Study recommends changes, improvements for Rush County's EMS services

Earlier this year, in an effort to better define the county’s needs and evaluate the services of current emergency medical providers in Rush County, an independent study was commissioned. Currently, five ambulance services provide medical transport in the county: Rush Memorial Ambulance, Rushville City Fire Department, Anderson Township Volunteer Fire Department, Carthage Volunteer Fire Department and Raleigh Fire Department.

The extensive and in-depth study was conducted through phone conversations as well as on-site visits and interviews with each of the departments. 

RMH is the county’s sole paramedic ambulance service. RFD provides advance life support (ALS service) while each of the volunteer department provide basic life support (BLS level of services).

The study found that each of the services are providing adequate service for their departments and the area they service. Additionally, it was noted that each department works well together and there are open lines of communication beginning with the 911 dispatch through treatment and transport of patients.

The study however found areas that could and should be improved upon:

• Although there is communication between departments, there is no standard radio system currently in place; with many departmental communication devices not compatible with other departments on a single radio frequency.

• There is no one individual serving in the capacity of medical director (MD) charged with overseeing each of the departments and as a result no standard set of protocols utilized by each of the services defining their responsibilities while in the field. The study recommended a single medical director and a single set of protocols be set in place, so that each department is driven by the same medical oversight, policies and guidelines.

- There is no single individual bridging the gap between the MD, the individual EMS department and county officials. It was recommended that the county implement a EMS supervisor as a means to provide a link between the departments and county officials. This position would receive monthly activity reports from each department and present that information to county leaders on a monthly basis. It was stated that in most counties throughout the nation, that position is filled by the county EMA Director.

Following a brief question-answer session, the county commissioners and council members took the information under advisement.

A second special commissioner meeting was held Wednesday and it was anticipated that the county leaders would finalize their decision. However, that was not the case.

“Currently, we are within the budget approved by the county council in the fall of 2017. We will have to stick to that budgeted amount. Projections are not good looking forward. We are anticipating a 20 percent decrease in funding within the next two years. Regarding the EMS providers, we are not a united front,” commissioner Paul Wilkinson said.

After reviewing the information at hand Wednesday, a public question session was opened and comments were heard from four of the five currently subsidized EMS providers in the county: Carthage, Anderson Township, Rushville City Fire Department and Raleigh Fire Department, and others.

The county leaders agreed with parts of the extensive study that was conducted regarding one county employee to oversee the EMS process and the need for one set of medical protocols for the ambulance service(s) to work. The single set of protocols was met with resistance from a number of department representatives in attendance.

Nancy Custer of Raleigh questioned why each of the volunteer and city fire departments were showing profits while RMH was not. She stated that she understands the value and need for Advanced Life Support and a Paramedic service in the county, but feels other means to provide those advanced skills could be reached. She further stated that monies currently set aside for EMS service at RMH could be used instead to offer other hospital services and not an ambulance provider.

County council member Steve McCorkle said he was not in favor of giving one extra dollar to RMH to provide an ambulance service.

Currently, the county has an annual working budget of $526,000 to provide county-wide ambulance service. Although different in size, EMA Director Chuck Kemker said that nearby Shelby County has a working budget of more than $1 million dollars annually.

“It is projected that by 2017 our (Rush County) assessed value will decrease by 20 percent or roughly $125,000 less than we have as working capital today,” Wilkinson said.

“If it’s going to work and work right, it has to have the support of everybody. We have to work together paid and unpaid (volunteer departments),” Wilkinson said.

Commissioner Mark Bacon suggested that another committee comprised of a representative from each of the EMS providers be formed to seek a workable solution. The measure failed to pass.

The decision was then made by Wilkinson to divide the county into three sections for ambulance service: north, central and south and that by May 25 any and all EMS providers should submit a new proposal if they desire to provide ambulance service for one or multiple areas of coverage.

The county leaders then sought to extend the contracts with the EMS providers.