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Post by lifesaver on Aug 13, 2013 10:34:31 GMT -5
Sharing this for those of you who may not have seen the article. IMO this does not bode well for the taxpayers of Adams County, but I also believe that it is the future of our county whether we want it to be or not. A fact of life. WellSpan will say that the impetus for this decision is the duplication of services but I'm sure the decision is mostly financially driven due to loss of revenue related to changes coming in the Affordable Care Act. (Another day, another post). York County will suffer the cuts very soon. There are private ambulance services based in York County that provide ALS services. For the most part, these services do not extend to Adams County. All fire and EMS services in Adams County are volunteer, and there is no such thing as volunteer Advanced Life Support service. Hence, at this moment, Medic 28 provides a vital service to the residents of Adams County. Which is also why there will still be ALS (Medic 28) services provided for the time being. So what does this mean for Adams County? It means that eventually the responsibility for these services will be transferred to the County, who will be obligated to provide these services. Our volunteer fire departments are struggling, from decreased revenue and donations to increased training and time obligations REQUIRED to perform a VOLUNTEER service. I'm not saying the training isn't needed, it is, but there are very few among us willing to give/afford the exorbitant amount of time away from work and family. So if you know a volunteer firefighter or EMT thank them by donating generously, supporting their fundraisers, and understanding the contribution they are giving back to their community. You cannot volunteer ALS services, which I believe will be the beginning of the end for volunteer departments in our area. Translation: paid departments and Fire Tax. So, while you can support your local fire departments. And for those of you who think we don't need ALS service in Adams County, think again. Sometimes those few MINUTES that ALS can start lifesaving treatment that otherwise can't be given until you reach the hospital can mean the difference between life and death.
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Post by Venter on Aug 13, 2013 11:19:11 GMT -5
I kinda read the article to mean that although WellSpan may be stopping their OWN Service, they may be working with the local departments to help THEM provide the ALS.
I assumed this meant that they would be considering "donations" to certain departments to help provide them with ALS support.
Did I read more into it than it said?
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Post by lifesaver on Aug 13, 2013 11:52:34 GMT -5
I kinda read the article to mean that although WellSpan may be stopping their OWN Service, they may be working with the local departments to help THEM provide the ALS. I assumed this meant that they would be considering "donations" to certain departments to help provide them with ALS support. Did I read more into it than it said? That's a wonderful thought Venter, but they would not be able to "donate" enough to fund these services. If fire departments are struggling now to stay afloat it would be a stretch to think that the public would dig even deeper into their pockets to donate more to fund these services, even with help from WellSpan. I really wish they would Venter, the reality is that I think most people don't begin to realize the service and commitment these VOLUNTEERS provide to the community. I really hope that it doesn't come to that, but realistically I don't see that happening.  ALS services must be paid, they can't be volunteer. |
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Post by Fire Marshal Bill on Aug 13, 2013 15:01:32 GMT -5
LS, first I do agree, this will put a burden on people to provide that ALS service, and it is something the community needs. As I recall, Adams County was one of the last in the state to get ALS, and now it looks like we may well be one of the first to loose it, and that loss could be many lives lost.
I don’t know how long Paramedic training is now, but way back when I took the course in Maryland it was only 320 hours. Even then that was a long time to spend when you think that back then basic fire was only 56 hours and EMT was only 81 hours. Using that as a standard Paramedic training must be at least 500 hours by now.
But I don’t understand your statement that ALS can’t be provided by volunteers? Years ago when I was in Montgomery County Maryland our service WAS all volunteer, except for the Cardiac Care unit out of on of the hospitals with nurses staffing it.
Yes I do realize that if I am going to go to school for that long, I will expect to get some financial reimbursement for my time and I am not going to just give it back to the community.
