I, I can send you that information and I'll get you, I think actually I think I already have it in my, one of my files in 00:17:34
the office. But so is all your trucks paramedic? No, they are not. We run 3, three different types of trucks. We run just an EMT 00:17:39
truck. 00:17:44
We run an advanced EMT truck and we run paramedic trucks. We try. It's our, it's our goal to have no well, our goal is to have no 00:17:49
less than 5 on a day. Our minimum is 3 paramedic trucks a day out of the four. 00:17:56
Our goal is always 5 and then goal is really 7. I'll be quite honest with you, but but we we like to keep it at 5. We go into 00:18:03
overtime at 5:00 and then we go into mandating overtime at 3. So do you have chase vehicles as paramedics? We only have a chase 00:18:10
vehicle when we have say an EMT or someone calls in sick and we have an odd number and we'll put a paramedic in the chase vehicle 00:18:18
that is not a normally staffed position. 00:18:25
You mentioned that you tend to be short on the EMS side when you're moving firefighters and EMS back and forth. 00:18:37
Is that a nutrition issue or a little bit of it? Is a little bit of it is we overstaff? So in my mind, I got to be real careful 00:18:45
about how I say this, not not because I'm worried about any repercussion. So a normal engine company on the would have four 00:18:52
people. Fern Creek allows it to ride with three. The normal ambulance rides with two, we never ride 3 or 4. So there's always a 00:18:59
cut back on if somebody calls in sick. 00:19:06
Or take that has to leave for an injury or whatever the case may be. We generally have one person on an engine to be able to roll 00:19:14
over to them. So that, that is the main reason why usually we never have extra people on the ambulance side, which might be one of 00:19:20
the what, what's the downside? Well, we ride a little bit extra on the fireside, but we never do on the on the ambulance side. And 00:19:25
sometimes there's some resentment built up. And, and when I talk about what are the main problems, I think the system works 00:19:31
better. 00:19:37
In the Firebase system. But I think the resentment and the personnel issues that come from that resentment are probably the 00:19:44
biggest downfall. 00:19:47
Of it all, you have to balance that when they have a boss that's been in the fire service for 34 years and now I have to say, and 00:19:51
I don't have to say it, I'm proud to say I'm in the fire and EMS service, right? But sometimes it's really easy for it to roll off 00:19:58
my lips. I'm a Fire Chief, I'm a fire this, I'm a fire that an EMS never rose off. And when you're an EMS person and you never 00:20:05
hear your name called, there's resentment built in that. So that has to be built into the culture and we're trying to do that. 00:20:12
And and just one example of that was that. 00:20:20
At Pleasure Ridge Park, there is not a firefighter appreciation week, but there is definitely in Jefferson County, State of 00:20:23
Kentucky EMS appreciation week. We made a huge deal of that. That was a big deal for us because it was a way to say, hey, you all 00:20:30
are important and we do want you all to be part of our system so that that's a cultural thing. 00:20:37
When you hire an employee at Fern Creek, are they hired as a firefighter or EMS or how do you do that? We do both, so I. 00:20:46
First off, let me start with. They're currently working on getting a complete. 00:20:55
Their first? 00:21:02
Full time recruit class at Fern Creek's ever put on? 00:21:03
And that's just because of our growth and because the old volunteer system, which used to funnel people into the system doesn't 00:21:08
exist in Jefferson County anymore. And so they're they're doing their first full time recruit class that will start in January of 00:21:12
25. 00:21:17
We have, although we can teach EMT's and advanced EMT's, we have a outside contractor that uses our our facilities to teach EMT 00:21:23
classes and he doesn't charge anything for us to put people in him because he gets free rent from us. So that is how we bring our 00:21:29
EMT's in. 00:21:36
To the system is we, we currently have three EMT recruits coming in and then we'll do our own fire. So we do both and then 00:21:44
paramedics are pretty much laterals or we send them to school while they're in. Of course that depending on what program you get. 00:21:51
But the main one that we use is a 2 year process for that. And so it's tuition reimbursement. It's through the Jefferson Community 00:21:59
Technical College so that it's just like you're going to college and Fern Creek. 00:22:06
Reimburses that as the student goes through and then I know you didn't ask this question, but to give you empts and firefighters 00:22:14
paid the exact same thing. You get an advanced EMT, you get a $4000 raise. You get a paramedic, you get an $8000 raise. So the 00:22:22
paramedic, the paramedic certification holds $8000 worth of value to Fern Creek. Are you union shop? No Sir. OK thank you. 00:22:31
Chief, one more question. I know that I don't think I've ever really talked to you guys about this, but we, we've seen a lot of 00:22:40
departments over in Jefferson County merge and come together. I. 00:22:45
Obviously Fern Creek has gone through that as well. Fern Creek isn't just Fern Creek anymore. It is Fern Creek, but they've 00:22:52
