There's More to the Story

by John Linn and Bob Dew

In a couple of days there will be a special meeting of the Sublette County Rural Health Care Board (Board). The Pinedale EMS is pressing to have three full time employees (TFTE) hired to take them and you out of the current crisis. At this point the core group of the Pinedale EMS is portraying the Board of a lack of common sense or lack of compassion to their plight. The Board has reviewed their proposal and from our point of view has given it a fair and honest evaluation. Now two new board members have been installed and the Pinedale EMS sees fit to bring the TFTE proposal back with even greater urgency. The new members and to a certain extent the current members of the Board are grappling with many questions about the existing needs and future ramifications of their decisions. Needs, not only of the Pinedale EMS, but also of the Big Piney service and clinic obligations. The Board turned down the TFTE proposal partly because it only offered the higher compensation to three members, which was not fair to everyone. The Board also questioned whether the problems would really be solved or if TFTE didn't work, could the Board ever rescind it.

Recently the Board enacted increased compensation and other incentives including retirement benefits designed to treat both services and individual members equally. It was the best way to reward the EMTs countywide. The EMTs that sign up for call and take the runs are the ones who make the money. Under the current system, any EMT who signs up for call and makes the runs expected during their coverage time would receive roughly three-fourths of the money that the TFTE proposal would pay a full time employee. Sublette County is paying the EMTs one dollar per hour of call time, 24 cents per mile to and from the run, a twenty dollar per run fee and any meal expenses which may be incurred during the run. The supervisor of each service is paid $300.00 per month and a janitorial fee is paid to whoever cleans the ambulance.

Other remedies are in the works to lessen the load on the Pinedale EMS. Some calls in the past were sent out by dispatch to the Pinedale EMS when the Big Piney EMS was either equal distance or closer to the call area. Using the Sheriff's Department or possibly firemen on an emergency basis as drivers for the ambulances could also lessen the load on the EMTs. Every Board member has thought long and hard about how to recruit more members and not lose the members we have. We are in desperate need of updating equipment and look at the new ambulance purchases as incentives for the EMTs concerning their safety and their pride in the service. The Board tries to keep similar support for both clinics and both EMS services. The TFTE proposal would mean that Sublette County would be paying nearly $100,000.00 more to satisfy the EMTs on the north end. Costs to run the Pinedale EMS have exceeded revenue from billing for a long time. The Big Piney EMS has only in the last few years been breaking even. The Pinedale EMS has out spent the Big Piney EMS substantially in the last ten years. Different philosophies and training preferences plus fixed costs make up the difference between services.

Now coming to the point of this writing, please attend this special meeting and give all the options discussed at the meeting an honest look, then stand up and express your opinion. There is a lot more to the story than the Pinedale EMS is portraying. The Board members have had many options suggested to them by the public besides the ones offered by the Pinedale EMS, or already implemented by the Board. Others to consider are, a contract for services, increasing pay again, change the leadership of the EMS, and creating or changing responsibility or coverage area. Some of these options like the contract for service, the TFTE proposal and significantly increased payroll costs are options that have to include revenue-enhancing discussion that might ultimately affect the amount paid to the Doctors. Rates for ambulance calls most likely will be increased if those options are chosen.

Whatever happens at this next meeting, you can feel assured that the Board members will look at all the options and will apply common sense and make an educated decision about this issue.

Mssrs. Linn and Dew are past Rural Health Care District Board members.