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Post by lifesaver on Aug 13, 2013 16:41:16 GMT -5
LS, first I do agree, this will put a burden on people to provide that ALS service, and it is something the community needs. As I recall, Adams County was one of the last in the state to get ALS, and now it looks like we may well be one of the first to loose it, and that loss could be many lives lost. I don’t know how long Paramedic training is now, but way back when I took the course in Maryland it was only 320 hours. Even then that was a long time to spend when you think that back then basic fire was only 56 hours and EMT was only 81 hours. Using that as a standard Paramedic training must be at least 500 hours by now. But I don’t understand your statement that ALS can’t be provided by volunteers? Years ago when I was in Montgomery County Maryland our service WAS all volunteer, except for the Cardiac Care unit out of on of the hospitals with nurses staffing it. Yes I do realize that if I am going to go to school for that long, I will expect to get some financial reimbursement for my time and I am not going to just give it back to the community. FMB, I don't want to give the wrong impression, it is because the county relies on ALS service by Medic 28 that services in Adams County are not being discontinued as quickly as they are in York County. WellSpan will not leave Adams County high and dry. But I believe eventually they will put the responsibility for ALS services to the county, which has a responsibility to provide these services to the community. Not sure how it will look in the future, but if it is paid services provided by the county it will cost the taxpayers dearly. Could a paramedic serve in a volunteer role, yes, I imagine they could, but it would be like me working in a volunteer role. My license would not cover me administering medications, or providing much of the care I can provide in the hospital setting. I could perform CPR, use an ACD (automatic defibrillator), take vital signs, and utilize my assessment skills. Not a whole lot of help when minutes count. I can't start an IV or give drugs and I can't intubate anyone even at work, even though I am certified in Advanced Cardiac Life Support and that is one of the skills in the class. All of these things (except the intubation) covers me in a hospital setting. I'm certain the same thing would apply to a paramedic. For informational purposes, here are the qualifications needed for a paramedic When the program first started some of the nurses cross-trained as pre hospital RN/Paramedic. None of them are working in that capacity any longer. |
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Post by Alex Oreilly on Aug 13, 2013 18:55:54 GMT -5
Adams County has Caring Hearts and White Rose for ambulance transportation, would it be possible for private ambulance companies to add a ALS vehicle?
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Post by lifesaver on Aug 13, 2013 21:00:45 GMT -5
Adams County has Caring Hearts and White Rose for ambulance transportation, would it be possible for private ambulance companies to add a ALS vehicle? A private company doesn't respond to emergency calls like our local EMS companies. White Rose already has paramedics on staff. We use them frequently for ground transports. |
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hawg
Going Postal
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Post by hawg on Aug 13, 2013 22:40:44 GMT -5
The County is not the responsible party each municipality is responsible for the life safety and emergency protection of their citizens. There isn't one Fire Department in Adams Co. that will be able to provide volunteer or paid ALS. Paramedics go to school for this because this class isn't one taught in the firehouse Tuesdays and Thursdays nights and costs a lot of money that most Departments don't have to send those FF's to. Also overlooked is the EMT's that are in the departments that are employed by Wellspan they are going to leaving also and once again it falls right back on the volunteers. This is just the start of it and that deficit that Gettysburg has and not knowing how to pay for it well you can add paid employees to provide medical services to it. I hope know one gets mad when their taxes go thru the roof but the volunteers have told you and told you to help by donating to them.
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Post by Alex Oreilly on Aug 14, 2013 8:52:28 GMT -5
Adams County has Caring Hearts and White Rose for ambulance transportation, would it be possible for private ambulance companies to add a ALS vehicle? A private company doesn't respond to emergency calls like our local EMS companies. White Rose already has paramedics on staff. We use them frequently for ground transports. I realize that they normally don't do emergency runs but they could if they wanted too, so why not add an ALS unit to their services |
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Post by thats ogp on Aug 14, 2013 11:49:32 GMT -5