absorbed several. How many districts have you all absorbed? So including Fern Creek, the Fern Creek district, there's four 00:22:58
districts put together, Fern Creek, Highview Mutual and Camp Taylor that that has happened over the last three years, which is 00:23:05
rapid to do that many mergers. And so we we've grown. 00:23:11
Exponentially, let's say over the last three to four years. 00:23:18
One of the reasons I was brought in to the Fern Creek Fire Department was for that my guidance on working with bigger departments 00:23:22
versus a single Firehouse department. And the chief saw that value, and that's one of the reasons I was put on his staff. So. So 00:23:29
do you think in in your mind, was this easier to accomplish because you all came together? Could you imagine doing this as if 00:23:36
every department had their own EMS division? So they did, Yeah. Out of the three, out of the four that merged together. 00:23:44
Three of them had their own EMS separately. And so again, I know state laws, but they had to pick one to go with and Fern Creek 00:23:52
was the one they went with because we got licenses. And so the Fern Creek's license was more, more suitable than the mutual or the 00:24:00
high view license that came with it. So and you all are a certificate in the state over in Kentucky. That's correct. 00:24:07
Can you explain to what just real quickly what that is? So we could so it first goes through. So there's A2 sections, there's the. 00:24:16
I'm drawing a blank now. The House Health and Human Services Division branch of the government of state of Kentucky requires any 00:24:25
medical providers to have a certificate of need. And that means you we map out our our areas and say, hey, we don't have enough 00:24:33
ambulances for this. Or if we wanted to put a hospital in, I mean, that's a whole different thing. But it goes through all any 00:24:40
medical facility that you build over there and you have to prove your need for it. And, and it has. So just as an example, it has. 00:24:47
Anybody that already runs that type of service can, can put their two cents in on it. So it used to be AMR was over there and they 00:24:55
said, hey, we don't, we won't fight your certificate of need as long as you don't do private transports, meaning you don't go pick 00:25:03
up somebody at the at the ambulance, at the ER that's being released or at the hospital that's being released and you charge them 00:25:10
a fee to take them home. That's a private transport. We could only do emergent trans. 00:25:18
And, and so everybody got to sign off on that. And for a long time in the city of Louisville would not sign off on that. And then 00:25:26
they, I believe they finally realized we either got to quit fighting this or we got to do EMS better. And instead of fighting it 00:25:33
and doing Ms. better, they allowed the county to do it. And so the fire departments have it. And so, so we had to get a 00:25:40
certificate of need. And then that certificate of need, you tell what you're going to do. And when I first took over at. 00:25:48
We didn't have paramedics, we had EMTs and so we made it ABLS system. 00:25:56
And part of my hindsight is probably should have kept it a BLS system, just you don't get to charge as much as Medicare, Medicaid, 00:26:02
but there's a abundance of EMTs out there. Paramedics are tough to come by. So anyway, I digress. We, but so, so we, we go back 00:26:10
and, and you have to say what you are doing. And at first, when I was at PRP, we did it. 00:26:18
Basic life support system. And then after we grew a little bit, we did, we went, we moved to a an ALS system. 00:26:28
Which was a little bit easier than the whole certificate of need. Thanks chief. Anybody have any additional questions? 00:26:35
Chief, thank you very much. Appreciate your time. Thank you. Yes, Sir. 00:26:42
Huh. 00:26:48
We'll have public comment at the end. 00:26:51
For him. 00:26:55
About how many fire stations do you have? Fern Creek has 7/7. 00:26:57
All right. 00:27:06
So we're going to move on. I have a presentation I like to make as well, something that we had talked about. 00:27:07
Would be used to deliver EMS in Floyd County versus where the Floyd County EMS Advisory Board was kind of used to identify the 00:27:45
specific needs of what we as a community needed from our EMS service. 00:27:52
So I think in order for us to kind of understand the EMS system and its totality, I think we kind of need to 1st discuss, you 00:28:01
know, the history of emergency medical services here in the United States. So let's go ahead and start from the beginning. So a 00:28:07
lot of people believe that EMS service in the United States kind of started in the 1960s and 70s. Actually the pre hospital care 00:28:13
kind of goes back a lot farther than that, so. 00:28:19
Back in during the Civil War, there's a gentleman by the name of John Letterman. 00:28:27
And he established the US core ambulance court during the Civil War in 1862. And his corpsman basically the the thing that 00:28:31
differentiated his people between the others was is in the past that they would wait for people to go onto the battlefields to 00:28:38
clear the patients off. His people actually go in while the battles were were going. And it saved a lot of lives during that time. 00:28:46
But you know that that ended up being a model that the entire Union army adopted, so. 00:28:53
