From the pages of
The Sublette County Journal
Volume 4, Number 34 - 4/20/00
brought to you online by Pinedale Online

EMT Coverage Issues Emerge at Board Meeting
Ambulance response time could be delayed
by Tony Tully

A proposal for full time, paid emergency medical technicians (EMTs), expansion of the Pinedale clinic, and new contracts for the physicians operating the Pinedale Clinic were the major issues before the Rural Health Care Board on Monday night. The lengthy meeting brought major gaps in accountability and EMT coverage to light.

Gary Wilson, lead EMT for the Pinedale EMTs, brought a preliminary budget proposal to the board that included three paid full-time EMTs. He reported that over the past year there have been "major gaps" in the EMT schedule, due to low recruitment of new EMTs and the loss of long term volunteers, resulting in periods when no one was accountable for responding to emergency calls. Mr. Wilson reported that to date no emergency calls have gone unanswered, but when no one is scheduled to be on standby, available volunteers must be located and response time is increased. He is also concerned that without staff EMTs, service cannot be guaranteed during the summer months when the increase in tourism coincides with the drilling season.

The proposal is for a salary of $1200 per month for the first year, increasing to $1600 and $2000 per month during the second and third years respectively. Mr. Wilson concluded that the current "core" members of the group are getting burned out balancing jobs, family life and the heavy time demands of being an EMT, noting that an ambulance run to Jackson averages five hours. He maintains that having a paid staff, supported by volunteers, is the best solution to what could become a serious situation. The board took no action on the EMT proposal, but all members expressed concern about increased cost and the need to either raise fees or taxes to increase available funding. Under the current schedule, ambulance fees are expected to generate $80,000 in the coming budget year. Board members Greg Anderson and John Linn agreed to meet with Mr. Wilson and the other EMTs on Wednesday evening to discuss the matter further.

Drs.' Contracts

Earlier in the evening discussion on contracts to operate the Pinedale Clinic evolved into a lively debate on billing for after hour and emergency calls, and how they are accounted for. Board members John Linn and Jim Greenwood took the lead in trying to discover how much revenue these calls generated. Doctor Ron Glas, Manager of the Pinedale Clinic, countered that the current accounting system only set up to report billings, not collections, doesn't allow for tracking by time of service, and that it wouldn't be useful information anyway. Dr. Tom Johnston noted that over the years after hours calls were only six percent of visits to the clinic, and that this rate has been remarkably constant. John Linn moved to amend the contracts to increase accountability for after hours and emergency calls. The motion was seconded by Jim Greenwood, but failed on a 2-3 vote. Mr. Linn then moved to renew the clinic contracts for another year. Mr. Anderson seconded the motion and it passed unanimously.

Pinedale Clinic Expansion

Dr. Glas then presented a proposal to expand the Pinedale Clinic by 1144 square feet at a projected cost of $170,394. The expansion would increase the number of examination rooms from seven to ten, and would include enough office space to allow for a third doctor, and to keep all medical records easily accessible. The board discussed various funding scenarios including grants or loans from the Farm Home Loan Board and soliciting funding from the County Commissioners. They agreed that as the expansion would be county property, county funding should be solicited. Board member Jim Greenwood was concerned that the proposal as presented was not optimal and didn't lend itself to future expansion. Board member John Linn moved to contract a traffic study not in excess of $500, which will produce preliminary sketches to be integrated with the current proposal to produce a final plan. The board unanimously approved the traffic study.

Other actions taken by the board included agreeing to solicit bids for siding repair and painting on the west side of the Pinedale clinic, agreeing to solicit bids to paint the Big Piney Clinic, and agreeing to contract with local vendors to patch the parking lot at the Pinedale clinic and build dumpster enclosures at the Pinedale clinic and ambulance barn.

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