Wise County

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Wednesday, September 21, 2005

Privatizing EMS appears DOA

Published Thursday, September 22, 2005

By Skip Nichols

The move to privatize Wise County’s emergency medical service is apparently

over.

“My vote is to keep what we’ve got,” said Precinct 1 Commissioner Rankin

in a phone interview Tuesday.

Rankin’s comment came after CareFlite, a not-for-profit ambulance service based

in Grand Prairie, made a formal proposal Monday to the county to take over the

EMS. The price tag was a hefty $750,000 per year – plus the county would be

required to provide facilities and ambulances to CareFlite for $1 per year.

“It was considerably higher than I anticipated,” Rankin said after CareFlite’s

initial proposal. “I’ve seen enough. I’m not even interested at looking at

proposals by for-profit companies.”

Rankin said he and EMS Director Dillard sat down together Monday

afternoon after the CareFlite proposal.

“It’s something I should have done sooner,” Rankin said. “We had a good talk. I

feel like I can work with and I feel like he will work with

commissioners. I feel like we can stop the escalating price without sacrificing

patient care.”

Commissioners asked few questions during the 30-minute presentation.

Rankin’s comments are significant since he initially suggested the possibility

of privatizing the EMS, saying the county might be able to save as much as

$500,000.

The county has proposed spending as much as $879,000 on EMS in the 2006 budget.

Auditor Ann McCuiston has estimated the county will spend approximately $700,000

on EMS in the current budget year, which ends Sept. 30.

Dillard, who has staunchly defended the county-run EMS, said he was glad that he

and Rankin finally met. He called it a productive meeting and vowed to work with

the commissioners.

“We can get close or be even less than that with some financial adjustments,”

Dillard said when comparing the EMS budget situation with the CareFlite

proposal. “We are looking at an adjustment of our rate schedule, which I will

give to commissioners for their approval.”

Dillard said that while the controversy hasn’t been pleasant, it showed a strong

community support for EMS and it provides a mechanism for improvements.

Rankin agreed.

“I’m willing to work with to stop the escalating price of EMS,” Rankin

said. “There are some things we can do without compromising our patient care.

That should always be the bottom line.”

Precinct 2 Commissioner Burns, who has been skeptical of the privatization

from the beginning, said the proposal by CareFlite left no doubt that keeping

the current EMS was best for the county.

Precinct 4 Commissioner Terry Ross agreed and said he could not vote to make a

change at this time. Ross said Rankin and had each gotten copies of

the CareFlite proposal on Saturday.

CareFlite’s proposal attracted more than two dozen people to the courthouse.

Jim Swartz, the president and CEO of CareFlite, told commissioners at Monday’s

meeting that “our only mission is superior patient care.”

“You should only be looking at how CareFlite can improve patient care. In terms

of cost, working together we can build a better system,” he said.

, the vice president and chief financial officer, told the

county leaders that the locally operated EMS “does not appear to be financially

accountable.”

Mark Kessler, the clinical director for CareFlite’s ground services, said that

the EMS does not currently prioritize calls or provide medical triage for

patients.

CareFlite proposed standards for response times and performance, but gave no

change in the number of ambulances or staffing if selected to take over the

ambulance service.

Kessler said that calls would be triaged by severity and crews would receive

pre-arrival instructions by trained emergency medical dispatchers based in Grand

Prairie. Response time would be based on priority in two zones, including a

rural remote zone outside of a 12-mile diameter from the center of the cities of

Decatur, Bridgeport and Boyd. Inside the zone closest to the cities, a

life-threatening emergency call would have a response time of 16 minutes, 59

seconds on 90 percent or more of the calls. In the rural remote zone, that time

would be 23 minutes, 59 seconds.

According to CareFlite, the county EMS currently has response times of 20

minutes or less on 82.6 percent of its calls. Wise County EMS made 2,615

transports during the current year with transports averaging 14 miles, CareFlite

said. Gross charge per transport for Wise County EMS was $820, while CareFlite

projected its charge as $817.

The CareFlite team also emphasized that they would not make any cuts in pay.

County Judge Dick Chase said after the meeting that he would schedule

presentations by Guardian and AMR, two for-profit national companies, on Oct. 10

and Oct. 17. Then, he would have Dillard make a similar presentation for Wise

County on Oct. 24. An evening public hearing for proponents and opponents of

privatizing EMS would also be scheduled during that time.

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