That's kind of the birth place of United States EMS or with Mr. Letterman and I kind of like to call him the cot father, if you 00:29:00
can kind of get that. 00:29:06
Anyway, so moving on, Cincinnati, OH 1865 established their first ambulance service, and New York City themselves followed in 00:29:13
1868. 00:29:19
You know, even throughout the 20s and, and all the way through the 60s, you had, you had organizations that were all over the 00:29:26
United States that were providing not just transport, but first aid services that would give some pre hospital care to their 00:29:33
communities. As you can see right here, we have Lynchburg Life Safety and First aid crew. 00:29:39
So despite, you know, all the advances that they had made in EMS. 00:29:48
For years it was just really kind of seen more as a transportation agency, and they really kind of offered very minimal patient 00:29:54
care. So in 1972, the National Academy of Sciences and the National Research Committee released an analysis of the United States 00:30:01
EMS system. The analysis clearly just really outlined a complete failure to advance the EMS in the United States. 00:30:09
So in 1973 the EMS services adopted the act Development Act of 1973 was passed. It kind of ushered in a new era of pre hospital 00:30:18
care. And there was a real deep pool of people who were willing to work in this new system a lot because you know, during the 00:30:24
Vietnam War, there's a lot of medics that were trained that were looking for work. So that was one of the reasons that a lot of 00:30:30
people got into it. And then there was ATV show that was really popular back in the day. Some of y'all might remember emergency 00:30:36
any of those. 00:30:41
They worked in EMS. It's kind of a cult classic. It followed up Los Angeles County paramedics Johnny Gage and Roy De Soto, and it 00:30:48
really did kind of capture the attention of the nation and really kind of highlighted what EMS was capable of. 00:30:54
So here in Indiana, we had our very first paramedic class in 1973 and that happened at the General Hospital in Indianapolis. You 00:31:03
know, at the time the paramedic training consisted of about 400 hours of classroom followed by, you know, laboratory rotations and 00:31:08
in hospital clinical rotations. 00:31:13
And about another 100 hours of internship out in the field. 00:31:19
So historically here in the United States where there's been three primary EMS delivery models, we have the municipal style, which 00:31:25
is your city and your county based and also fire based kind of fits in that as well. You have the hospital base and you have 00:31:31
private ambulance. One of the new types of of models that's kind of come out over the years is what they call a public utility 00:31:37
model. It's it's a hybrid model that utilizes private EMS assets that are just managed by an authority that has jurisdiction like 00:31:43
the county, so or. 00:31:49
Fire department even and that was developed by a fellow by the name of the Jack Stout. And there's a reason that there's a 00:31:55
multitude of different EMS models out there because there's not A1 size fits all model. It really kind of depends on your 00:31:59
environment. 00:32:04
Your jurisdiction as far as like the population, I mean, there's a lot of determining factors on which EMS model is best suited 00:32:10
for your jurisdiction. 00:32:15
So when we look at EMS and we look at some of the the top challenges of delivering our different EMS models. So the one of the top 00:32:21
ones is obviously the workforce challenges. There's a real lack of EMS in in the field. It's resulting in about a 65% decline in 00:32:28
applications. And that's system wide that it doesn't matter if it's private, doesn't matter if it's at hospital base or municipal, 00:32:36
They're all seeing a decline in people who want to come. 00:32:43
Serve in that capacity. 00:32:51
So capital and operational expenses have also gone up pretty dramatically, about 11% increase in wages and 12% cost for equipment. 00:32:53
And they're, they're thinking that these costs are going to go up even higher. And I, I forecast them to do that as well from what 00:32:58
I've been researching over the last several months. 00:33:03
Stagnant revenues are also a problem. The cost of providing service versus the return in revenue is not keeping up. Indiana is is 00:33:10
trying to change that right now. They have some legislation supposed to take effect of the first of the year to help speed up 00:33:16
recovery and increase those payments, but yet to be determined, yet to be seen. So we'll have to see how that goes. But this is 00:33:22
resulting basically in a higher subsidies. So this isn't something that's just kind of been unique to Floyd County, we're seeing 00:33:28
this. 00:33:34
All over the United States. 00:33:40
Continuing on, we have also service delivery changes. So people are seeing 49% longer response times, 37% of these different 00:33:46
companies are going to alternative responses to low acuity calls. 28 percent is moving from all ALS to ALSBLS deployments and 00:33:52
about 23% of those are moving away from having dual medics riding in the same e-mail list because there was a lot of agencies that 00:33:59
do that. 00:34:05
Because of the shortage of paramedics are having to go to a single paramedic. 00:34:13
