No Bookmarks Exist.
Transcript
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
Link
Start video at
Social
Embed
* you need to log in to manage your favorites
My Favorites List
You haven't added any favorites yet. Click the "Add Favorite" button on any media page, and they'll show up here.
Transcript
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
scroll up