Ambulance district debate Proponents speak for, against ESFD receiving contract for Western District service

Wednesday, March 15, 2017

On Tuesday, Feb. 21, Carroll County residents gathered at the regular meeting of the Western Carroll County Ambulance District Commission. The commission had agreed in late 2016 to put out bids for ambulance service rather than renewing its contract with Eureka Springs Fire & EMS, and many were unhappy with the decision.

“I don’t want anybody else responding. I put full confidence in the guys at Eureka Springs Fire Department,” Jed Bullock said, who volunteers with the ESFD. “They’ve got outstanding facilities and training. They know their stuff.”

“The community has been well-served by the exceptional medical performance by our ambulance crews,” ESFD’s Mike Fitzpatrick said. “There’s never been an occasion when the ambulance services failed to respond to an emergency call, and yet there is dissatisfaction among the commissioners. I can think of no reason the commissioners would want to find an alternative to this exceptionally fine service.”

According to commission chairman Sam Ward, there are a few reasons for this. Ward spoke to the Citizen on March 1, saying he wants those who live in western Carroll County to be well-informed on everything that went into the commission’s decision to put the service out for bid.

Response time

Ward pointed to the performance specifications in the document the commission released requesting bids. The document says the commission requires an emergency vehicle to be on the way to an emergency call within two minutes of being called by a dispatcher, with the vehicle arriving on the scene around 15 minutes after the initial call. Ward said it’s vital that ambulances respond within 15 minutes of receiving a call.

“It’s a standard. It’s not something somebody just picked,” Ward said.

Austin Kennedy, who lives at Inspiration Point and has 20 years of experience as an emergency responder, agreed that 15 minutes is an industry standard. When he worked in Houston, Kennedy said, response times were usually under 10 minutes.

“Every single minute is sacred. As a taxpayer, I want an ambulance service that will be able to get to me or my family or my friends within a very reasonable amount of time,” Kennedy said.

Eureka Springs fire chief Nick Samac said he’s happy with the department’s response time. The response time is almost always around 15 minutes, Samac said.

“In rural America, 15 minutes is actually a good response time,” he said.

Samac recalled working in Cleveland, Ohio, where he said his department received so many calls it was sometimes difficult to respond within 30 minutes.

“By the time you dropped one patient off at the hospital, you might have had two ambulance calls waiting for you,” Samac said. “Sometimes it took a half-hour in the inner city to get an ambulance. Fifteen minutes is not an unrealistic timeline.”

Holiday Island fire chief Bob Clave said he has no problems with the response time, either.

“I don’t think I’ve ever had a 20-minute or longer response time … some of our farther-out areas in inclement weather, maybe,” Clave said. “I don’t think there is an issue with it. They get here as quickly as they can.”

One of the problems related to response time, Clave said, is the way this information is reported. Clave said the dispatch team doesn’t have a good system to report the response time accurately.

“It’s a reporting problem, not a problem with the actual performance,” Clave said.

This is true, Samac said, but the department has been improving it. He explained that there is usually a three-minute difference between what gets reported by dispatch and the actual response time.

“Dispatch knows of this timeline issue, and they’re working through that,” he said.

He added that the department uses several factors to determine response time, including times generated by equipment such as the cardiac monitor.

“If we went by exactly the time dispatch showed, we might not have arrived yet when we already have the patient on the monitor,” Samac said.

Two ambulances

Something that could affect response times, Ward said, is the number of ambulances dedicated full time to the Western District. Ward again referred to the document, which says a fully-trained four-person crew should be available at all times. He said this isn’t always possible, because the department serves those in the Western District with the same ambulances and personnel serving Eureka Springs residents.

Former Eureka Springs fire chief Randy Ates said this has been a problem for years.

“The contract specifies that two ambulances must be for use by the Western District. However, the way the fire department is set up, they have four people on staff each day, two on each ambulance,” Ates said. “Those personnel are also firefighters for the city. They are also firefighters for the Western District. They are also providing EMS services for the city. They are also providing EMS services for the Western District.”

Ward said the commission put out bids to clarify some parts of the contract, including the part regarding how many ambulances and personnel must be available for the Western District at all times. During his time as fire chief, Ates said, he had several problems responding to calls in the Western District. Ates said the reason for this is the lack of personnel to staff an ambulance.

“I believe in one year there were 98 instances of not having enough ambulances,” Ates said, saying he “frequently” felt the situation was unsafe. “The call volume between the city and the rural needs more than just two ambulances, especially if they’re going to be doing double duty.”

Eureka Springs Mayor Butch Berry said he wasn’t aware Ates felt this way.

