EMS Supplemental Staffing of St. Mary’s County Rescue Squads Will Cost $110,000 per Month; Board Approves Grant Request of Half Million
BOARD READY TO EMBRACE MEDICAL BILLING TO INSURANCE COMPANIES FOR LONG-TERM FUNDING OF PROVIDING AMBULANCE AND RESCUE SQUAD PAID STAFF
By Kenneth C. Rossignol
THE CHESAPEAKE TODAY
LEONARDTOWN, MD. – St. Mary’s County Emergency Services Director Steve Walker presented a proposal to the St. Mary’s Board of Commissioners to provide for contract EMTs. The request was made due to the crisis of lack of EMT volunteers to answer the call for help when residents of St. Mary’s County call 911 and sometimes wait over an hour for an ambulance to arrive.
Walker reviewed with the Board his discussions with each of the St. Mary’s County rescue company leaders about their needs, the critical drop in the response times to 911 calls, and what the County can do to assist the volunteers. The funding available under the Cares Act supplemental grants to state and local governments can fill the gap, explained Walker.
The dangerous increase in response times is a county-wide problem experienced in many other areas of the state and nation.
Walker explained that the County was responding to each county rescue squad’s written requests for help in staffing. The existing volunteer system depended on EMS personnel from each county rescue squad responding to calls. Since the Covid crisis began, many of the volunteers have been prevented from responding due to restrictions put on them by their full-time employers, fearing Covid being contracted by the volunteers and brought back into the full-time place of employment.
Others who are St. Mary’s County volunteers are in their 60s, 70s, and even 80s and decided to refrain from answering calls to protect their health. As a result, the severely diminished level of response calls for medical emergencies to dangerous and unacceptable levels. Sometimes calls go out to multiple rescue companies before an ambulance can respond.
“I am here to brief you on the availability of volunteer rescue squads and the lack of volunteers. I was amazed to see the number of people in their 50s, 60s, 70s, and even 80s running EMS calls and doing an exceptional job. But, at that age, they are concerned about contracting Covid. They aren’t running as many calls, that’s a fact of life, and we have many volunteers that work for other agencies in DC, and PG and their agencies will not let them run on a volunteer ambulance for fear of contracting it and bringing it back to their department,” said Walker.
Many calls for help are taking up to and over an hour for a response…
“About 1400 of our calls have gone over fifteen minutes and many over 20 minutes, over 30 minutes, and even over an hour, it’s being impacted, Charles County and Calvert are regularly running calls into our county and are not happy about it,” said Walker.
“Each rescue squad has between two and four ambulances; each rescue squad normally has two EMTs on duty twenty-four hours a day, and the main hours they are occurring are the daytime hours,” Walker told the St. Mary’s Commissioners. “All the chiefs told us they want our assistance, and six have sent us letters, and we are waiting on the official approval of Mechanicsville.”
Walker said that “Leonardtown VRS wants two EMT’s twelve hours a day, four days a week; Mechanicsville wants two EMTs, twelve hours a day, five days a week; Lexington Park, two stations, two EMTs, twelve hours a day, five days a week, that’s four for Lexington Park; Ridge Volunteer Rescue Squad, two EMT’s twelve hours a day four days a week; Seventh District, four days a week, Second District, four days a week, all twelve hours a day; and Hollywood, four days a week. So, everyone is asking for assistance.”
“So how is it going to work, how is it physically going to work?” asked Walker. “So, we hire a contractor; we hire a contractor who has qualified personnel. We set up an assessment center, get the applicant in there and go through it all in one day and get them out there. The contract has been reviewed by the county attorney, and he is good with it. That is the staffing plan, and there are some additional things in there we are doing. Mr. Stamey runs more than I ever anticipated, we brought him in to do planning, and we put into work as an active paramedic, and he works as much as twelve hours a day running calls. We will be buying ambulances; we have a number of qualified drivers. I don’t want to alarm anyone, but we are at a critical point in care, and there are very long delays before there is a response, and we have to reach out to nine or ten rescue squads before we get an answer. This is going to cost us about $110,000 a month. EMS billing is an important part of this, we can hire a contractor to come in and do the billing, and they collect the money and pay the County.”
Commissioner Eric Colvin (R. Valley Lee, Ridge) stressed that the problem brought about by the lack of drivers and EMS volunteers due to the Wuhan Virus from China sidelining a large portion of the EMS volunteers from answering calls was the icing on the cake. Colvin pointed out that the volunteer system was already stressed.
“People tell me that citizens don’t recognize what our volunteers do to save the county money, and the work they do is invaluable to the county,” said Colvin. Colvin gave kudos to Walker for his team to bring the proposal together and emphasized that Covid didn’t bring this problem on; it was already there.
