Guest guest Posted July 4, 2007 Report Share Posted July 4, 2007 Sorry I'm late getting into this, but things have been a bit hectic in my world. I've seen the question asked if there was really a problem and I can tell you that it IS a very real problem in this area. When the volunteer organizations started (way back when) and they were only making one call a day, employers were happy to support the EMS. It was good PR and all that. There were plenty of volunteers and the world was nice and bright. As the population increased and the area grew, so did the call volume. Now we all know that by the time you make a call and get all the necessaries done(patient care, paperwork, restock, and back to work) it takes about an hour. One time a day wasn't bad, but when it got to be 3 or 4 or sometimes more, a lot of people were given a choice by their employers, the ambulance or their jobs. Not much of a choice and you can guess what they chose. End result, fewer and fewer volunteers and those that were left spending more time on call. Many volunteer organizations are now being forced to seek a variance or shut down completely and turning over their coverage area to a paid service which stretches them very thin. Many others are on the verge of having to do the same. Now, I guess somebody thought the law would be a good idea to keep the volunteers going, but the way it was written wouldn't have done a bit of good. The small towns that have depended on volunteers have dang few,if any, companies with 50 or more employees. It wouldn't have applied so it wouldn't have given us any relief. I hate to say this, but I'm afraid that the hand writing is on the wall for volunteer EMS. From the been there done that(and right now the being there doing that} perspective, I just don't see it getting any better. We just aren't able to attract or keep volunteers like we used to. Trying to convince the local politicos of that is a whole nother can of worms too. Currently, the volunteer organization I'm with is trying to cover 2600 sq miles with 8 people 24/7. You can guess how that is working out. We're butting heads with the city, county, and hospital district over going to a paid service to get people in, but getting past all the small town politics and getting them together is an experience in itself. They know they have to do something, but getting them to do it has proved danged difficult to say the least. In the mean time, it's killing US to provide coverage and keep patient care where it should be. I don't have all the answers, but, even if there were such a law, I don't see it helping much. It might delay the inevitable some, but wouldn't stop it. As much as we hate to see it happen. I'm afraid the days of the volunteer EMS are over. It's just one more of those things that had it's time and was fun while it lasted, but now has to pass on. Seems I got long winded again (as usual). Just some thoughts I wanted to share with everyone. JoeT Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 4, 2007 Report Share Posted July 4, 2007 You are exactly right, Joe. The issues and trying to get the local politicians to actually bite on the issues and help is almost impossible in many of the rural areas. Our politicians have looked me in the face at two different budget meetings and said, " We know, we have discussed it, but we just don't want to go there right now. " It is very sad.... but I think you are probably right. Jane Hill -------------- Original message from " Joe " : -------------- Sorry I'm late getting into this, but things have been a bit hectic in my world. I've seen the question asked if there was really a problem and I can tell you that it IS a very real problem in this area. When the volunteer organizations started (way back when) and they were only making one call a day, employers were happy to support the EMS. It was good PR and all that. There were plenty of volunteers and the world was nice and bright. As the population increased and the area grew, so did the call volume. Now we all know that by the time you make a call and get all the necessaries done(patient care, paperwork, restock, and back to work) it takes about an hour. One time a day wasn't bad, but when it got to be 3 or 4 or sometimes more, a lot of people were given a choice by their employers, the ambulance or their jobs. Not much of a choice and you can guess what they chose. End result, fewer and fewer volunteers and those that were left spending more time on call. Many volunteer organizations are now being forced to seek a variance or shut down completely and turning over their coverage area to a paid service which stretches them very thin. Many others are on the verge of having to do the same. Now, I guess somebody thought the law would be a good idea to keep the volunteers going, but the way it was written wouldn't have done a bit of good. The small towns that have depended on volunteers have dang few,if any, companies with 50 or more employees. It wouldn't have applied so it wouldn't have given us any relief. I hate to say this, but I'm afraid that the hand writing is on the wall for volunteer EMS. From the been there done that(and right now the being there doing that} perspective, I just don't see it getting any better. We just aren't able to attract or keep volunteers like we used to. Trying to convince the local politicos of that is a whole nother can of worms too. Currently, the volunteer organization I'm with is trying to cover 2600 sq miles with 8 people 24/7. You can guess how that is working out. We're butting heads with the city, county, and hospital district over going to a paid service to get people in, but getting past all the small