zippyRN Posted April 4, 2006 Posted April 4, 2006 I would say that if you have less than 5,000 people for a township (depending on the size of the township- as some will encompass several "towns"), it would be hard pressed to have the tax base for paid municipal service or the run load to attract a private service. My vollie agency is in the process of switching over, but we are well over 6,000 people now and it is over due. We are almost to a full time BLS bus and pretty much have full time ALS as well. A few years ago, it would have been almost impossible to do though. you are trying to draw the tax base to support the service too small, although UK services are funded through central taxation, the Uk adminstrative county was felt to be the smallest size viable in 1974 ( when the services moved to full NHS control) and this is currently blikely to be replaced by governmental regions, ith each service serving 2 - 8 million people
Ridryder 911 Posted April 4, 2006 Posted April 4, 2006 True size does matter.. (as a man did I say that ?) but as well it has to do with your population income level and tax level is as well. Some smaller communities have sales tax and land tax that allows a nice revenue is some small communities. Oklahoma has had a advolrem county tax for several years allowing counties to vote a 522 state bill in at a low rate high interest. Most services in smaller communities are able to operate of the interest and the taxes does not increase to about $20 -50 yr per household. It has been successful in some of the lower socio-economic areas or areas that have a decreased industry area. I know many states have adopted or placed similar taxes. These are ear-marked strictly for EMS operations only.. so it cannot be dispensed to other departments. Be safe, R/R 911
Dustdevil Posted April 4, 2006 Posted April 4, 2006 But let's face it: EMS is fun, especially in small doses, and the entrance requirements are quite low for such a dynamic job. The only way that I see to make our dilemma better is to radically increase education requirements... or take the lights and sirens off of the rigs. And I just found my new signature line! =D>
AZCEP Posted April 4, 2006 Posted April 4, 2006 Yes, the administrators have to be a bit creative, but it can be done. Taking the L & S away is fuel for an entirely different discussion, but it does have merit.
Ridryder 911 Posted April 4, 2006 Posted April 4, 2006 ? The only way that I see to make our dilemma better is to radically increase education requirements... or take the lights and sirens off of the rigs. There you GETrrrr done ! Do both ! R/R 911
hfdff422 Posted April 4, 2006 Posted April 4, 2006 you are trying to draw the tax base to support the service too small, although UK services are funded through central taxation, the Uk adminstrative county was felt to be the smallest size viable in 1974 ( when the services moved to full NHS control) and this is currently blikely to be replaced by governmental regions, ith each service serving 2 - 8 million people I am not precisely sure what you are trying to say- I think you are trying to get at the township is not an adequate entity to fund services. In many cases that is true, in others it is almost too big. Depends on the area. Where we are at, we are along a transition line (for now, it is growing fast). 10 miles east is basically Indianapolis, 10 miles west is almost purely farm land. There are too many operational municipalities within our county who do too good of a job to hand over their power to the county. Not to mention the county is about the most worthless entity we have. There are only 35 road deputies for our county and the commisioners don't have a clue why they want more deputies to cover the 420 square miles and 120,000 people. Townships are adequate in our area, as they grow they can afford the needs of the growing population. But for the next county over, it would be more difficult to not depend on some volunteer services, especially as a first response- regardless of whether or not the county would be the primary funding entity as there are too many miles to cover with too few people to justify enough ambulances to be within a 5 minute response.
Nate Posted April 4, 2006 Posted April 4, 2006 This is a never ending battle. I'll sum it up like this. It will take someone of importance turning up dead in each small town to get people to change to paid staff.
bandaidpatrol Posted April 5, 2006 Posted April 5, 2006 Perhaps we should also focus on the lack of EMS in many places. Opinions please: Given what we know, as far as how long it takes for emergencies to go from serious to critical to dead, heart attack, CVA's, cardio-pulmonary arrest, seizures, car accident victims, etc. How long is too long to wait for an Ambulance? How far is too far for populations to be from an Ambulance? How far is too far for populations to be from a receiving hospital with a certified ER? This is not a paid/volunteer question, it applies to every location in the United States. Obviously, in some cities, people wait a long time due to lack of units, caused by "bull shit" runs. I remember going through a list the whole shift, in a fairly large city, people were on there for hours... everyone. There was no specific order, except cardiac and pediatric patients held priority. What can be done to free up units from BS calls? What can be done to prevent patients from being put on waiting lists, excluding times of disaster? Opinions only, please.
Rescue0ne Posted April 5, 2006 Posted April 5, 2006 Opinions please: Given what we know, as far as how long it takes for emergencies to go from serious to critical to dead, heart attack, CVA's, cardio-pulmonary arrest, seizures, car accident victims, etc. How long is too long to wait for an Ambulance? From the time of tones going off...over 8 isn't good. Over 10 is wrong. How far is too far for populations to be from an Ambulance? In my opinion...8-10 miles. Urban areas, much less. Majority of my experience is with Suburban & Rural. How far is too far for populations to be from a receiving hospital with a certified ER? Considering there are some grossly rural areas in this country, I'd say 20 miles, maximum. I know, it's wishful thinking...but whatcha gonna do. What can be done to free up units from BS calls? Having the Senior EMS Provider on scene be authorized to release his/her rig from the scene, if the situation does not warrant an EMS transport. Medical Control may be called if necessary. NOTE: Of the several agencies I've been a member of, all of them allow AIC's to make that call, with AIC's instructed to call Medical control if necessary. If it's a true non-emergency, we'd ask them, if possible, to go by POV. If not possible, we'd offer to have an Ambulance Service respond. If they refused that, then we'd offer to take the patient to the CLOSEST hospital ER...which usually isn't even a Level 3 Trauma Center. If they refuse that, then Medical Control was contacted, situation explained to the Doc. 9 times out of 10, they'd release us from the scene. Now...if you're talking about EOC not even toning the EMS agency out for the call to begin with if it's a BS call...that's a really good question. If I were the EMS director of my state...I'd put in place a directive that any prospective patient not requiring EMERGENCY care and transport...be routed automatically to a non-emergency Ambulance Service. Have something worked out between the municipailty and the A.S. where they'd respond, and bill whatever insurance the patient might have...and if no insurance...A.S. bills the patient. I Don't Know. This is a truly magnificent, and quite common dilemma. I'm paid to think about issues like this. I'll get back to ya if ever a viable solution revelas itself. What can be done to prevent patients from being put on waiting lists, excluding times of disaster? Unsure what you mean by this. A waiting list for Emergency Care & Transportation to an appropriate Medical Facility?
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