" It means that eventually the responsibility for these services will be transferred to the County, who will be obligated to provide these services." Unfortunately this comment or conclusion is incorrect, the County is NOT required to provide ALS Service. As for the BLS Service, those fire companies that have their duty crews paid for by WellSpan will have to do what others have done in the past: hire their own personnel, rely on mutual aid agreements and volunteers. As a paramedic for the past 27yrs, I have seen this happen all over this Commonwealth, where Hospital based ALS services are discontinued purely because of their financial cost (Medicare and insurance reimbursements just don't cover the cost of the services supplied). Private companies can continue that service (ALS), which has been an increasing norm in this Commonwealth. Read more: boroughvent.proboards.com/thread/1071/wellspan-cut-back-medic-units#ixzz2bxh9FsNm |
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Post by lifesaver on Aug 14, 2013 19:04:52 GMT -5
" It means that eventually the responsibility for these services will be transferred to the County, who will be obligated to provide these services." Unfortunately this comment or conclusion is incorrect, the County is NOT required to provide ALS Service. As for the BLS Service, those fire companies that have their duty crews paid for by WellSpan will have to do what others have done in the past: hire their own personnel, rely on mutual aid agreements and volunteers. As a paramedic for the past 27yrs, I have seen this happen all over this Commonwealth, where Hospital based ALS services are discontinued purely because of their financial cost (Medicare and insurance reimbursements just don't cover the cost of the services supplied). Private companies can continue that service (ALS), which has been an increasing norm in this Commonwealth. Read more: boroughvent.proboards.com/thread/1071/wellspan-cut-back-medic-units#ixzz2bxh9FsNmTechnically you are correct. There is no law that requires the county to fund ALS services. Technically there is no law requiring the county to provide EMS/fire service. There is no law that says a volunteer fire department has to respond if your house is on fire. So no, there is technically no law. I do believe that there is a civic and moral responsibility to help and to provide these services to the citizens of Adams County. And insurance reimbursements would be the same for a private ALS company, as opposed to hospital provided services. It's not a money maker. And since you know about private companies, are there private companies that respond to emergency calls like Medic 28 does? Because if they only operate 9-5 and you have your MI at 5:30 you're pretty much SOL. I know we have emergency ground transports on off shifts, but these are arranged between the hospital and White Rose. They don't respond to the scene of an incident to my knowledge. Are these private units at paid departments, or do they respond to areas covered by volunteers? |
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Post by Fire Marshal Bill on Aug 15, 2013 5:27:20 GMT -5
One thing that I think have affected the financial aspects of WellSpans EMS system is the use of personnel.
Yesterday I spent a bit of time at the fire stations, and in just about an hour I saw three WellSpan supervisors come into the station. Each of the three was in his/her own vehicle.
Do they need three supervisors on duty at one time? Do they need three supervisors’ vehicles on the road at one time?
ALS services do save lives. Getting the advanced care to the patient as quickly as possible is essential, and must be provided. Should one of the local fire departments take this duty on there are so many administrative and financial issues to look at, and it will require a lot of consideration for any organization taking it on.
It is my understanding that White Rose has several MICUs in service and staffed and I wonder if they are ready to fill the void left when WellSpan discontinues service?
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Post by thats ogp on Aug 15, 2013 8:13:40 GMT -5
Let's address the financial aspect of this situation. Insurance reimbursements are quite different for non-transiting ALS services ( Medic 28 ) than for transporting units. That is why QRS ALS services enter into billing agreements with local BLS units so that they can be reimbursed for services rendered ( normally an ALS accompaniment charge/ cardiac monitor). Unfortunately this reimbursement is not nearly enough to offset the cost of operating this service (salaries, insurance, equipment, fuel, vehicle upkeep ). So, it is quite correct that the service ( if non-transporting ) is not a " money maker": nor was it originally intended to be, but to provide much needed services. And I do, understand the outrage and questioning this decision to end ALS services. I happened to be employed at two hospitals which ended their ALS units, one of which was sold to a private EMS company.
Addressing the questions posed, yes, many Private ALS services and volunteer services throughout this Commonwealth which provide the services identical to those of Medic 28.Health care systems ( such as WellSpan ) choosing to end their ALS units is nothing new, beginning in the late 1990's. For example, both in Luzerne and Lackawanna Counties, private ALS services were formed by paramedics, who were previously employed by hospitals, who chose to end their ALS coverage. Those companies began operation the same day that the hospital based ALS units ended. At this point, there is time ( WellSpan units are scheduled to end service Dec. 2014 ), have companies or local EMS units to fill the void.
County funded and operated units is the ideal that paramedics have dreamed of for decades, unfortunately it has never borne fruit. Politics, along with those very administrative and financial issues make Commissioners wary.