town politics and getting them together is an experience in itself. They know they have to do something, but getting them to do it has proved danged difficult to say the least. In the mean time, it's killing US to provide coverage and keep patient care where it should be. I don't have all the answers, but, even if there were such a law, I don't see it helping much. It might delay the inevitable some, but wouldn't stop it. As much as we hate to see it happen. I'm afraid the days of the volunteer EMS are over. It's just one more of those things that had it's time and was fun while it lasted, but now has to pass on. Seems I got long winded again (as usual). Just some thoughts I wanted to share with everyone. JoeT Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 4, 2007 Report Share Posted July 4, 2007 Joe, Thanks for the viewpoint...if I could ask, what part of the state (don't need a county name but a RAC or " general " area would be cool).? You said some very interesting things. 3, 4 or more calls a day.? Any guess as to how many of these get transported and what the average cost of the bill is for these transports? Lastly, do you have a hospital in your jurisdiction (1 hour per call makes me think you do) and are there any private transfer services in operation? Thanks for the additional information. Dudley Volunteer Law : Should We or Shouldn't We? Sorry I'm late getting into this, but things have been a bit hectic in my world. I've seen the question asked if there was really a problem and I can tell you that it IS a very real problem in this area. When the volunteer organizations started (way back when) and they were only making one call a day, employers were happy to support the EMS. It was good PR and all that. There were plenty of volunteers and the world was nice and bright. As the population increased and the area grew, so did the call volume. Now we all know that by the time you make a call and get all the necessaries done(patient care, paperwork, restock, and back to work) it takes about an hour. One time a day wasn't bad, but when it got to be 3 or 4 or sometimes more, a lot of people were given a choice by their employers, the ambulance or their jobs. Not much of a choice and you can guess what they chose. End result, fewer and fewer volunteers and those that were left spending more time on call. Many volunteer organizations are now being forced to seek a variance or shut down completely and turning over their coverage area to a paid service which stretches them very thin. Many others are on the verge of having to do the same. Now, I guess somebody thought the law would be a good idea to keep the volunteers going, but the way it was written wouldn't have done a bit of good. The small towns that have depended on volunteers have dang few,if any, companies with 50 or more employees. It wouldn't have applied so it wouldn't have given us any relief. I hate to say this, but I'm afraid that the hand writing is on the wall for volunteer EMS. From the been there done that(and right now the being there doing that} perspective, I just don't see it getting any better. We just aren't able to attract or keep volunteers like we used to. Trying to convince the local politicos of that is a whole nother can of worms too. Currently, the volunteer organization I'm with is trying to cover 2600 sq miles with 8 people 24/7. You can guess how that is working out. We're butting heads with the city, county, and hospital district over going to a paid service to get people in, but getting past all the small town politics and getting them together is an experience in itself. They know they have to do something, but getting them to do it has proved danged difficult to say the least. In the mean time, it's killing US to provide coverage and keep patient care where it should be. I don't have all the answers, but, even if there were such a law, I don't see it helping much. It might delay the inevitable some, but wouldn't stop it. As much as we hate to see it happen. I'm afraid the days of the volunteer EMS are over. It's just one more of those things that had it's time and was fun while it lasted, but now has to pass on. Seems I got long winded again (as usual). Just some thoughts I wanted to share with everyone. JoeT ________________________________________________________________________ AOL now offers free email to everyone. Find out more about what's free from AOL at AOL.com. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 5, 2007 Report Share Posted July 5, 2007 Dudley, To answer your questions, I'm in Pecos in Reeves County. I would guess that our transports run about like everybody elses, probably around 90% get transported. We've got a fairly large group that don't have a regular Doctor and wait till things get bad before seeking help and of course the ones that think an ambulance is a big taxi with pretty lights, so we do a fair amount of transports. Our call volume is about 100 to 110 911 calls a month, average around 3 to 4 a day. We do have a Level IV here that does a pretty good job of taking care of the people and they have their own transfer ambulance (yeah, that's what pays my bills LOL). The closest private services we have are about 80 miles away. We get a lot of help from Carestar and Southwest for the air stuff too. Those guys are great about coming whenever we need them and they can fly. When I said an hour a call, that was for the in towns. With the area we cover, we do get some hellasious transport times. Some of our calls are 40 to 50 miles out. Serious stuff that far out, we holler for Carestar and they do quite a few scene calls for us. I'm not sure off hand what the bill is for transports, but