Help me convert Ruraltown EMS from volly to paid.

[spenac]

I do not listen to people who tell me they can't afford a full paid service. My home town runs a full paid service with 2 units (only 1 paid full time, other is utilized if staff are around to run it), and they have ALS (unless he is on the first car)

Anyway point is the company does 100 - 120 calls / year. That's right full time ALS supported by a mere 100 calls / year.

If there is a will there is a way!

EDIT to add this:

I am about 95% sure on these numbers: Wages in said 100 call/year town:

PCP (EMT) $19.70/hr $4.50 on call

ACP (Paramedic) 26.19/hr $4.50 on call

I to have seen slow services be paid. Communitys just have to get prioritys straight. In our day and age there is no excuse for any community to still be served by vollys.

[wcremtp]

Creating an emergency services district "ESD" in your coverage area with the assistance of the county officials responsible for emergency management, possibly including your service with fire departments that recieve money by way of taxes is a start. Developing an ESD is not the easiest way, however, if the votes are in your favor, the city can only opt out. the you can get county tax money, and lobby the city for a contracted rate to continue service there. once the citizens catch wind that they will not have service, they will change thier tune rather quickly. also, get with a online service to produce run reports and have their billing service bill for you, all you have to do is forward the information.

[spenac]

Creating an emergency services district "ESD" in your coverage area with the assistance of the county officials responsible for emergency management, possibly including your service with fire departments that recieve money by way of taxes is a start. Developing an ESD is not the easiest way, however, if the votes are in your favor, the city can only opt out. the you can get county tax money, and lobby the city for a contracted rate to continue service there. once the citizens catch wind that they will not have service, they will change thier tune rather quickly. also, get with a online service to produce run reports and have their billing service bill for you, all you have to do is forward the information.

Good ideas except for joining with fire. Actually communitys need to change money from fire budget to the EMS budget. Fire and EMS are completely different fields and have no business together.

[unknown]

I realise spenac , you are describing a very rural service. Somewhere in that 3000 sq. miles there has to be some industry. If you approached them and explained in detail, your predicament, perhaps they could apply some pressure to the county gov't. After all, they are in business and should understand that to function properly, some influx of cash is required. It would indeed be to their benefit to have professional, full time ALS service and I'm sure they haven't got a clue as to how you run now.

As Hells Bells stated, the newspaper is an excellent idea.

Jake I see and feel what Spenac is getting at here. I serve these area's every day/night I work. Small Rural Counties with just the County seat centrally located serving a vast area from one location with a hand full of Volunteer units available..... That's why we fly so much in these area's. Then we get slammed with the "over use and abuse of Helicopters" well what do you do when the only ALS response available is coming with that air craft?

Happens too much too often. Spenac if you get a good response out of this write up a plan of action I can give you SEVERAL county seats to present it to!

[betheljen]

When you calculate your facts and figures, are you including insurance and other full time items that the township would be required to pay? Our department runs part time/paid on call and we average 1000 to 1500 runs per year. We bill for EMS, but we "soft bill," so that folks without he benefit on their insurance won't go broke trying to pay an ambulance bill.

With all that, going full time has been brought up but quickly shot down. Even part time employees have a max number of hours they can work...exceeding that number would qualify that worker for benefits.

So even with a billing system that cushions our EMS budget and loyal voters, the increase to go full time would be astronomical.

[Dustdevil]

That brings up an interesting point. Is such a system as you describe significantly better than a volunteer system? I certainly see benefits to it over a volunteer system, and it's definitely a step in the right direction, but many of the drawbacks remain. Discussion?

[betheljen]

This system is very common in our region; most township departments are part time and paid on call. The part timers schedule is 0600 to 1800, seven days a week, and from 1800 to 0600 is the paid per call.

Put into place because of the regular problem of finding day time volunteers, we have used it for approx 8 to 10 years now.

A department close by, very small city department, went to 24 hour part time coverage and it destroyed their volunteer program. I like the way our system works, as we have plenty of volunteers to handle responses at night - not to mention, during the day if the part time crew heads out on the engine, we will likely get a handful for other apparatus.

The unfortunate part of it is that there are so many firefighters and medics who make their living working two to three part time jobs. The money might be great, but they live without benefits or much security.

[tinman694]

We are part time--doing both Fire and EMS. We operate 3 ALS units 24/7 with a Full time Day Crew and On Call Night crews. Works Well---but then again, this is a small southern town--not a 1000+sq mi. enterprise. We Bill and get paid (sometimes--although better than the local hospital!) ---so it can work. Local population voted for and approved a $100 per household 'emergency response fee' paid annually to cover---that helps in the transition to full time---but it will stay part time for the foreseeable future.

