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Washington Co. Commissioners OK revised EMS plan

County will provide independent companies with subsidies to provide 24/7 staffing

County will provide independent companies with subsidies to provide 24/7 staffing

December 15, 2009|By HEATHER KEELS

WASHINGTON COUNTY -- The Washington County Commissioners on Tuesday approved a revamped plan for addressing emergency medical services staffing shortages that involves spending as much as $1.7 million a year on staffing subsidies to EMS companies.

The plan also involves making EMS salaries more competitive, instituting annual audit reviews and other accountability measures, and establishing a second advanced life support (ALS) chase car that would supplement ambulance responses in the South County area.

The additional chase car, plus one additional ALS technician for the county's existing chase car that serves Clear Spring and points west, will add roughly $300,000 a year, County Administrator Gregory B. Murray said.

The commissioners voted 3-1 to approve the new plan, with Commissioner James F. Kercheval opposed and Commissioner Kristin B. Aleshire abstaining.

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Kercheval said he thought the plan was too expensive, while Aleshire said he didn't want to vote until he saw a more-formal document outlining the plan and its conditions.

The new plan was developed by EMS company leaders in cooperation with county staff and replaces the county's previous EMS Master Plan, Murray said. The old plan had two phases, with phase I consisting of hiring 12 advanced life support technicians to supplement the EMS companies out of three chase cars, and phase II involving placing county-paid staff in the EMS companies as needed.

EMS company leaders had asked for an opportunity to review that plan before the county proceeded with hiring the chase car ALS technicians. They developed the new version and presented it last week at a meeting of the Washington County Volunteer Fire and Rescue Association. There, 22 fire and rescue companies voted for the new plan, two voted against it and two abstained, association president Glenn Fishack said.

Under the new plan, the county will provide each of the eight independent EMS companies with the subsidy needed for that company to have the minimum staffing available 24 hours a day, seven days a week, Murray said.

The staff work on a 24-hour-on, 48-hour off schedule, so to have an advanced life support provider and a basic life support provider on at all times, including covering sick days and vacations, each unit needs 3 1/2 of each, according to plan documents. That will cost about $417,000 for most companies, which operate one unit each, and about $2 million for Community Rescue Service, which operates five units, the plan shows.

The subsidy for each company will be the difference between that minimum staffing cost and what the company takes in through billing income, Murray said.

The companies' billing income depends not only on how many calls they run, but on the demographics of the area and how much is paid out by the insurance companies of the people served, Murray said.

The starting subsidies range from $60,225.88 for Halfway's ambulance company, which has been taking in an average of more than $350,000 a year in billing income, to $309,235.86 for Sharpsburg's ambulance company, which has been taking in an average of only about $100,000 a year in billing income, Murray said.

As part of the new plan, the county will require billing reports that document that the companies attempt to bill for every call they run, he said. In future years, if the companies' billing income increases, the county subsidies will go down, Murray said.

The county will also institute several other accountability measures as a condition for receiving the subsidies, Murray said. The county will review each company's financial audit each year, require each company to submit more detailed information about its fundraising activities and how that funding is used, and use an electronic staffing tracker to ensure the subsidies are being used for 24-7 staffing, as intended, he said.

Another change in the new plan is a shift to a standard pay scale, with all companies offering a base salary of $32,500 a year for BLS (basic life support) providers and $41,000 a year for ALS providers, Washington County Director of Fire and Emergency Services Kevin L. Lewis said. Those salaries are for 48-hour work weeks.

Those figures were recommended to make the county competitive with the surrounding area so it will be able to attract full-time, career ALS technicians, said Smithsburg Emergency Medical Services Chief Jon Snyder, who chairs the VFRA EMS committee.

CRS Assistant Chief David Hays said in his six years of experience hiring paramedics for CRS, the company has always struggled to attract applicants because of its "substandard wages," which currently start at about $38,000 for an ALS paramedic.

Other companies' wages are even lower, Snyder said.

"There are departments in this county that are paying their ALS provider, someone who is likely going to save someone's life, $11 an hour," Snyder said. "You can go to Sheetz and make $12 an hour."

Murray said he would work with the companies to craft operation agreements based on the plan. He said it would probably be 30 to 60 days before the newly approved plan could be put into action.

How they voted



John F. Barr - yes

Terry L. Baker - yes

James F. Kercheval- no

William J. Wivell - yes

Kristin B. Aleshire - abstained

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