By: Jennifer Britt
The Parsons Advocate
After prayer, Pledge of Allegiance and offering condolences for the Sponaugle family the Tucker County Ambulance Authority got down to work on their very extensive agenda. Tucker County Commissioner Lowell Moore opened with the comment, “I am very saddened by the comments made by some of our local businesses” in reference to a meeting held in Timberline to discuss the Amusement Tax and other options for funding for EMS. Those in attendance included representatives from Timberline, Canaan Valley Resort, Pickin’ in Parsons Bluegrass Festival & Five Rivers Campground, and the Tucker County Convention and Visitor’s Bureau.
President of TCAA Dennis Filler thanked Moore for his help and support with moving forward with the levy and in reference to Moore’s statement Filler said, “The overall comment was it (the amusement tax) was a dis-apportioned taxation on them as businesses relative to the general population of Tucker County.” “They seem to think it was going to come out of their pockets and affect their profit and that is simply not true”, said Moore.
Debra Stiles that is running for county commission said, “I have been trying to identify the key issues when I talk to constituents and at the top of mine is the Ambulance Authority and how do we accrue ambulance services for the county. How do we fund that. How do we make it work. People have been confused in the past, but I think there is now a sense that we need to pay the people that are doing the hard job what they deserve. We need to figure this out and do it as soon as possible. If there is anything I can do once your work is done and you have decided your path moving forward, I will be supportive.”
For the Treasurer’s report Chris Davis explained that thanks to the $44,000 in extra monies given by the Tucker County Commission the TCAA ended the fiscal year with $22,000 in the positive. The fiscal year ended June 31 and after spending $438,688 for expenses, $788,000 for employee cost the budget year ended with $1.2 million with an average expense per day of $2,684.
After explaining that every call that goes out cost $936 and it is billed for $979 of which most insurances only pay $579 Davis said, “There is a deficit every time we go out. I am not saying we should not go out but if you look at the cost of employment and all of that, that is the cost from the run point of view.” Filler added by saying, “That is based on actual data. We do not have the luxury of charging more and the other way to solve the equation is to make fewer runs. We cannot manipulate either one of those variables.”
Davis explained with the new data they were receiving from billing company the authority can see what is being charged per run so when someone says they were charged $3,000 the TCAA can show where there is no data to support that accusation.
Board members discussed the options for their target staffing. Filler said, “We have to set the direction of which we are going or at least aspire to go to. That is the destination point then we will have to determine what the target budget is that we are shooting for to work with to get there. Then work with the Director and Deputy Director to staff according based upon the findings we have available.”
Tucker County EMS Medical Director, Dr. P.S. Martin, provided the board with what he suggests should be the minimum and optimum staffing for the EMS crews. Martin said, “What I gave you were my recommendations as Director based on the amount calls we have, the distance it is to transport to a hospital, and the time it takes. In the past it shows consistently that by the time a call comes down to when the crew gets back into the county, not even back to the station, it takes a minimum of two hours and usually exceeding that.
The bare minimum will not cover 100 percent of our calls but will get most of them is having two ALS crews 24/7 (24 hours day and seven days a week) and having a single paramedic (plus a driver) on a response vehicle.
Truly what is in my heart and what I want for Tucker County; because I know if someone goes down with a cardiac arrest in this town, they have little to no chance of surviving at this point; is to see three ALS crews 24/7. We do not have that luxury, but I want to strive for that luxury. I will fight until my last breath to try and get that for Tucker County.
So, what I see is that EMS has been forced to act as a business in this country, but all the legislation is against it being a profitable business. The only thing way you can actually come close to making it in this business is to do transports. I think our optimum goal should be to build towards some way to start accommodating some transports into our repertoire of what we do.
The optimum business model I see us starting out with would be two crews 24/7, one ALS crew and BLS crew, and then on Monday through Friday we start looking for whenever the peak times of most of our calls. Then when finances are available, we start adding an eight-hour third crew. And during those peak times is when we will try to schedule those transports (with the eight-hour crew).”
The main difference between ALS (Advance Life Support) crew and BLS (Basic Life Support) crew is that in BLS, it has a non-invasive latter which means that the technicians in a BLS ambulance cannot perform any kind of surgery or medical treatments which requires the use of needles and other instruments that make cuts and cannot provide any kind of severe medicines, while on the other hand, the technicians in an ALS ambulance can perform any kind of surgery or medical treatments.
A crew consists of two people, usually one driver and a paramedic or EMT or a paramedic and EMT. EMTs and paramedics are both trained in driving. Martin said, “Unfortunately across the country it has become the standard for a two-person crew on every ambulance. That is the standard care for all across the country, not that is the best, but again financially it has become standard way of running the business. There are lots of calls for that but every ambulance service I have has to put out calls to fire departments or anybody else they have for lift assistance. That is everywhere. Anyone in the community complaining about having two person crews it is all hog wash. You have two-person crews all over this country.”
Board member Diane Hinkle said, “Without a hospital I feel like two ALS crews is really the minimum. I realize it easier to do one ALS and one BLS but as a medical care provider I have a hard time saying that I am ok with that. We have no hospital, and we are just looking at cost so personally I am striving for two ALS crews.
I do not think we can recommend less than two ALS crews. I really do not in a county this size, the number of people that come through here, and to do justice to the people of this county. If we had a critical care facility or Emergency Room, then I think one ALS and one BLS, but we do not have it.”
Board member Jon Bush added, “If we talk about the levy going forward, unfortunately you can not go forward with this EMS. There is no way to go forward without having the narrative of where we are going to end up without a levy. That narrative has to be out there, and that narrative is by May of next year we will not even have an EMS at all. That is the narrative. Now, I agree if you want two ALS crews unfortunately a $400,000 levy is not even going to give us the money to do that.”
Filler responded by saying, “The levy alone is not the only strategy we are pursuing. We all agree that $400,000, the numbers on this sheet, are not going to get us there. It is a piece out there as well other options we have to continue to explore. But it all has to be towards the same goal.”
Members of the board voted to accept the finalized draft of donation mailer cards that will sent out to the residents of Tucker County in mid-September. The cards will ask for donations to help EMS get through the fiscal year. A separate bank account has been set up for the donations. Donations can be sent to TCAA, PO Box 333, Parsons, WV, 26287. The treasurer and vice-president are the only ones with keys to the box.
The next Tucker County Ambulance Authority monthly meeting will take place on September 15, 2022, at 5:30 p.m. located on the third floor of the Tucker County Old Courthouse Courtroom in Parsons.