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Post by lifesaver on Aug 15, 2013 10:34:34 GMT -5
Let's address the financial aspect of this situation. Insurance reimbursements are quite different for non-transiting ALS services ( Medic 28 ) than for transporting units. That is why QRS ALS services enter into billing agreements with local BLS units so that they can be reimbursed for services rendered ( normally an ALS accompaniment charge/ cardiac monitor). Unfortunately this reimbursement is not nearly enough to offset the cost of operating this service (salaries, insurance, equipment, fuel, vehicle upkeep ). So, it is quite correct that the service ( if non-transporting ) is not a " money maker": nor was it originally intended to be, but to provide much needed services. And I do, understand the outrage and questioning this decision to end ALS services. I happened to be employed at two hospitals which ended their ALS units, one of which was sold to a private EMS company. Addressing the questions posed, yes, many Private ALS services and volunteer services throughout this Commonwealth which provide the services identical to those of Medic 28.Health care systems ( such as WellSpan ) choosing to end their ALS units is nothing new, beginning in the late 1990's. For example, both in Luzerne and Lackawanna Counties, private ALS services were formed by paramedics, who were previously employed by hospitals, who chose to end their ALS coverage. Those companies began operation the same day that the hospital based ALS units ended. At this point, there is time ( WellSpan units are scheduled to end service Dec. 2014 ), have companies or local EMS units to fill the void. County funded and operated units is the ideal that paramedics have dreamed of for decades, unfortunately it has never borne fruit. Politics, along with those very administrative and financial issues make Commissioners wary. There is another article in the Times today but I am on my mobile and can't figure out how to copy and paste it here. If someone else could that would be great. Your response begs another question though, if these ALS units operate as volunteers in what capcity can they function? ACLS protocols? |
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Post by thats ogp on Aug 16, 2013 10:03:21 GMT -5
Lifesaver, these volunteer ALS units respond in the same nature as a paid medic unit. They have either a volunteer crew ( medic and emt-driver ) or a paid medic and volunteer emt-driver. The service is licensed by the Commonwealth, following the identical EMS regional guidelines / protocols as a paid service, providing a 24/7 service to their service area.
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Post by lifesaver on Aug 16, 2013 15:05:22 GMT -5
Lifesaver, these volunteer ALS units respond in the same nature as a paid medic unit. They have either a volunteer crew ( medic and emt-driver ) or a paid medic and volunteer emt-driver. The service is licensed by the Commonwealth, following the identical EMS regional guidelines / protocols as a paid service, providing a 24/7 service to their service area. OK. That answers my question. No matter which way this turns out I believe it will be an expensive solution for the taxpayers. There was another article in the Times today that helps to explain the situation of volunteer departments an what the future may bring to Adams County. |
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hawg
Going Postal
Posts: 43
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Post by hawg on Aug 18, 2013 17:11:59 GMT -5
But it still boils down to that there are very very few volunteer's that are going to get their Paramedic cert. and no matter how hard our local leaders hope and pray the volunteers get it they are going to be saddled with the burden when the hospitals stop doing ALS. They are going to have to take that responsibility on and won't be able to just not worry about it like they do now. Therefore the taxpayers are going to feel the first wave of paid emergency services. Also the EMT's that are stationed at Fire Department's right now from WelSpan will be gone also and need to be replaced from another hospital in the area or private service "rented out" to them. For everyone's information there is only one Ambulance that is staffed 100% by volunteer's in Adams county anymore and that is Lake Meade all the rest have some sort of paid service and hours. There are some local leaders that had better get their heads out of the sand and wake up. They had better start preparing for the major tax increase that is not so far down the road and building a big head of steam that they have always overlooked and never worried about.
