Dissapointment

[FredG]

An ALS tiered response then ?

Triaged by whom....a dispatcher with a crystal ball?

Dispatched using EMD trained call takers and dispatchers, run by the county. the quality of dispatch triage is a whole different topic, but regardless of the quality of any EMD protocol, they are the ones that make the initial assessment and assign an initial priority.

This is NOT a cost effective "in most areas" it is redundant, so explain to me why not put the Paramedic on the Truck ?

Running another truck and a second party providing service when other's are not reimbursed for their time looks clear to me that its a rip off, no brainer.

I believe with this information you provide, I do think your being dupped into believing this is a good thing for the longevity of essential care for your community.

In an ideal situation, we all would have all ALS units with all EMS professionals making a living wage. But, each area has it's own challenges and needs.

My county is about the size of Rhode Island and aside from one small city, the rest of the region is covered by 2 medic fly cars with a single medic each and 19 volunteer BLS transporting agencies. We had a 3rd ALS fly car, but R/M decided it was not profitable and got the county to approve dropping the unit a few years ago. So, I do not see how this is redundant.

I know that R/M has to maximize profits, but if their 3rd fly car could not be profitable when they only pay their medics about $12/hr in this region, then how can the volunteer squads justify staffing their 19 ambulances with 2 staff each?

And again, I cannot justify spending 2+ years in the process to get my department to the point where it would be allowed to bill for ambulance service and become paid just to get some low paying EMS jobs in the area.

On my other volunteer position, on the board of Directors for a Local Development Corp, we are trying to bring in businesses and jobs that build wealth and will bring our area's recent grads back into the area for employment. $8/hr jobs simply don't do that and will not improve the quality of life. If I could see a way to start EMTs in this area around $14+/hr, then I would have a different opinion. But, I know the political players and I know the budgets. Even crunching the numbers with a 40% payment rate (which IMO is high for most any 911 unit), there is not enough funds to subsidize EMS service with salaries even below minimum wage. Raising taxes is not a viable answer either as property tax increases are limited to a small percentage by state law.

Going to a pay per call system is one option, but that is only a stopgap between volunteer and paid and does not help improve EMS salaries anywhere.

[tniuqs]

Are you Police State or Local...if you see where I am going with this again ?

They are considered Essential, funding formula can change if it is mandated look up the food chain, not laterally.

I may be misunderstanding you but 2 or 3 fly cars is redundant when one can put the Paramedic IN the Transport Truck....then Dispatch/Triage calls accordingly.

You stated that the fly cars are profitable so who profits/controls this?

Raising taxes is not a viable answer either as property tax increases are limited to a small percentage by state law.

Does the State tell the taxpayers how the funds are spent or should it be the other way around?

A fundamental political science question is all.

[tniuqs]

HEY I sure hope we can get your problems solved here and soon !

I have to back to work in 2 days, and if I dared to tell you what EMTs and Paramedics wages were here your jaw would hit the floor, yes really, as I have said, fight the right fight.

That is all.

cheers

[CBEMT]

Not once have I ever seen any of those volunteers take their volunteer spirit down the road to the public library to put away books, to the parks department to mow grass, to the city hall to answer phones, to the sanitation department to pick up trash, to the school district to drive buses, or to the city garage to wash cars and change oil. Wait... what happened to that volunteer spirit? What happened to all that concern for giving back to the community? If you were so concerned about your neighbours having EMS, then why did you fight the city plan to go paid at every council meeting for three months? And if it is all about YOUR community, why are you now driving ten miles to the next fire district to volunteer?

Funny you should mention it. 20+ members of my PT/volunteer department volunteered their labor to help install a playground paid for with donated funds because the town won't pay for a place for their own kids to play. Needless to say, paid paramedic-level EMS is nowhere on their radar screen.

Which is why I take weekday daytime shifts despite the fact that I don't live in the town. Something is better than nothing. Sometimes I even have a crew. Sometimes it's just me. On those days, it would literally be me or nobody.

It is, however, EXACTLY what the townspeople are willing to pay for, which they have demonstrated repeatedly at the ballot box over the last 50 years. Which doesn't say much, because our call stipend is funded through billing.