since we went with Intermedix, I know our collections are way up. Not a plug for them, just that they're a lot better at collections than the folks we used to use LOL. We've gone to the City, County, and Hospital Distrct with figures to show that with a minimal kick in and our collection rate, we can be just about self sufficient. We just can't get em to agree on how to go about it. They know they have to do something, but the foot dragging has bogged everything down. If the people we have weren't so dedicated, we'd turn in our pagers and tell the politicians to handle it. Of course, you all know that aint gonna happen, but it's a nice thought LOL. From the feedback I've gotten, I can see that there's a lot of us in the same boat and it's full of holes and sinking fast. If Austin will get off their duffs and make EMS an essential service, maybe that will help get the local governments attention and get us all some relief. Naturally, they'll study it to death before they do anything. Dang it, I'm so tired I'm starting to look fondly at socialized medicine and that's bad LOL. Ok, I'm gettin off the soapbox and giving somebody else a chance. Thanks for listening. Joe -- In texasems-l , THEDUDMAN@... wrote: > > Joe, > > Thanks for the viewpoint...if I could ask, what part of the state (don't need a county name but a RAC or " general " area would be cool).? You said some very interesting things. 3, 4 or more calls a day.? Any guess as to how many of these get transported and what the average cost of the bill is for these transports? > > Lastly, do you have a hospital in your jurisdiction (1 hour per call makes me think you do) and are there any private transfer services in operation? > > Thanks for the additional information. > > Dudley Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 5, 2007 Report Share Posted July 5, 2007 I just want to jump in here. First I respect volunteers, I was one when I started in EMS. I do not want to offend anyone because several on here that volunteer are my amigos, some are my past instructors. So I do ask please do not take offense. I feel the time of volunteer EMS is a thing of the past. Can a small community support a full time career EMS? Honestly regardless of what the people in charge say, the answer is yes in my opinion. Think about it this way, which communitys have some of the best 4th of July bashes, Christmas, New Years, Easter, Thanksgiving, etc? The small towns. They find money for this. If it is the community that raises funds for this then the community should be able to raise funds to pay to have EMS. They find money for what they feel is important. Why pay for something they can get for free? Maybe it is time to tell them that as of this day(90 days notice should suffice) it's paid or I'm sorry you will have to tell the people that voted you into office why there is no ambulance coming when they dial 911. I am dedicated to but I gotta feed my family. Get your side in the paper, explain that it costs everyoe, the volunteer losing work, the companys losing productivity, etc. I know here in Presidio County (large land wise) , as far as population a small county, we have 2 paid services, not well paid but paid. Presidio (city) has almost everyone living at or below poverty but money is found to pay us. Now because there are volunteers in nearby areas, at time the discussion starts why can't we have a volunteer department? The volunteers make it harder to request a decent income. Thankfully some areas are increasing pay (ie Fort Stockton is going to $14 basics, $16 intermediates, and $18 paramedics if I understood correctly) still not on par with other healthcare professions but a start. And once all services at least start paying a per run system if not full time all of us will be able to start getting better pay as healthcare professionals. No other healthcare group is expected to give all services for free, why should we. Volunteer to staff a first aid booth at some charity event but for the most part demand payment for services rendered. Again no offense intended. I enjoy EMS and intend to stay in it. I knew income was not good when started and I am not looking to get rich in EMS. I am hoping to see things improve and this is just my opinion of one of the steps needed for said improvement. Now again this is my opinion. Please don't condemn my instructors, my amigos, my workmates, for my opinion. Have a great day. Renny Spencer NREMT-I (and trouble maker ) > > > > Joe, > > > > Thanks for the viewpoint...if I could ask, what part of the state > (don't need a county name but a RAC or " general " area would be > cool).? You said some very interesting things. 3, 4 or more calls a > day.? Any guess as to how many of these get transported and what the > average cost of the bill is for these transports? > > > > Lastly, do you have a hospital in your jurisdiction (1 hour per > call makes me think you do) and are there any private transfer > services in operation? > > > > Thanks for the additional information. > > > > Dudley > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 5, 2007 Report Share Posted July 5, 2007 Hey, Renny. Being one of your instructors, I am honored. You do give great thought to your postings and definitely have a future in EMS in Texas. That having been said, let me interject here that in OUR situation in County, we have done most of what you suggested at one time or another. We have tried the media. We have tried the events issues. We have gone and pitched our situation to the Lions Club, etc. We even now contract with the county to provide service for major events on county grounds just to get money flowing into the service with