Combined ambulance/fire service proposed

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October 6, 2012 - 12:00 AM

It’s only open a crack, but a window of opportunity to agree on countywide ambulance and firefighting services exists — if the powers that be can settle on one of two proposals. 
“There are enough people on both sides who want to see something get done,” said Tom Williams, Allen County Sheriff and the presumptive replacement for Rob Francis’ seat on the county commission. “I see plenty of middle ground in which we can work.”
The two sides Williams is referring to are the Allen County Commission and the Iola City Council.
Since December 2008, the county and Iola have provided separate EMS services, resulting in a burden to taxpayers, a duplication of services and equipment and underused staffs in both departments. 
Earlier this year a committee was designated to find a way the city and county could once again provide one EMS service as well as retain Iola’s fulltime firefighting force.
From there, Ron Conaway, Iola EMS director, and Jason Nelson, his counterpart for the county, were ordered to come up with a proposed merger.
Both have since developed separate proposals that have been, or will soon be, presented to the public.
Conaway sat down with Register reporters in late September to discuss many of the specifics of his proposal. At the time of the interview, he still had to flesh out final details, particularly with costs.
Nelson declined to speak with the newspaper about his proposal, instead handing it over without comment to the ambulance committee.
CONAWAY’S proposal mirrors another developed in recent months and promoted by Sheriff Williams.
“It would involve giving a little on both sides,” Williams said of the compromise.
The Conaway/Williams proposed merger would have the Iola Fire Department assume responsibilities for EMS services throughout the county.
The key is all EMS employees would also be trained in fire protection.
One EMS service would reduce the number of ambulances needed from the current six, to four. Firefighters would continue to staff the Iola station, with others stationed in Humboldt and Moran.
For paramedics and ambulence personnel who have reservations about fighting fires, they need not worry.
Not all firefighters “would be asked to go into burning houses,” Conaway said, although they would respond to fire calls. Those crews instead would be stationed outside of any fire scenes to provide medical support, to stand by for other medical needs, or to re-equip other firefighters’ equipment with items such as fresh air tanks.
“There are a number of duties that are required at a fire scene,” the sheriff said, “not just fighting the fire.”
THE FIREFIGHTERS would remain as Iola employees, but would operate under the direction of a board of EMS directors made up of health care professionals and others in Allen County.
The consolidated service would remain a Type 1 ambulance service, which mandates a paramedic be assigned to at least one ambulance at all times.
“That would resolve the county’s concern about oversight and quality of service,” Williams said.
The board and its responsibilities is a pivotal point in making a merged service work, unlike the system in place up until the two services split in 2008.
“The old system was designed to fail,” Williams said.
That’s because the county EMS director was for years the Iola fire chief.
Iola officials recognized that the fire chief had authority, but little oversight, over ambulance personnel in Humboldt and Moran.
Then, when the county decided to manage its own service, the opposite was true.
“We had a county EMS director who had oversight and authority over Moran and Humboldt, but no oversight over the Iola employees,” Williams said.
Having an EMS board review and recommend changes within the system would eliminate that discrepancy.
Under Willams’ scenario, the county would be responsible for billing. Williams cites Terry Call’s highly regarded efforts in collecting unpaid bills for the county; after counting write-offs, Call’s collections rate stands north of 80 percent in recent years, the sheriff said.
“If you have somebody that good at what he does, it makes sense to keep him,” Williams said.
In exchange for Iola’s services to the county, the county would increase “substantially” the subsidy it provides Iola, Williams said.
HAVING full-time firefighters stationed throughout the county would benefit other communities as well. Williams and Conaway both noted Iola firefighters stationed in Humboldt and Moran would provide support in a number of ways for the neighboring communities.
“They could do building inspections, host educational programs for schools, work with the volunteers on training,” Conaway said.
An added benefit: multi-agency cooperative efforts are more likely to receive grants for upgraded equipment or manpower, the sheriff said.
“We rely very much on our volunteer departments,” Williams said. “They provide an outstanding service. But if you’re augmenting those volunteer departments with professional, full-time firefighters, you can’t tell me you won’t have a better service overall.”
NELSON’S PROPOSED merger, on the other hand, would have the county assume responsibility for all ambulance runs in Allen County, including Iola, out of its building on North State Street. 
Three ambulances would be in use: one in Iola, one in Humboldt and one in Moran. A fourth ambulance would be operated by Iola firefighters on an “as-needed” basis. Such instances are rare: of the more than 1,400 ambulance calls since January in Iola or Allen County, only once has it needed four ambulances on scene.
The county would not need to hire additional personnel, Nelson said, and the ambulances would be moved strategically around the county, “based on call-driven demand.”
Under Nelson’s scenario, Iola firefighters would continue to receive the $80,000 annual subsidy the county provides to man the county’s rescue vehicle and provide hazardous materials cleanup. Firefighters also would be called to serve as first responders for EMS calls within the city.
Nelson said the advantages to his plan is a reduced Iola Fire Department.
Nelson also said the city could give up funds made available from a federal grant that would have added three more firefighters to the IFD staff for the next two years. Because the funds have not yet been used, the grant could be returned without penalty, Nelson’s proposal said.
If the county oversaw EMS in Iola, that would add about $300,000 to county coffers, Nelson said.
CONAWAY’S proposal also would realize significant savings.
While Conaway was hesitant to provide numbers ahead of Monday’s city council meeting, estimates obtained elsewhere point to a savings of about $500,000 from the combined $2.5 million the city and county spend collectively for ambulance and fire protection.
Williams said all county paramedics and ambulance personnel would be given first dibs on the added positions at IFD — 29 full-time employees would be needed to make the whole system work — although some, realistically, would choose not to work for the city. Attrition would take care of the rest.
WILLIAMS pointed to other potential stumbling blocks, and their solutions.
What would happen, say, if Iola took over all ambulance services and then decided down the road to drop the added service?
“The ambulances and equipment would be county property leased to the city for a token fee, say $10, a year,” Williams said. “If the city wanted to drop the service, the equipment simply would go back to the county.”
Williams, Conaway and Nelson all envision a full-scale effort into developing a countywide network of first responders: volunteers who could respond quickly in case of a medical emergency.
“You could have a Gates employee as one, or a farmer in a rural area,” Williams said. “Rapid response is vital to saving lives.”

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