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Post by Venter on Aug 19, 2013 8:27:49 GMT -5
Hawg, I'm not even sure how to phrase this question without sounding as ignorant as most of us are: If it becomes an all-paid-service, instead of volunteer service, will any of the current volunteer stations be "converted" to "paid stations"? In other words, are the current volunteer stations prepared to become fully-staffed fire stations? What conversions, if any, would need to be made in order to become full-time stations? How many stations may we lose in the transition, and how will that affect response times? I would assume that since there would always be a squad on duty, that there would be no delay in getting the equipment out. As it stands, there is some lag time while volunteers rush to the station. So, even if there are fewer stations, resulting in further travel to some emergencies, it seems that the "exit time" from the stations may compensate for the distance. Does any of this make sense?  |
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Post by Venter on Aug 19, 2013 8:47:43 GMT -5
On another note... If the Elected Officials were to use this latest dilemma with Emergency Services as the impetus, it would be the PERFECT time for them to broach the subject of Increasing Taxes. I always LOVE when the Old Folks in the Region complain about paying "School Taxes". Maybe they should be required to pay "EMS Taxes" instead!  If the County could begin to incorporate a system where we just pay "TAXES", then who gives a shit WHERE those funds go once they are received by the County? What I mean is - If part of it goes to EMS/Police/Fire, part Roads, part Schools, part Administration, etc., then technically it is ALL Taxed as ONE TAX. After that, the County doles it out as needed, in a fair manner. Next time, when the Taxes need to be raised, it is for "County Residents", not for each individual/particular County Entity. There seems to be so much Duplication of Effort as each tiny Municipality tries to eke out services for their own Piece-of-the-Pie. That causes divisions that are not necessary, and our Local Municipalities are attempting to compensate for this by forming "Coalitions" and "Pooling Resources". We STILL PAY State and County AND Local Taxes to get services. Instead of using the resources of these Larger Systems to their fullest, we duplicate efforts, and have so many different Fiefdoms - each with their OWN set of Rules! This "Trickle UP" system is so redundant, that the monies we spend in Local/Municipal Taxes would be thrown into a larger pot that could be distributed more wisely. While Straban, and others, benefit from using the State Police that EVERYONE pays for, they STILL get the benefits of using the Borough Police and Cumberland Police which only SOME of us pay for. Spread the Expense, Spread the Wealth, or Spread your Cheeks... I Opt for the first two, since we've already been using the last option for too long.  |
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Post by orrtannaexpat on Aug 27, 2013 5:19:29 GMT -5
This is going to be a very interesting discussion.
>>>>>>>>>>>>>>>>>>>
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Post by Venter on Aug 27, 2013 8:51:45 GMT -5
I think this line says a lot!Isn't it in WellSpan's best interest to provide the best services to Emergency Patients? Even THEY know that the first few moments are CRITICAL when it comes to the survival rate of patients. The better prepared the Emergency Room is, the better the chances are of a recovery, or at least, there could potentially be less damage done to the patient. The Response Times COULD affect the Survival Rate of the Hospitals in the WellSpan Network, and eventually lead to other complications. Over the years, I've heard many people say, "I'd never go to Gettysburg Hospital" (a member of WellSpan). I must say, from my own experiences, I disagree with that. I had my back operated on at Gettysburg Hospital, and through the WellSpan network, I was operated on by the Head of Neurology from York Hospital - at Gettysburg! I've always been pleased with the service - and I come from a part of Baltimore that was serviced by the "Johns Hopkins Health System". Maybe in "the old days" in its stint as a "small, local hospital" (Annie Warner Hospital and Nurses' Home) the hospital may have not been the "world-class" medical provider that people have come to expect. But I truly believe that Gettysburg WellSpan has a lot to offer. With that said... Consider the repercussions that are possible from this Business Decision that they are making now. It may be a case of robbing Peter to Pay Paul. Maybe the "Success Rates" of Emergency Service at the WellSpan Hospitals is
DUE TO THE FACT THAT THEY ARE INVOLVED IN THE OPERATIONS FROM THE BEGINNING!?
I get it - the EXPENSE of providing this service is high, but consider the COST of NOT Providing the Service...
If you have control over the preparation, then you are a few steps ahead.
Things are done in a standard method, in the manner proscribed by your Medical Professionals.
I'm in no way implying that the Volunteers are inefficient, but Everyone has their own ways of doing things.
What if every fire company had their own hose connections instead of a Standard Connection?
Sure, there may be adapters available, but every moment counts in putting out a fire, or saving a life.
AND THAT IS THE ULTIMATE GOAL - ISN'T IT... TO SAVE LIVES???
What if the Emergency Personnel had a different type of I.V.?
Maybe they're just a step behind because they were trying to "Fill Boots at the Square", instead of manning the Station!?
I think we all underestimate the PROFESSIONALISM of our "VOLUNTEER" FORCES - and we take them for granted.
Some people assume that "You don't get anything for free".
Well, when it comes to Emergency Services, it has been "Free" so far, but their Services have been as Effective and Important as Any Paid Services.
I wonder if WellSpan may be underestimating their "Bottom Line" by eliminating their ALS Services.
As a sort of "Supplemental Service" in its present state, using "Chase Vehicles", they are providing essential, life-saving services - at a Critical Moment of Health Care -
DURING THE FIRST MOMENTS AFTER AN EVENT, AND IN PREPARATION FOR THE EMERGENCY ROOM.