For their deployment, they're also seeing a lot of alternative schedules. So you know, there's there's communities that are kind 00:34:17
of in ponder here. Many of these communities are kind of forced to rethink how these EMS services are being delivered and how 00:34:23
exactly we're going to fund it. So the discussion is being driven by, you know, basically peer reviewed data. I mean, this isn't 00:34:28
just opinion. This is peer reviewed data that highlights the importance of clinical effectiveness, effectiveness in economic 00:34:34
realities. 00:34:39
So according to a fellow by the name of Jonathan Lashko, he's very famous in the EMS world. He says the most significant challenge 00:34:46
in our U.S. healthcare is the lack of delivery of care systems, not the care itself. That's very true. 00:34:54
So in July of 2023, the Floyd County EMS Advisory Board really kind of set off to answer a specific question and that was what is 00:35:07
Floyd County need from his emergency medical services. And after months of meetings and reviewing prior studies in the current 00:35:13
national EMS standards, it was determined by the board that the Floyd County needs between 3:00 and 4:00 ambulances to provide 00:35:18
adequate emergency coverage. After further discussions and recognition of the current EMS shortage, it was determined that 00:35:24
strategically. 00:35:30
3 ambulances in addition to one paramedic response vehicle that are dedicated to emergency calls would ensure that the citizens of 00:35:36
Floyd County are receiving a prompt and professional service. 00:35:42
So I think. 00:35:49
No matter what system that you have or that you're looking at, there's certain benchmarks that you really kind of needed to hit to 00:35:51
be successful. And obviously there needs to be accountability and that and that's from both a clinical level and having the good 00:35:57
appropriate response times and customer service and satisfaction. I mean, the end goal is to have, you know, a good professional 00:36:04
service that's, you know, providing quality clinical care and that you have a happy public that's, that's. 00:36:10
Very satisfied with their service. 00:36:18
Oversight, You know, having a body to monitor service performance with independent, outsized audits. 00:36:20
Accounting for all service costs, multiple jurisdictional approaches optimizes this efficiency, and this includes all billable 00:36:28
runs. 00:36:32
Ensuring the service supply meets the community demand. So what does that mean? That means if if you have a large multitude of 00:36:37
calls and you only have certain amount of ambulances, it's not meeting that need. Well, your, your, your supply is not meeting 00:36:42
that demand. 00:36:46
Stability you need to offer, you know, long term stability for the county and this includes both clinical and fiscal stability. 00:36:52
You know, with all these previous benchmarks of mine. 00:37:07
I'm going to present the following solution that I include several of the items that we've talked about, you know, throughout our 00:37:11
time on the task force. 00:37:14
And through this presentation. 00:37:18
And that's the Floyd County Emergency Medical Services. 00:37:21
So Floyd County Emergency Medical Services would be a standalone county based emergency medical service. It would provide 3 00:37:24
ambulances and a paramedic and a quick response vehicle 24/7 365. 00:37:29
This agency would service all of Floyd County, not including the City of New Albany. 00:37:35
While the initial Floyd County EMS proposals it does not include the city of New Albany, the system itself would be scalable to 00:37:41
accept the city into its coverage area if it were agreed upon by the mayor and the county commissioners. 00:37:47
If the City of New Albany were to decline the Mississippi service, the county would agree, then agreed to pay the EMS subsidy to 00:37:54
the service provider of New Albany EMS services. But this could only happen if there is an EMS lit and it was adopted. If a Public 00:38:00
Safety lit was selected, it would allow the City of New Albany to choose their own pathway for emergency medical services or they 00:38:06
could still opt in to the county service. 00:38:11
If the Floyd County Council. 00:38:20
Dedicated a funding stream such as EMS or a public safety lit. It would provide the necessary funding required to accomplish the 00:38:22
following one. It would provide a sustainable budget for county EMS operations without utilizing the county's general fund. The 00:38:29
funding stream would be utilized to pay for the current system until the EMS contracts expire on December 31st of 2026. It allows 00:38:37
to choose the department head to set policies, protocols, procedure, and procure all necessary equipment and obtain all. 00:38:44
Certifications and inspections. 00:38:52
It would put the newly created agency in a position to assume full EMS operations for the county at the end of the current 00:38:56
contracts. 00:38:59
This is a table that Baker Tilly had presented us on the funding, what it would look like versus an EMS lit public safety Lits and 00:39:06
also the property tax liability impact if we were to do the Max levy for the fire department. And correct me real quick, Mike, 00:39:14
this is a once in every three-year kind of thing for the fire departments. Was that correct? 00:39:22