Walker said many issues had been sorted out with the leaders of the county rescue squads. One point was the old rivalry in fire and rescue services that exist nearly everywhere between paid career personnel and volunteers.
“We are going to provide the EMTs to the squads, and they will work for that chief and respond to their instructions, not to us,” said Walker. “There is always the concern we are trying to take over, and I think that got sorted out. We are giving that staffing to stations, and that chief has to run that station.”
CHARGING FOR AMBULANCE SERVICE
A bell went off at the Board meeting when Walker brought up his plan for medical services billing. That bell was rung loudly when Commissioner President Randy Guy (R. At Large) explained that he recently reviewed the system in place in The Town of Emerald Isle, North Carolina, where he owns a second home.
The billing of insurance companies for services to residents in Emerald Isle provides hundreds of thousands of dollars each year to provide eight full-time EMS staffers to supplement their volunteer force of thirty-two EMS staff.
“We don’t have to reinvent the wheel,”St. Mary’s Commissioner President Randy Guy
Guy explained the service, the subscriptions, or donations from residents and that a contractor did the billing, and the government never touched the money.
“We don’t have to reinvent the wheel,” scolded Guy, noting to Walker that the system in place in North Carolina works without adding any public employee staff to the town. “It’s already there.”
Walker, who seemed to be anticipating expanding his empire even more at the county Emergency Services with new employees doing billing to insurance companies, quickly retreated to a position of desiring to examine all options and selecting the process that costs the least.
That option is seldom the government.
Commissioner Guy told THE CHESAPEAKE TODAY that the Town of Emerald Isle operates a subscription program for residents who pay an annual fee of $50 for the head of the household and $10 for each additional member of the family with the funds earmarked for the emergency services. Citizens of the Town of Emerald Isle can also donate any amount they wish over the voluntary subscription.
Those who do not subscribe are still provided emergency rescue squad services.
The many Lexington Park area residents who call 911 when they have a headache and get a free ride to St. Mary’s Hospital to avoid taking a number in the ER’s waiting room will still get a free ride. However, if they have Medicare, the County will be reimbursed $100.
With volunteers staffing all seven of the St. Mary’s County rescue squads, the number of false calls for those not sick coming in at various times of the day can be demoralizing to volunteers stuck with such calls in the middle of the night.
Members of the volunteer rescue squads also hold fundraising events at their station houses, dinners, raffles, and go door to door begging donations in addition to the fire and rescue tax that is part of the real estate taxes of each property owner.
Neighbors attempted to block locating a rescue squad
Substation in their neighborhood.
A pervasive attitude of laziness and ingratitude was displayed by some members of the neighborhood adjoining Buck Hewitt Road in the California area when the Lexington Park Volunteer Rescue Squad was in the process of getting zoning approval for a new substation, now designated as Station 38, in that area.
Snitty and whiny residents of that neighborhood appeared at public hearings and complained that they didn’t want a rescue squad station located near their homes and have ambulance sirens waking them at all hours.
Really. There are people like that living in St. Mary’s County.
The substation’s approval was granted; the building was built and hopefully those nitwits who opposed it have moved away so as not to be bothered by sirens on ambulances rushing to save the life of a person in medical distress or a victim of a fire or collision.
The prospect of having funds from the CARES ACT to provide for paid contract EMS personnel to supplement the volunteers, as well as billing insurance companies to provide funding, sparked serious consideration from the Board.
Commissioner John O’Connor (R. Mechanicsville, Seventh District) pushed for immediate authority granted to Walker to proceed with medical billing. At the same time, St. Mary’s Administrator Rebecca Bridget explained that the process of providing policy statements for the Board of Commissioner to adopt would be included in early December of 2020 to be part of the coming fiscal year budget.
Walker presented the plan for spending $552,000 with the CARES Act funding for obtaining ambulances and contract staffers to supplement the
The County ought to watch out that the move ahead for the contract employees under the medical billing may not provide the funds that are or may be anticipated, warned St. Mary’s Commissioner Mike Hewitt (R. Hollywood, Leonardtown). “Don’t count your chickens before they hatch,” said Hewitt.
Commissioner Todd Morgan (R. Lexington Park, California) said he agreed with Commissioner Mike Hewitt to ‘not count our chickens before they hatch.’ Morgan warned that implementing new programs with the funding undetermined could be causing a more precarious financial situation in the future. Morgan said that the present economic crisis facing the County as it enters the next budget cycle is fraught with new problems due to the national Covid turmoil and its effect on all government spending levels.
O’Connor warned against imitating the problems created in Charles County when that County began inserting County paid EMS staff into volunteer organizations and ended up causing a lot of problems and animosity.