Maybe the system is getting a bit "cocky", in underestimating the effect of getting Patients who have been properly prepped from the onset.
- Will their Hospitals look as good if their Survival Rate shrinks?
- Will they even KNOW if the Patients lose faith in their system... or why?
- How long before (if) they realize that they were penny-foolish?
- Once they lose the confidence of the Public (their customer base), how much will they have to spend to reclaim it?
Hey, I do get it... It's a Business, and in order to satisfy their investors, they need to improve their bottom line. We may never know whether this decision will come to bite them in the ass, but are they willing to bet their lives on it?
One day they may need to - remember, they are potential customers too!
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Post by lifesaver on Aug 27, 2013 17:06:04 GMT -5
I think this line says a lot!Isn't it in WellSpan's best interest to provide the best services to Emergency Patients? Even THEY know that the first few moments are CRITICAL when it comes to the survival rate of patients. The better prepared the Emergency Room is, the better the chances are of a recovery, or at least, there could potentially be less damage done to the patient. The Response Times COULD affect the Survival Rate of the Hospitals in the WellSpan Network, and eventually lead to other complications. Over the years, I've heard many people say, "I'd never go to Gettysburg Hospital" (a member of WellSpan). I must say, from my own experiences, I disagree with that. I had my back operated on at Gettysburg Hospital, and through the WellSpan network, I was operated on by the Head of Neurology from York Hospital - at Gettysburg! I've always been pleased with the service - and I come from a part of Baltimore that was serviced by the "Johns Hopkins Health System". Maybe in "the old days" in its stint as a "small, local hospital" (Annie Warner Hospital and Nurses' Home) the hospital may have not been the "world-class" medical provider that people have come to expect. But I truly believe that Gettysburg WellSpan has a lot to offer. With that said... Consider the repercussions that are possible from this Business Decision that they are making now. It may be a case of robbing Peter to Pay Paul. Maybe the "Success Rates" of Emergency Service at the WellSpan Hospitals is
DUE TO THE FACT THAT THEY ARE INVOLVED IN THE OPERATIONS FROM THE BEGINNING!?
I get it - the EXPENSE of providing this service is high, but consider the COST of NOT Providing the Service...
If you have control over the preparation, then you are a few steps ahead.
Things are done in a standard method, in the manner proscribed by your Medical Professionals.
I'm in no way implying that the Volunteers are inefficient, but Everyone has their own ways of doing things.
What if every fire company had their own hose connections instead of a Standard Connection?
Sure, there may be adapters available, but every moment counts in putting out a fire, or saving a life.
AND THAT IS THE ULTIMATE GOAL - ISN'T IT... TO SAVE LIVES???
What if the Emergency Personnel had a different type of I.V.?
Maybe they're just a step behind because they were trying to "Fill Boots at the Square", instead of manning the Station!?
I think we all underestimate the PROFESSIONALISM of our "VOLUNTEER" FORCES - and we take them for granted.
Some people assume that "You don't get anything for free".
Well, when it comes to Emergency Services, it has been "Free" so far, but their Services have been as Effective and Important as Any Paid Services.
I wonder if WellSpan may be underestimating their "Bottom Line" by eliminating their ALS Services.
As a sort of "Supplemental Service" in its present state, using "Chase Vehicles", they are providing essential, life-saving services - at a Critical Moment of Health Care -
DURING THE FIRST MOMENTS AFTER AN EVENT, AND IN PREPARATION FOR THE EMERGENCY ROOM.
Maybe the system is getting a bit "cocky", in underestimating the effect of getting Patients who have been properly prepped from the onset.
- Will their Hospitals look as good if their Survival Rate shrinks?
- Will they even KNOW if the Patients lose faith in their system... or why?
- How long before (if) they realize that they were penny-foolish?
- Once they lose the confidence of the Public (their customer base), how much will they have to spend to reclaim it?
Hey, I do get it... It's a Business, and in order to satisfy their investors, they need to improve their bottom line. We may never know whether this decision will come to bite them in the ass, but are they willing to bet their lives on it?
One day they may need to - remember, they are potential customers too!