I believe so, but yeah, I would. I would want to check to make sure. I think so too. 00:39:31
So Highlander, Highlander Fire Department, they're still going to be involved. We still want to use them. So Highlander Fire 00:39:38
Department, it's emergency medical services would be utilized in the system. Highlander would be the primary EMS provider for 00:39:43
their protection district and received a subsidy from the EMS or public safety lit. I think the actual dollar would need to be 00:39:49
negotiated and probably really depends on what type of. 00:39:54
The council would utilize, but All in all, you know, Floyd County, Mississippi and Highlander Fire EMS would have a mutual aid 00:40:00
agreements with one another. We'd be backing up one another and assisting each other on a request. 00:40:07
So. 00:40:17
What are some of the benefits to a system like this? Well, stability, so there's no need to depend on private contractors to 00:40:18
provide necessary service. 00:40:22
We would have a service director that would be chosen by the commissioners to oversee the systems operations. The County Council 00:40:27
will provide the fiscal oversight, ensuring fiscal responsibility. 00:40:32
With a revenue stream in place, we could determine how our citizens are built, which to me is very important because all Floyd 00:40:38
County residents under my system would never personally receive a bill for service. 00:40:43
EMS will build a patients health insurance provider and after that would accept the insurance payment is paid in full. 00:40:49
The Floyd County residents shall never see a bill even if you do not have insurance. 00:40:55
The goal is to ensure that our residents have a very clear return on investment with a system like this and. 00:41:00
Our goal here is to ensure that not only is there a clear return on investment, but we want to reduce the negative outcomes by 00:41:07
alleviating the worry of whether or not that patient can afford. 00:41:12
They Angela's treatment and transport. I can tell you from personal experience that, you know, there's been several occasions 00:41:18
where people have delayed calling for help because they were afraid they couldn't pay for the ambulance ride or you got there on 00:41:25
scene and they didn't want to be transported because they were referred transported by the annual. So put them in some sort of 00:41:31
fiscal hardship and next thing you know, they're they're going into bankruptcy. Well, this route alleviates that. 00:41:38
So what would the future look like? Well, I think setting up the system with the EMS lit at .15 or a public safety tax at its Max 00:41:49
will give the system room to grow. 00:41:55
When billing revenue starts being generated, it's possible that the rate itself could be reduced. If the city was to opt into our 00:42:01
system, that could generate an increased revenue by increasing the amount of billable calls and increase the likelihood of 00:42:06
reducing the rate. 00:42:10
I also see that the system kind of changing. I think that mobile integrated health or the MIH. 00:42:16
Sometimes people call it Community Paramedic is the way of the future. The use of Community Paramedicine reduces the unnecessary 00:42:22
strain that is already being placed on our 911 systems by identifying those callers that are not in need of critical or emergent 00:42:28
services. Community Paramedic can also assist law enforcement with psychological evaluations without committing a transport unit 00:42:33
until necessary. 00:42:39
Lastly, community paramedic can resist those that are underserved here in Floyd County as well by helping. 00:42:45
Those in need of specialized services find those resources that they truly need, and many of those services that they offer in 00:42:51
community paramedicine are available. 00:42:55
We would create a training institution that could help instruct up to the paramedic level. This would help alleviate all the 00:43:00
roadblock of quality pre hospital education that we've seen here at a local level. 00:43:05
There has been no advanced life support training in Clark or Floyd County since 2012. 00:43:11
That's unacceptable. 00:43:17
So just kind of in closing, you know, we have an opportunity here to do something great. We have an opportunity to put an EMS 00:43:20
system that is solely dedicated to emergency calls. It is a system that provides strength, stability and is focused on providing 00:43:26
pre hospital quality, pre hospital care. The dedicated funding system, our stream allows the Floyd County Emergency Medical 00:43:33
Services to bill your insurance only. No resident of Floyd County should personally ever receive a bill, an ambulance bill. 00:43:40
And to me, that's a real clear return on investment for our citizens and they deserve that so. 00:43:47
That's my presentation. 00:43:52
Mr. Chairman. 00:43:56
Yes, Sir. 00:43:58
So you know, we had Putnam County here, we all filled it questions amongst ourselves even afterwards. 00:43:59
Floyd County has always been behind when it comes to EMS service, and it seems that the can has always been kicked down the road. 00:44:09
Your proposal for and this is actually to start conversations. I'd like to make a motion that we accept. 00:44:18
This proposal to be sent to the Floyd County County Commissioners. 00:44:26
