05/16/12 — County plans to add two new emergency response vehicles

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County plans to add two new emergency response vehicles

By Steve Herring
Published in News on May 16, 2012 1:46 PM

Population growth is straining the ability of Wayne County's emergency medical services to maintain the eight-minute average response time county commissioners set 10 years ago when a countywide EMS system was established.

On Tuesday, commissioners agreed to buy two quick response vehicles to help reach emergencies even before an ambulance can get to the scene. A $275,000 appropriation in the 2012-13 budget was approved for what EMS officials admit is just a stopgap measure. The money will be used to purchase and equip two quick response vehicles.

Blair Tyndall, county EMS and safety director, told commissioners during their meeting that two options were available to speed response time.

The first would be to add an EMS station that would be housed in a fire station. The annual operating cost would be about $377,171, plus another $644,283 for the building lease, equipment and personnel, he said.

The second, and recommended option, was to buy two quick response vehicles at $77,996 each, with paramedic level services. It will cost another $88,189 to stock the vehicles and $245,509 for six additional personnel for total of $411,694.

On top of that would be an annual operating cost of $333,698, Tyndall said.

The $275,000 represents the net cost of the start up, County Manager Lee Smith said.

Commissioner Steve Keen asked Smith what the source of the funding would be. Smith said it will come from fees charged for using the emergency services, Medicaid and Medicare and from the county budget's general fund.

One vehicle would be stationed at Belfast and the other at Dudley.

"A QRV is basically a highly trained paramedic in a vehicle that has everything that an ambulance has in it," Tyndall said. "It is permitted by the state. The only thing that they cannot do is complete the transport. They don't have anywhere to put the patient. They have the identical equipment that an ambulance has in it.

"That QRV can respond to a call that an ambulance may not be able to get to. A lot of times we see people who don't actually need to go to the hospital. That paramedic at that point can talk to that person, see if they need to go to the hospital. If not, that call is handled without having to tie up the resource of an ambulance. If they do need to go to the hospital we do have paramedic level treatment there and they can begin treatment and life-saving measures and wait for the ambulance to arrive."

It also provides the opportunity to use Wayne NET ambulances, Tyndall said.

Wayne NET, the county's non-emergency transportation service, started in 2006, responded to 625 EMS calls and 219 transports in 2011. When not scheduled for non-emergency transports, those vehicles are staged around the county to assist with emergency calls, he said.

"It is a very good Band-Aid, a very good bandage as to what we will need to do," Tyndall said. "I don't want to lure you into thinking that this going to be a permanent fix for several years to come, but it is going to help our response time and help serve our citizens with emergency care."

Tyndall provided commissioners with a recap of how 10 years ago the county took on the responsibility of EMS following passage of a new state law mandating the move. The old system was spending about $1 million with no billing and no recoup of costs, Tyndall said. The county now bills for its services and collects about 65 percent of services billed for, he said.

The county budgets about $4.1 million in expenditures and has about $3 million in revenues for EMS, he said.

The county's goal is an average response time of eight minutes 90 percent of the time. As of 2011, the average response time had increased up to nine minutes because of the increase in the number of calls, Tyndall said. They went from 12,266 in 2004 to 16,342, in 2011 -- an increase of 32 percent, Tyndall said.

Work is under way to expand the emergency department at Wayne Memorial Hospital. Based on nationwide data, hospital officials expect to see a 10 percent increase in emergency room cases, Tyndall said. If that happens ,Wayne EMS could see an increase of about 2,000 calls annually, he said.

Commissioner Ray Mayo asked if the response time had been adversely affected by the county's new radio system. It has not, Tyndall said.

Keen, who made the motion to buy the vehicles, asked Tyndall if the county would be able to track calls to provide data that the county could use to possibly secure state or federal funding. Personal information cannot be tracked, but locations and types of calls are, Tyndall said.

"Wayne County is growing and that means that the demand for services is going up and there is no more important service as response of emergency medical services to individuals in distress," Smith said. "Right now, the QRVs are in the budget but I wanted to make sure that we are headed in the right direction.

"There is a cost two ways. There is a cost if we don't do it by virtue of our response time going up. But there is a cost in dollars. That is what I need for you to weigh in on."