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Full-time paramedic service may become EMS's future

Staff writer

Because of a shortage of Emergency Medical Technicians, Marion County Ambulance director Steve Smith said the county will eventually have to provide a full-time, paramedic-run ambulance service.

As a stopgap measure, Smith said he will propose to County Commissioners that they should hire another full-time Emergency Medical Services staff member, like Smith, who can fill in as an EMT.

Smith said the county is interested in keeping EMS because it is one of the few county functions that brings in revenue.

Smith said the county will delay the implementation of a professional service as long as it is feasible. The cost for 30 full-time EMTs, to operate three ambulances, would be over $973,000, Smith figured from a previous commission presentation.

The county would also have to build two ambulance hubs, which Smith estimated would cost $2.4 million each.

Currently the county spends $674,674 on its ambulance service. Smith said the ambulance service responded to 120 calls last month. They have already responded more than 700 calls this year and are on pace to respond to more than 1,000.

“A lot of full-time services are not doing 1,000 a year,” Smith said.

Smith commended the job of the volunteer EMTs currently working in Marion County. He cited multiple situations where volunteers slept on cots in fire stations while they were on call.

“For our volunteers it’s an incredible job,” Smith said. “That’s why it’s lasted so long.”

Marion, Hillsboro, and Peabody account for 80 percent of county calls. Marion has six people covering the call schedule. Peabody has nine but Smith wrote in the July newsletter, “only four crew members are constantly staffing the ambulance in order to make sure their community is covered.”

Hillsboro has 19 crewmembers. While they spread the workload more evenly, the Hillsboro ambulance service still has only a few volunteers to cover daytime shifts.

“We’re in a situation where volunteers are getting shorthanded. These people are getting older; they’re getting burnt out,” Smith said. “People have jobs out of town. It’s getting harder and harder to find these people.”

Smith has been an EMT for more than 20 years and he understands the pressure the job puts on the families of EMTs.

“I went through a divorce because I’m an EMT and I’m gone all the time,” Smith said.

Tampa crew chief Jesse Brunner said he serves more than 300 hours of call time a month.

“You have no private life for the most part,” Tampa ambulance crew chief Jesse Brunner said. “It’s a huge commitment by each and every one of us.”

At the EMS program’s infancy, Smith said EMTs were paid nothing. Eventually that was increased to a $1 and hour. Now, EMTs receive $2 an hour. Some Kansas cities, like Argonia, and some counties have researched paying EMTs minimum wage. Smith said that paying EMTs minimum wage would be an unnecessary step toward a full-time service.

Smith and Brunner understand that there may be serious drawbacks to a full-time service. Both were concerned with the logistics of the situation. With only two hubs, one section of the county may be vulnerable.

“You put one in Hillsboro and one in Marion,” Brunner hypothetically proposed. “All of northern Marion County has to wait for 30 minutes .”

However, there is an unseen advantage to having paramedics staff ambulances. Paramedics have gone through more training than EMTs and can administer drugs and perform procedures on patients.

“The only thing they’re going to get is oxygen and diesel fuel,” Brunner said the quick ride they can provide to a hospital.

Smith teaches paramedic classes in the county. He said the vast majority of his students leave the county to become full-time paramedics. He is asked frequently when the county will go to a full-time service.

“I’ve got two people right now in paramedics’ school,” Smith said. “They’re not going to stick around Marion County.”

Smith recognizes the situation County Commissioners are facing with regard to a full-time service. As a member of Marion’s City Council, he said he understands the desire to not raise taxes.

Inevitably, a full time ambulance service will force the county to raise taxes, Smith said.

“It’s an ever increasing burden on the tax payers,” Smith said.

Last modified Aug. 11, 2011

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