All right. I have a recommendation or recommendation. Yeah. 00:44:32
For a proposal. 00:44:37
I can either take a second or we can have further discussions. 00:44:41
I'll second it. 00:44:47
OK, I got a motion in a second from Mr. Moon. 00:44:49
Mr. Moody. 00:44:53
Is there any further discussions? I'm gonna I've got a hard stop here in just a few minutes for another appointment, but. 00:44:55
It's my belief that this model has. 00:45:04
Emerged. 00:45:07
For specific reasons as what fits. 00:45:09
What our county needs, we've had. We've had different presentations and everyone who's presented has said. 00:45:14
None of these work for every county. That's why the counties. Different counties use different methods I. 00:45:23
I think we're at a point where. 00:45:31
We can't be. 00:45:35
Chasing the private providers every couple years and wondering if they're. 00:45:38
What the bill is going to be, what the contract cost is going to be, if they're even going to be around. 00:45:42
So for those reasons I back this this proposal. 00:45:48
I don't think it would be out of order, but I. 00:45:56
Just because there was a motion and a second made, I do want public input here. I would like to hear from the public before we 00:45:59
take our final vote if, if everybody would find that. 00:46:05
Acceptable. 00:46:12
No, OK. 00:46:14
Everybody OK with that? 00:46:16
Is there anybody from the public that would like to comment? 00:46:18
As we move forward. 00:46:22
Yes, Sir, if you can come to the podium, state your name. 00:46:23
Tim Harbison, Edwardsville, Galena Rd. I. 00:46:35
I think your proposal. 00:46:38
In a perfect world sounds great, but I have a question. Does the ability to. 00:46:41
Move this proposal forward, depend on what lit and what level the Council. 00:46:51
Approved. In other words, does the Council have to? 00:47:01
Vote approval. I think there were like last council meeting where they're like three options of lits that would. 00:47:06
Would this proposal be based on? 00:47:13
What the council approved, which one of the lit options the council approved, you understand what I'm saying, like to meet the 00:47:16
financial needs to have a service director or whatever. Well, yes and no. The council needs a recommendation on which way the 00:47:24
commissioners are going to move forward. So we know how to plan for that. We also have a two year window of fixed cost, but within 00:47:31
that two year window if we push forward with. 00:47:38
This proposal we'll need to start acquiring equipment. 00:47:46
And planning for the latter part of that contract to be able to take off on day one. I guess maybe I maybe I'm not getting this or 00:47:50
maybe I'm not making myself clear, but. 00:47:57
But there were three different options that brought in three different amounts of money to the county budget. Wouldn't it depend? 00:48:03
Like if you got the lowest? 00:48:09
Lit would that still be able to be what this proposal still be able to be funded? You could you could fund both proposals with the 00:48:16
the public safety or the EMS let whatever the county. 00:48:22
Thank you. 00:48:29
Mr. 00:48:32
I got to go. 00:48:35
Denise Konko County Council. 00:48:43
I guess the part that's missing for me here is the dollars. 00:48:46
And I would absolutely want to see the dollars that this is going to cost. 00:48:51
On, you know for the next getting ready period and then on a go forward period. So I would need like a five year projection to 00:48:57
understand what kind of lit we would need to put in place and are we willing to really do that? 00:49:06
And what other options we have and what the money would, what the cost would be for those other options? So for me I'm looking at. 00:49:16
Because that's my responsibility. That's what I'm. I'm the fiduciary body and for me to make a decision. 00:49:25
Would have to have some dollars attached to this proposal versus a fire based proposal. So that that's what I would need to see. 00:49:35
Do you have any of those? Well, I think part of the problem is, is that we haven't, we have kind of a rough estimate of what that 00:49:41
budget would kind of look like. 00:49:48
But there's a lot of things that go in there and this is a very volatile market. So for example, depending on the type of 00:49:55
ambulances that you went with, not only what type as far as type one through type 3 or you know, but even when you start talking 00:50:01
about the manufacturer. So buying an ambulance is not like buying a Toyota. It's, it's, there's some of these manufacturers that 00:50:07
are. 00:50:13
Have a service delivery time of out to 2028 depending and that's a spec model now obviously. 00:50:20
Demo models you can get before then, but it depends on what demo model you want what, what brand is it going to be, Is it going to 00:50:26
be gas? It's going to be diesel. And I think those are questions that ultimately the head of an agency needs to answer, not 00:50:30
necessarily. 00:50:34
Us up here trying to to figure out how to operationally run this department, of course, Jason, But what we would need is maybe a 00:50:40
high low number or a media or this is what you know, I think we need some kind of financial number so we know what the tax. 00:50:49
What gave us was 3.24 million. So I'd say about 3.5 million annually. But startup is really going to kind of depend on what type 00:51:00