“He never brought that up to me,” Berry said. “I don’t remember that happening.”

Samac said he can’t think of any time the department has ever failed to respond to a call.

“There’s not been a time that we’ve not had an ambulance available to respond to an emergency call in this half of the county,” Samac said.

Ates said the problem is staffing, not emergency vehicles.

“Used to, this wasn’t such a big problem because if there was a fire, you could call an off-duty person to man the ambulance,” Ates said. “As times have changed, it’s next to impossible to call someone in.”

Samac disagreed, saying the department calls in part-time emergency responders when others have to respond to a call.

“Whenever both of our ambulances go out, or one goes out and we know they’re going to have a lengthy transport time, we’re going to go ahead and call in that third personnel,” Samac said.

Community support

Ward remembered the commission’s Feb. 21 meeting, where many citizens spoke in favor of the Eureka Springs Fire Department. Ward said he believes it’s popular to support the department.

“I think probably everybody wants Eureka Springs. I don’t know anybody that doesn’t want Eureka Springs,” Ward said. “Being humans, we don’t like change. We resist change. That’s where a lot of people are coming from.”

Ward said he’s heard some people saying Eureka Springs has better-trained personnel than other departments that might submit a bid for the service.

“The people are insinuating that the other ambulance services are not trained. Where do they get this information?” Ward said. “How would you know whether Mercy is incompetent or Ozark is incompetent?”

Samac said the department has one of the most respected fire and EMS programs in the state.

“We usually send out two paramedics at a time in an ambulance, when most services send out one paramedic and one EMT,” Samac said. “You have two sets of eyes looking at that patient … two highly educated professionals helping your loved ones. It’s a rarity.”

He continued, “The Eureka Springs Fire Department has been respected and looked up to statewide. We have an unparalleled service. These guys are just committed to providing the best quality care that’s available.”

Ates agreed but questioned how effective the department is given its size.

“Unabashedly, I think Eureka Springs is the best. It’s quality in a small package versus quantity in a larger package,” Ates said. “So what’s best for the Western District: small quality, or large quantity?”

Clave said he wants to see the quality of service continue in the Western District.

“I personally would really like to see Eureka keep that contract. They provide such a good service to me and my community,” Clave said. “They work well within my department. I think some of the options that may present themselves might not be as good as the option we have, so I’d like to see it stay.”

Opening the bids

Ward said the commission plans to open the bids at 4 p.m. Thursday, March 23. The commissioners probably won’t make a decision quickly, he said.

“The bids will be opened at the same time, and then probably there will be several meetings after that to decide who’s going to get it,” Ward said.

If the Eureka Springs Fire Department doesn’t receive the contract, Samac said, the department will likely have to cut down on its personnel. He said the department received around $250,000 from the Western District last year, dollars that helped fund additional personnel at the department.

“That’s a challenge. We have a town that has a population a little over 2,000 in the winter,” Samac said. “Any given day in the summertime, we may have 20,000.”

Ward said he’s not for or against any organization. The commission will make its decision, he said, based on how well the organizations submitting bids comply with the performance specifications. He spoke against claims saying he doesn’t want the Eureka Springs Fire Department to receive the contract.

“I don’t want anybody to have the service that doesn’t give us what we ask for in the contract and what we’re paying for,” Ward said. “If Eureka Springs can’t do it, I don’t want Eureka Springs to have the service. But nobody knows what will happen until March 23.”

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  • Eureka has the BEST paramedics, EMTs, and fire fighters. The issue is with the available volunteers who are often needed as the "third out" crew. America has a huge problem getting people to volunteer in the fire and EMS service. Why? There is a LOT of training involved, up front, and on-going. You can get a volunteer to become pretty competent on the fire ground doing in-house training in about 6 months or so. Becoming an EMT is much more time consuming, and honestly, the class is not that easy by any stretch of the imagination. It takes a lot the volunteer's time and energy to get through this class. And going on to be a paramedic as a volunteer? You can forget that. Eureka needs to compensate their volunteers who have become EMTs. You surely cannot expect someone to leave their full time employment (if the employer even allows that) to respond for an hour or more on a "third or forth out" call. I would suggest at least $20 dollars per EMT just to respond for a third out call, plus and additional $15 per hour on duty. You get what you pay for. This is not Randy or Nick's fault. It is the fault of the all of the previous elected officials the citizens of Eureka Springs has elected. Mayor Berry can't undo decades of poor government over night.

    -- Posted by rockpilefarmer on Thu, Mar 16, 2017, at 10:11 AM
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