From the pages of
The Sublette County Journal
Volume 4, Number 46 - 7/14/00
brought to you online by Pinedale Online

EMTs Get Call Pay, Retirement Benefits
Health Care Board moves to stop attrition of overworked volunteers
by Rob Shaul

It wasn't what they wanted, but Sublette County's Emergency Medical Technicians (EMTs) weren't complaining Monday when the Rural Health Care District Board voted to pay the volunteers $1/hour for on-call pay, and begin an EMT retirement program.

The Pinedale EMTs have told the Board since last winter that the volunteers were being overworked and spread too thin. Pinedale Ambulance Service Director Gary Wilson asked the Board to consider hiring two full time EMTs to supplement and relieve the volunteers currently operating the ambulances.

However, the Board has been hesitant to take this step primarily because of financial concerns. Monday, it sought a compromise designed to retain the current volunteers. Dave Racich of Pinedale presented a spread sheet of figures showing the costs for paying the EMTs a $1/hour on call fee, increasing their mileage rate from 24 to 31, and adding EMT retirement benefits. Mr. Racich estimated that implementing all three increases would cost the District approximately $118,000 per year.

Mr. Wilson again reiterated that the primary need was for more EMTs, not better paid ones. At one point during the discussion, privatizing the service was discussed. Under this scenario, the District would contract with the respective EMT services to provide emergency transport within the county. The arrangement would be similar to that which the District currently has with the doctors at the two clinics.

The EMT services would be paid a certain set amount a month to provide the service, and would get to set and keep any transportation fees from the patients.

Mr. Wilson told the board his service had considered this type of arrangement, but had rejected it because the EMTs didn't want to be held responsible for rate increases.

The board moved on to better compensating the volunteers already on the services. Mr. Wilson said he wouldn't object to any of the pay increases being suggested. However, his favorite was the retirment benefits. He said studies have shown services which offer retirement to their volunteers have 20% - 30% better retention rate than services which don't.

After some discussion of the numbers, board member and acting Chairman John Linn of Big Piney told fellow board members Jim Greenwood and Dave Racich, "I want something to happen tonight." Mr. Linn then made a motion to pay EMTs $1/hour for taking call, and increasing their mileage rate from 24/mile to 31/mile.

Mr. Linn later modified his motion to offering the call pay and retirement benefits. His motion passed 3-0. Together, the measures are estimated to cost the District $70,000 annually.

EMT Abuse

The Board also took up the issue of doctors and PAs at the Pinedale Clinic taking advantage of the EMTs by making them work in the emergency room after they've delivered a patient during off duty hours.

The Pinedale EMTs say that at the Pinedale Clinic, only the doctors and PAs are on call during off-duty hours and no nurses or other staff show up to handle emergency room duties. When the EMT volunteers bring in a patient during off duty hours, they are often called upon by the doctors to assist. The problem is, they are volunteers and aren't compensated for their time or help, though the doctors charge the patients for the emergency room service. The EMTs openly resent this, but say they can't very well leave a single doctor to handle the emergency care for a patient in need.

Monday, the Rural Health Care Board took up this issue and made policy to address it. "I think we should come up with a policy that makes it damn plain that you guys are delivering the patient to the professionals, and once you've done that, you're free to go," said Mr. Linn.

Dr. Burnett told the Board that at the Marlbeton Clinic, "EMTs are not looked upon as clinic help." He said that in addition to having a doctor on call, the Marbleton Clinic also has a nurse on call, and if there's an emergency, both arrive at the clinic to handle the patient, freeing up the EMT volunteers.

Pinedale Physician's Assistant Kris Roork admitted that sometimes the Pinedale doctors and PAs "take the EMTs for granted."

After the discussion, Mr. Linn made a motion which stated that once the EMTs delivered the patients to the clinic, their care became the responsibility of the clinic. Further, his motion stated that the doctors at the clinics are required to have "adequate staff on hand" to handle the emergency so the EMTs aren't called upon, and that the EMTs should be released by the doctor unless further transportation of the patient is "imminent." The motion passed 3-0.

Other Items

John Linn told the other board members he felt strongly that two new ambulances were needed, one at each end of the county. The rest of the board agreed, and directed Mr. Wilson to begin writing the grants to the Farm Loan Board for the vehicles. The new ambulances are expected to cost $100,000 apiece, half of which will be funded by the grant.

Kris Roork informed the Board that the x-ray machine at the Pinedale Clinic has been inoperable for 10 days, and the clinic has been using the machine at the Pinedale Chiropractic Center. She said the problem seems to be related to the machine's motherboard, and that the manufacturer's representatives were working on it.

The Board is actively searching for another doctor for the Pinedale Clinic. Dr. Johnston is cutting down his work hours, and is just working office ours. Nurse Practitioner Leslie Rozier of Pinedale has been hired to take Dr. Johnston's call. The new doctor will come in and begin to assume Dr. Johnston's duties as the older doctor gets closer to retirement. The Board wouldn't give any details as to its recruitment efforts.

Dr. Judy Boyle of the Marbleton Clinic told the Board she was having trouble getting school loan reimbursement from the National Health Service, and requested the Board write a letter on her behalf. She told the board she took a $30,000/year pay cut and retirment benefits to work in the Marbleton Clinic, and even though Sublette County was an under-served area, she was having trouble getting assistance with her school loan debt. John Linn agreed to write the letter from the board.

The final fiscal year 2000-2001 budget hearing for the Board will be held on the evening of Thursday, July 20th in the Sublette County Courthouse.

Finally, Walt Bouseman and Garry Eiden Sr. filed for the two open seats on the board and barring a successful write-in campaign, will be elected to the Board at the August 22 election. They will take their seats on the Board October 1. Current board members Bob Dew and John Linn decided not to seek for re-election.

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