of equipment these people are going to go with, you know, so we need startup cost and annual cost and the annual cost is 3.5. 00:51:10
You're telling me we're running it now at a $1.3 million. So I, I have, I have a really hard time doubling our current budget. 00:51:19
I, I don't know, I need more information is what I'm saying here, and we'll get it. 00:51:29
This is more to talk about the delivery model as far as more than, but we can't talk about a delivery model if we don't understand 00:51:37
what kind of taxes we need to put in place. 00:51:41
But this is exactly how can kicking keeps us going and going and going because this this market is so volatile, right? And I 00:51:48
respect what you're saying about the fiscal body because it's just so uncertain as far as far as like. 00:51:54
What, what costs are going to be for equipment and so on and so forth. So I'd like to call for a vote because I need to leave. OK. 00:52:01
OK. Thank you. Thank you very much. Thank you. I got a motion and a second motion was made by Charlie. 00:52:08
Yeah, absolutely. 00:52:21
John Shellabear report again, Commissioner. 00:52:29
Couple questions. You said we would have 3 ambulances for the unincorporated. 00:52:31
Where would they be? 00:52:36
Well, the three county ambulances would probably stretch around through New Albany Township in Georgetown, with Highlander 00:52:38
protecting their area. 00:52:42
Decided during the EMS task force or the EMS Advisory Board. But you've got you've got you got 2 townships with a very large 00:53:16
population and geography. Well, I. 00:53:21
I'm going to discuss that. I got to go with. I'm sorry. I mean, this is regardless, this is coming in front of the. 00:53:27
Commissioners anyway, I understand. Well, that's that's why I was getting ready to say this is a recommendation that's going to 00:53:32
the commissioners. Hold on, hold on, hold on, hold on. If I can add, you're taking a vote and you got the medical director. 00:53:38
Doctor Harris is not here. I think his vote is also important. I've also, I've shared the slides with Doctor Harris and we've 00:53:45
talked about this system and he is supportive of this. 00:53:49
Is only a recommendation, Yeah, this is only a voter recommendation. And we can hear that. I just think it's kind of. 00:53:56
Last time you had you had a presentation from Putnam County and then today we had one from this gentleman. And so you see both 00:54:04
sides and all once then you're going to make a recommendation to the commissioner. I think that's kind of premature. Thank you. 00:54:10
Thanks. 00:54:17
Got a motion in a second. Any further discussion? 00:54:19
You gonna do roll call? Yeah, we'll do a roll call vote. 00:54:22
Mr. Huth. 00:54:26
Mr. Moon, Yes. 00:54:28
Mr. Short? Yes. Mr. Moody? Yes. Mr. Franklin, yes. And I know yes as well. 00:54:30
All right. 00:54:39
We have any further business? 00:54:41
Any of our board members? 00:54:44
OK. I will open up the floor back up to public comment if anybody has any further. 00:54:46
Comment. 00:54:52
That's to be determined by whoever sets up the agency, and that will be negotiated between all of those parties. This is just 00:54:56
figuring out the model that we're going to recommend to the Commissioner. 00:55:00
Which is important because they have a vote coming up. 00:55:07
Soon, as far as the funding stream, yeah. 00:55:09
I got something. Yes, ma'am. 00:55:13
I I just want to. 00:55:21
Go ahead with my thought about the fiduciary responsibility there had. I have never seen a plan. 00:55:23
Without dollars associated with it, there has to be some dollars associated with this plan before it moves forward, even to the 00:55:32
commissioners in my mind, so. 00:55:38
I'm just going to stop there. There has to be some dollars associated with this plan. 00:55:44
It makes absolutely no sense for our constituents to enter into any kind of plan without an understanding the consequences to 00:55:50
their tax dollars. 00:55:55
Yeah, if you don't mind your address, please. 00:56:05
Jeff Dixon I live in Clark County, Indiana, 5610 Scarlet Oak Rd. I have vested interest in Floyd County. My mother-in-law lives at 00:56:12
3025 Plantation Drive in Southern Estates. It's in Sellersburg, but it's in Floyd County. 00:56:18
She's elderly, she's widowed, and I'm her power. 00:56:25
So. 00:56:28
Charlie, I think said just a second ago, this is how he kicked the can down the road. Well, here's the thing with EMS And so, and 00:56:30
for you, for those of you all don't know me, I'm on my 25th year in EMS. 00:56:35
Been a paramedic for 25 years. I've worked private service, I've worked municipal service, I've worked for the federal government. 00:56:41
I've done all three. I've seen good, I've seen bad. The thing with EMS is this. You can have good, you can have fast, and you can 00:56:46
have cheap, but you can only have two of the three. So to sit here and say that you know, well, I understand cost and I understand 00:56:52
fiscal responsibility, I totally get it. I respect that. 00:56:58
But just taking the cheaper option every time gets you right back to where you're at right now, because that's what's always been 00:57:04
done. 00:57:07
As far as the deployment model goes. 00:57:11
You know. 00:57:14
There is no one-size-fits-all approach. 00:57:15
A countrywide service employee in Clark County won't work, period. 00:57:18