Benefits are a killer to pay for....take it from a business owner's perspective!

[menla]

I'm having this same conversation with spenac over in another topic, so I thought I'd pitch in here.

There will always be volunteers in professions with such a high degree of personal satisfaction as medicine and fire. Hospitals have had to deal with volunteers for a very long time, and the good hospitals do it very well. We should take that into consideration when planning our response to volunteerism in EMS.

So let's be rational. Volunteerism contributes to something that's called a "local maxima" in quantitative analysis. That is, something that was extremely useful in the past that has become a negative contributing factor to future growth. That's all... it's not some sort of pervasive evil that's destroying the world.

This doesn't mean you should remove it entirely, or even that you can. The cost in human suffering and loss of life if all volunteers stopped volunteering today would be significant. What it means is that you have to mitigate. This means that you have to manage the problem.

If EMS professionals were truly professional they would step up and take responsibility for the field rather than step back, throw up their hands, and just complain. Or, as I suspect some are doing, make volunteers so uncomfortable that they volunteer somewhere else.

They might, for instance, start an national level organization for EMS volunteers that was free to join and used donated funds to work with states and federal organizations to increase funds for EMS to the point where the volunteers could go paid without impacting patient care. Or help (gasp! volunteer!) organizations that already do this.

Another option would be to work with local legislators or political organizations to address the issue of funding at a local level. Or even forming (or working with) a group that raises awareness of the issue.

If we in EMS want to be taken seriously as professionals, we've got to start acting like it.

Tom White

[spenac]

My responses are made in line in various sizes and colors. Menla you really need to search this issue her before you go down a road on a horse that has been beaten to death, turned to dust, and blown away already.

There will always be volunteers in professions with such a high degree of personal satisfaction as medicine and fire. Hospitals have had to deal with volunteers for a very long time, and the good hospitals do it very well. We should take that into consideration when planning our response to volunteerism in EMS.

There is a big difference between volly candy stripers and paid nurses and doctors. I do not see doctors and nurses volunteering except for the rare special mission. They are there for the pay check.

So let's be rational. Volunteerism contributes to something that's called a "local maxima" in quantitative analysis. That is, something that was extremely useful in the past that has become a negative contributing factor to future growth. That's all... it's not some sort of pervasive evil that's destroying the world.

So you agree volunteering "has become a negative contributing factor to future growth". As it hurts the future of my profession it needs to been done away with.

This doesn't mean you should remove it entirely, or even that you can. The cost in human suffering and loss of life if all volunteers stopped volunteering today would be significant. What it means is that you have to mitigate. This means that you have to manage the problem.

If all volunteers stopped today we would see drastic improvements in pay which in turn would attract higher quality people. It then would also justify what most here advocate and that is much more education before people are let loose on the public. There would not have to be any harm to patients. Vollys walk in on 1st of month and state we will be paid starting first of next month. You publicise the fact there may be no ambulance and explain why, and all the blue hairs will demand you get paid and politicians will listen. So no patient care is lost. I have been a part of this and seen it work in some of the poorest areas of the USA.

If EMS professionals were truly professional they would step up and take responsibility for the field rather than step back, throw up their hands, and just complain. Or, as I suspect some are doing, make volunteers so uncomfortable that they volunteer somewhere else.

I am taking responsibilty to improve our profession. Volunteering hurts the profession. It holds us back in pay, which as above affects type of people coming into our profession, which also affects how limited the education is in our profession. These volunteers are welcome to join the paid ranks. If they truly do not want the money they can donate their pay to worthy causes and help many more people.

They might, for instance, start an national level organization for EMS volunteers that was free to join and used donated funds to work with states and federal organizations to increase funds for EMS to the point where the volunteers could go paid without impacting patient care. Or help (gasp! volunteer!) organizations that already do this.

Why help those that are hurting my profession. As a former volly I welcome with open arms my fellow ex-volunteers. There are organizations out there, some volly and some professional. We do need as professionals to get better organized so we have a voice that politicians listen to.

Another option would be to work with local legislators or political organizations to address the issue of funding at a local level. Or even forming (or working with) a group that raises awareness of the issue.

If we in EMS want to be taken seriously as professionals, we've got to start acting like it.

If we want to be taken serious requiring payment for services just like all other healthcare professionals do will be required.

Tom White