I really don't think that Wellspan will leave Adams County high and dry when it comes to paramedic service. I think that they will work with the county EMS to transition that care to county/community provided service, i.e. taxpayer funded service. I do agree that the way this was communicated was wrong. Wellspan has some service recovery to do. I also agree that our volunteer departments are under appreciated. The proposed fire tax will be a pittance if our volunteer departments go under. Not all of the community understands the service and dedication of our volunteer departments. I think for some it will be "you don't know what you got till it's gone." |
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hawg
Going Postal
Posts: 43
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Post by hawg on Sept 1, 2013 8:28:30 GMT -5
Knowing local responders in the volunteer ranks a lot of them are saying WellSpan is setting the table for the next and not so new way of providing care. The Pa surrounding counties of Adams have been staffing MICU's these are Ambulance's with an EMT and Paramedic on one unit. There is no "chase unit" because the Medic unit is already there on board, depending what the medical call is for determines who will ride in the back and provide care enroute to the hospital. Now as to who these responders are employed by is a whole other question and is the tipping point. The hospital is not required by any law to provide pre-hospital care as some may think it was a service thought up for this area in the 80's and has not been a main stay since Anne Warner hospital opened. Granted with pre-hospital care the survival rate does go up but not earth shattering but depending on who and what the problem was it is the greatest idea ever come up with. But I do have to question the two spokes people from Wellspan as to how all of the sudden this is a service is a drain on their budgets?
Two years ago a satellite medic unit was placed into Littlestown FD with a single provider staffed by Wellspan employee's and early this year another one was placed in Bendersville. There is also one at Gettysburg hospital and is backed up by the other two, when call volumes increase in a certain area the opposite end of the county unit moves up or is closer to Gettysburg so care is not depleted. These units do not go to the hospital but to a predetermined spot unless the primary unit is going to on extended calls like taking a Pt. to York. When this happens there is no place for the unit to sit other then outside so they are never turned off while they "move up" so they run for extended time. When that happens money is going out the tailpipe so you might ask why not turn them off well they can't because of the radio's and other things on the unit need to stay charged and rely on the unit running because there is no place to plug them in.
Also just so everyone knows the "fire tax" that Adams County municipal leaders are trying to work with is and will be the first in the state to do this if it goes thru. There isn't another county that has volunteer service doing this and once again Adams County is being watched to see what happens. But I know first hand that not ALL municipalities are on board and will not implement the tax even if every other municipality does! LS you bring up a point of "taxpayer funded" if they are baulking at .25 fire tax how do you think they are going to feel about an EMS tax? If that would happen and the volunteers get the shaft on what they have been saying and trying to get done for years I can guarantee you that you would be funding ALL emergency services.
Venter you bring up a point about hose connections, it was not so long ago that was the case until national standards were implemented. They now do a "NST" National Standard Threads and when hose is purchased it is a given that all ends are to be this but in our little town of Gettysburg all the hydrant connections are bastard threads and anyone that assists them has to have an adaptor to connect to the hydrants. The emergency services has come a long way but is still the service that is completely overlooked during development of everything. When something "all of the sudden" changes in the public eyes the emergency services (volunteer or paid)have to figure out how to provide at their expense the same service they provided prior to the change for the same money or less. Until the public (taxpayers)get it thru their heads that you get what you pay for they will never understand anything about the emergency services. The past 5 to 10 years the volunteers of Adams County have been telling your municipal leaders things have to change or you the taxpayer will be taxed with paid services and they have chosen to turn a blind eye to it.