Countrywide service in Floyd County would work. 00:57:23
But I'm also saying I'm not saying that a fire department based service won't work. 00:57:25
But all the presentations have been for one prior to today. And one of the questions that was always raised was is there was 00:57:30
always somebody that was going to be left out coverage wise. There was always going to be somebody that was going to be left out. 00:57:36
And with with at least what was proposed today, nobody's left out. 00:57:43
And anyone who's providing a ServiceNow is not being kicked to the curb. 00:57:48
You're basically building a hybrid service is what you're doing because. 00:57:53
You're going to have other services that are going to continue to function. 00:57:57
So you're still going to have two different services providing coverage and that's actually going to put 4 ambulances on the 00:58:01
street. 00:58:04
Plus parameter chase car instead of the current 3 plus plus parameter chase car. So you're going to have more coverage. The 00:58:08
biggest problem is look around. You have no mutuality. 00:58:13
Current, the previous provider left. 00:58:19
You have no mutual weight. Maripro is busy. They're going to be busy regardless of what happens in the county. They're going to be 00:58:22
busy in the city. You have no mutual aid, so you have to build the system from the county's perspective. 00:58:28
To have enough fluff in there, I guess you could say enough resources in there for that bad day because. 00:58:34
You know it. 00:58:42
Look around at both counties, there's not a whole bunch of ambulances anywhere. And I'm not saying anything bad about either one 00:58:43
of these delivery models. I think both of them have their pros, they have their cons, But I think it would be foolish if anyone, 00:58:49
regardless of which model they support, to completely turn their back on the other. You've got to look at both options. 00:58:55
So and I think that's what. 00:59:03
The position today was. 00:59:05
He's just presenting an option. 00:59:08
So I mean to me. 00:59:11
You know, you, you can't make an informed decision without having all of your information. So put all the information out there 00:59:12
and let let the commissioners and the council make the decision on what they want to do and. 00:59:17
The way I've understood it, I think that's what you all were trying to accomplish today. That's correct. 00:59:22
So thank you. 00:59:26
Thank you. 00:59:29
All right, so if there's no more further public comment. 00:59:31
Does anybody have any closing comments? 00:59:36
Can I get a copy of the presentation? 00:59:39
The slide presentation, yes. 00:59:42
You know, I think that this task force. 00:59:45
Has gave. 00:59:49
Or will be given the county commissioners enough to go off of? 00:59:52
You know, we've all discussed and we've had acclement amount of time to get presentations from other areas which I think all of us 00:59:56
pretty much touched out to other other local. 01:00:01
Fire or county wide EMS services kind of brought it back and kind of picked it through where no, that's not going to fit our 01:00:08
scenario. 01:00:12
You know, I think throughout these meetings and I don't want to speak for for Mr. Moody or Chief Franklin or Mr. Mills, but you 01:00:17
know, there's two departments here that really isn't really keen about doing EMS. They want to stick to fire. 01:00:25
And if they want to speak on that or if I'm wrong, please call me out on that. But you know, that's what I've got through through 01:00:33
these several meetings. 01:00:36
You know, we had the presentation done from Putnam and it was really good. 01:00:41
And she or from Clown Creek, I mean, we thank you for coming, but I really still didn't get a full picture of a fire base EMS. 01:00:46
You know what does a Firebase EMS look like? We actually have one here, employee county, but I don't think anybody can tell us 01:00:58
what it actually looks like right now, so. 01:01:03
Fire based part. So fire based team has by definition is. 01:01:09
You're you're basically serving the whole world. 01:01:15
Are civilian paramedics need increased the stat to staff? 01:01:17
There's different benefits, different benefits, different jobs are working. 01:01:24
If you want to just actually, we're getting ready to close the meeting up, but if you hang out for a minute, we'll be happy to 01:01:32
chat with you. 01:01:37
I want to take this direct involved for coming because he pretty much told you that it wasn't fire based you were. 01:01:43
Problems retaining people because there was no way to do but even even though maybe the. 01:01:52
I appreciate you being here. 01:02:00
Is that what you're trying to say, Mr. Reckon Wall? I'm sorry. 01:02:04
Just for clarification for the committee, were you trying to say that if we're not doing a fire based system and then that 01:02:08
there's. 01:02:11
One of his benefits? 01:02:15
There was no problem. 01:02:19
Ocean within the system if it wasn't a power based system. 01:02:20
Is that what you're trying to say, Mr. Right? 01:02:25
Vulnerable position for them. 01:02:29
OK. 01:02:33
OK. All right. We got a motion and a second. Any further discussion? 01:02:37
All right, all things in favor signify by saying aye aye. 01:02:42
Thank you. 01:02:47
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