volunteers volunteering to staff those events to help the service. It appears that no matter what is done, folks still think EMS should be for free. What seems to work in one area, doesn't necessarily seem to work in another. And sometimes NOTHING works until the service is gone and then everyone asks suddenly, " Why don't have EMS coverage??? " And unfortunately, once it's gone, it is difficult to get it back. I also was amused by the $ figures you quoted for your area of very rural Texas for each level. Do you realize there is almost NO service in our area of the state that pays that much an hour for those levels??? And we have Abilene, a city of >112,000 at its heart. So again, it is a difficult situation with difficult answers no matter what happens. You made the comment that even small communities CAN come up with the money. That is probably true. The issue is CONVINCING those people in those small communities that they must do it or the service doesn't survive. We tried that too. However, we haven't tried giving notice and unfortunately, that may actually come to pass because the future is unknown for many services like ours. We will continue to try and serve and to try and educate the public to the need as long as we can. But who knows how much longer that can be done? And the other part of the issue is that if you finally announce you are closing the doors, then the politicians who don't want to pay give the service area over to a contracted centralized ambulance service who will just tack on the service area but respond from their " city " location (thereby greatly extending response times to the folks in the service area in need) because this is cheaper and the community doesn't know any better until AFTER the fact - when it is usually too late to fix it. Apathy extends way beyond our own EMS community. I am not saying there is no solution. Many of your points hold validity, especially the part about volunteerism being just about dead because everyone nowadays has to make a living and feed their families and that EMS should not be any more free to the citizen than supporting their local hospital district or fire district. But I am still not sure of what the answers are for our own community. We continue to struggle and fight the good fight. Good conversation, guys!!!! Jane -------------- Original message from " spenair " : -------------- I just want to jump in here. First I respect volunteers, I was one when I started in EMS. I do not want to offend anyone because several on here that volunteer are my amigos, some are my past instructors. So I do ask please do not take offense. I feel the time of volunteer EMS is a thing of the past. Can a small community support a full time career EMS? Honestly regardless of what the people in charge say, the answer is yes in my opinion. Think about it this way, which communitys have some of the best 4th of July bashes, Christmas, New Years, Easter, Thanksgiving, etc? The small towns. They find money for this. If it is the community that raises funds for this then the community should be able to raise funds to pay to have EMS. They find money for what they feel is important. Why pay for something they can get for free? Maybe it is time to tell them that as of this day(90 days notice should suffice) it's paid or I'm sorry you will have to tell the people that voted you into office why there is no ambulance coming when they dial 911. I am dedicated to but I gotta feed my family. Get your side in the paper, explain that it costs everyoe, the volunteer losing work, the companys losing productivity, etc. I know here in Presidio County (large land wise) , as far as population a small county, we have 2 paid services, not well paid but paid. Presidio (city) has almost everyone living at or below poverty but money is found to pay us. Now because there are volunteers in nearby areas, at time the discussion starts why can't we have a volunteer department? The volunteers make it harder to request a decent income. Thankfully some areas are increasing pay (ie Fort Stockton is going to $14 basics, $16 intermediates, and $18 paramedics if I understood correctly) still not on par with other healthcare professions but a start. And once all services at least start paying a per run system if not full time all of us will be able to start getting better pay as healthcare professionals. No other healthcare group is expected to give all services for free, why should we. Volunteer to staff a first aid booth at some charity event but for the most part demand payment for services rendered. Again no offense intended. I enjoy EMS and intend to stay in it. I knew income was not good when started and I am not looking to get rich in EMS. I am hoping to see things improve and this is just my opinion of one of the steps needed for said improvement. Now again this is my opinion. Please don't condemn my instructors, my amigos, my workmates, for my opinion. Have a great day. Renny Spencer NREMT-I (and trouble maker ) > > > > Joe, > > > > Thanks for the viewpoint...if I could ask, what part of the state > (don't need a county name but a RAC or " general " area would be > cool).? You said some very interesting things. 3, 4 or more calls a > day.? Any guess as to how many of these get transported and what the > average cost of the bill is for these transports? > > > > Lastly, do you have a hospital in your jurisdiction (1 hour per > call makes me think you do) and are there any private transfer > services in operation? > > > > Thanks for the additional information. > > > > Dudley > Quote Link to comment Share on other sites More sharing options...
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