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Post by lifesaver on Sept 1, 2013 9:42:52 GMT -5
Knowing local responders in the volunteer ranks a lot of them are saying WellSpan is setting the table for the next and not so new way of providing care. The Pa surrounding counties of Adams have been staffing MICU's these are Ambulance's with an EMT and Paramedic on one unit. There is no "chase unit" because the Medic unit is already there on board, depending what the medical call is for determines who will ride in the back and provide care enroute to the hospital. Now as to who these responders are employed by is a whole other question and is the tipping point. The hospital is not required by any law to provide pre-hospital care as some may think it was a service thought up for this area in the 80's and has not been a main stay since Anne Warner hospital opened. Granted with pre-hospital care the survival rate does go up but not earth shattering but depending on who and what the problem was it is the greatest idea ever come up with. But I do have to question the two spokes people from Wellspan as to how all of the sudden this is a service is a drain on their budgets? Two years ago a satellite medic unit was placed into Littlestown FD with a single provider staffed by Wellspan employee's and early this year another one was placed in Bendersville. There is also one at Gettysburg hospital and is backed up by the other two, when call volumes increase in a certain area the opposite end of the county unit moves up or is closer to Gettysburg so care is not depleted. These units do not go to the hospital but to a predetermined spot unless the primary unit is going to on extended calls like taking a Pt. to York. When this happens there is no place for the unit to sit other then outside so they are never turned off while they "move up" so they run for extended time. When that happens money is going out the tailpipe so you might ask why not turn them off well they can't because of the radio's and other things on the unit need to stay charged and rely on the unit running because there is no place to plug them in. Also just so everyone knows the "fire tax" that Adams County municipal leaders are trying to work with is and will be the first in the state to do this if it goes thru. There isn't another county that has volunteer service doing this and once again Adams County is being watched to see what happens. But I know first hand that not ALL municipalities are on board and will not implement the tax even if every other municipality does! LS you bring up a point of "taxpayer funded" if they are baulking at .25 fire tax how do you think they are going to feel about an EMS tax? If that would happen and the volunteers get the shaft on what they have been saying and trying to get done for years I can guarantee you that you would be funding ALL emergency services. Venter you bring up a point about hose connections, it was not so long ago that was the case until national standards were implemented. They now do a "NST" National Standard Threads and when hose is purchased it is a given that all ends are to be this but in our little town of Gettysburg all the hydrant connections are bastard threads and anyone that assists them has to have an adaptor to connect to the hydrants. The emergency services has come a long way but is still the service that is completely overlooked during development of everything. When something "all of the sudden" changes in the public eyes the emergency services (volunteer or paid)have to figure out how to provide at their expense the same service they provided prior to the change for the same money or less. Until the public (taxpayers)get it thru their heads that you get what you pay for they will never understand anything about the emergency services. The past 5 to 10 years the volunteers of Adams County have been telling your municipal leaders things have to change or you the taxpayer will be taxed with paid services and they have chosen to turn a blind eye to it. Hawg, ALS service has always been a drain on the budget. It has never been a money maker. In the past, the deficits could be made up by tacking on the cost to services paid by private insurance, like room costs etc. It's important to keep in mind that WellSpan hospitals are not for profit. This means that no one can be turned away from care regardless of their ability to pay. If we do, we stand to lose reimbursements, which are also shrinking due to the implementation of the ACA. If you go to Carlisle hospital for treatment and you don't have insurance they can tell you to head on down the road to Gettysburg. They are a for profit hospital. There is a point where we can no longer tack on these losses to those with private insurances. We are fast approaching that point. Too much to go into here. I think all of you who have private insurance can agree that any claim you make these days seems to be a game of "let's see who else might be able to pay for this". How many hoops do you have to jump through today to get approval for a procedure that would have gotten a rubber stamp just a few years ago? When WellSpan made the announcement I had no doubt that the bottom line was money. That being said, it doesn't change the fact that eventually EMS services will change in Adams County. I want to reiterate that I don't think that WellSpan will leave Adams County high and dry, but I also don't think that they will drag on forever waiting for those municipalities that aren't willing to come on board with the fire tax to come around. Again, I want to stress how important it is to support our local volunteers in any way you can. If our volunteer departments dissolve the .25 mil fire tax will be a pittance compared to the tax which will be implemented to provide for paid services. My suggestion is to attend township meetings in your municipality and voice your support of the tax and the volunteer departments in our county. |
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Post by lifesaver on Sept 1, 2013 9:58:59 GMT -5
Hawg, one more comment. I beg to differ on your statement that survival rates aren't "earth shattering". When it comes to survival from trauma I think medic units and air medical have greatly improved the chances of survival and/or complications following traumatic accidents. Before the advent of ALS services in Adams County the BLS unit would bring accident victims to the hospital ER. Care would be given and they would be "stabilized" doing the things that medics could do on scene, then a nurse, (and sometimes a respiratory therapist) would accompany the patient to a trauma unit (again a delay if you had to make calls for someone to go along) praying that they wouldn't arrest until you got there. That "Golden Hour" can make all the difference between life and death.
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ALS services must be paid, they can't be volunteer.
