Clay County is on its way to having paramedic-level ambulance care, according to the Clay County Commissioners.
In their monthly meeting Tuesday morning, the board discussed the possiblity of bringing paramedic-level care to the county as early as January of 2005. The three commissioners went over a list of criteria with area healthcare representatives, including members of Air Evac, Athens Ambulance, and St. Vincent Clay Hospital.
The list, which included eight specifications and two alternates, was amended to add a few more specifications and alternates after talks with the healthcare representatives. A legal ad will be taken out in The Brazil Times and The Clay City News this month and bids for such a service will be opened in the October commissioners meeting.
Under the advertised specifications, a company should, among other criteria:
- Provide basic life support service from Jan. 1, 2005, but no later than June 30, 2005. This period of time will allow the company to "ramp up" staffing and training. By June 30, 2005, paramedic-level care should be provided to Clay County
- Enter into a mutual aid agreement with a service provider out of Jasonville to provide ambulance service to Lewis Township in order to provide quicker response times to the citizens of extreme southern Clay County
- Provide quarterly reports to the county with information on number of runs, response times, and staffing levels
- Work in conjunction with St. Vincent Clay Hospital
- Agree to a 180-day termination clause that the commissioners can exercise if the county is dissatisfied with the service
- Transport cadavers and inmates at no additional cost to the county.
None of these criteria are set in stone, however, as the commissioners added an alternate to the list during the meeting. Under alternate five, a company is allowed to think up its own proposal and submit it to the county for review.
"This will allow the companies an opportunity to be creative, and it could save the taxpayers money as well," Commissioner Daryl Andrews said. "We're asking them to design the most cost-effective proposal they can."
Submitting companies were asked to give two bids to the commissioners. In the first bid, the cost would be changed to reflect fees if the county provided the ambulances. In the other, the company would assume it was paying for its own vehicles.
Since the county's current contract with Athens Ambulance does not end until the first day of 2005, the county will have time to negotiate terms with the company they choose in October.
Some alternates allow the company to offer high-level care at peak hours. Under one plan, a paramedic will be placed in Brazil and Clay City from approximately 7 a.m. to midnight. From midnight to 7 a.m., the ambulance would go to a primary "base station" somewhere near the intersection of Interstate 70 and SR 59. This would allow a paramedic to be stationed at two ends of the county during busy emergency hours and cut costs by staying in a centralized location in "off hours."
Discussion arose over the funding of the paramedic level service. Several healthcare representatives said the cost of a paramedic-level service would be significantly higher than the county's current plan with Athens Ambulance. President David Parr said the commissioners would have no idea of costs until bids were opened in October, but most companies knew the county's price range and were encouraged to take advantage of alternate five.
Another cost-cutting option would be to base only one paramedic in Clay County, with the other vacancy being filled by an "intermediate" EMT. An intermediate has almost the same amount of know-how and authority in an emergency situation as an EMT. Andrews recommended that the paramedic be stationed in Clay City and the intermediate in Brazil because of Clay City's distance from SVCH.
"Obviously we would like to have one on both ends," he said. "This is just one option for the bidders."
Parr said he did not agree with that plan, however, citing a need for an "equal level of care across the county."
"You're not going to have a paramedic-level service here for what you pay for your basic service now," a healthcare representative said. "There's very little difference in an emergency situation between an intermediate and a paramedic."
The representative also said a paramedic would be more desirable in a long-distance, hospital-to-hospital situation.
Faril Ward of TransCare, a company the county showed interest in during the last contract signing, said an intermediate would cost a company roughly $4/hour less than a paramedic.
Spectators also questioned the use of two paramedic-level EMTs when Air Evac offers a similar service in the county. The company, which gives air-based paramedic-level care, has been based in the county for approximately six months. In that time, the company has made several runs. The commissioners said while the company provides a valuable service, the county needs paramedic-level care on the ground, as well.
Another issue raised was the lack of paramedics and intermediates looking for jobs in Indiana. With the demand for paramedics so high and intermediates being so new to the healthcare scene, Ward said the county would have to offer a high-pay environment where a paramedic made "more than one run a day" to be a desirable job market.
"There are so few of these kinds of people they tell you what they're going to do," he said. "They'll tell you when they can and can't work, how much they'll work for... they're so rare they can do that."
He did say, however, that the number of intermediate EMTs grows "month after month."
The next meeting of the Clay County Commissioners will be held at 9 a.m. in the Clay County Courthouse on Oct. 4. The public is invited.