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Thursday, May 5, 2016

Commissioners open quotes for ambulance service

Monday, November 16, 2009

(Photo)
When it comes to a new ambulance contract, the Clay County Commissioners now know what their options are.

In a special meeting Monday, the commissioners opened quotes for ambulance service in preparation for the expiration of TransCare's current contract at the end of the year.

Two companies submitted quotes, while Putnam County Operation Life, Greencastle, sent notification they were not interested in providing a quote.

Both TransCare, Terre Haute, and Rural/Metro Ambulance, Indianapolis, provided quotes of $194,295 for the upcoming year, but the additional terms differed.

Rural/Metro requested the quoted amount to be allotted annually with a three-year term, while TransCare requested a five-year contract, with the subsidy amount to increase 3 percent annually.

To ensure county residents would receive the best service possible, the commissioners took the matter under advisement, and will reconvene at a date no later than their regularly scheduled meeting on Dec. 7 to make a decision and possibly enter into contract negotiations.

However, they did take the time to inquire about the services Rural/Metro has to offer Clay County as Paramedic Dan Pennington was in attendance, representing the company.

Pennington told the commissioners Rural/Metro would need to find housing in the county should they receive the contract, and would have one base set up in both Brazil and Clay City.

With response time a large concern in the local community and the commissioners, the question was asked how many ambulances would be available at any given time.

"Until we are able to accurately determine the volume of runs, we will probably have three trucks staffed, but the third may be as a standby until then," Pennington said.

Citing the only information about daily runs available at this time is the average of 4.2 emergency runs, Pennington explained it may take a little time to figure out just how many staffed vehicles would be needed.

"We know there are a lot more than just the emergency runs with transfers and non-emergency calls," he said. "Should the volume of runs call for a fourth staffed ambulance in the county, we will do whatever it takes to be successful."

Pennington added Rural/Metro would also provide coverage at special events throughout the county and while there is a shortage of paramedics in the country, his company has been "blessed" as they are well staffed in that area.

"Our company does a lot of special event coverage, including at the Indianapolis Motor Speedway," he said.

Curious as to how Rural/Metro would work with first responders within Clay County, the commissioners inquired about the company's experience in that field.

"First responders must be involved because they are necessary in order to be successful," Pennington said. "There are times when they will be first on the scene and everyone has to work together to maintain the best care for patients as possible."

Knowing the commissioners were going to take some time to review the Rural/Metro and TransCare proposals, Pennington emphasized that he strived for the best.

"If everyone isn't willing to work together or be on the same page, I want no part of this," he said, adding he would be in charge of operations locally. "If a decision can be made in the next week or so, it will take a lot of work to get set up by Jan. 1, but I think we can do it."

The next regular meeting of the Clay County Commissioners will be 9 a.m., Monday, Dec. 7, in the Commissioners' Courtroom at the Clay County Courthouse.


Comments
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I'm in favor of Rural/Metro.

-- Posted by Dagnabbit on Tue, Nov 17, 2009, at 7:54 AM

When Mr. Pennington talks of success and discusses the necessity of first responders involvment to assure it, I hope that he isn't referring to continuing the practice of overusing this community's emergency responders to fulfill the contractual agreement of a private ambulance service. "Maintaining the best care for the patient" is misleading. Of course local emergency responders want to help, that is why they are involved in these types of organizations to begin with, but what is generally being misrepresented is that much of what these first responders are being asked to do is the responsibility of the private ambulance service. It is not the obligation of an outside agency not being compensated by the county or by individuals not employed by the private ambulance service. Unfortunately this problem is difficult to resolve, because of the calling that these individuals have and the general conception of these organizations, combined with the nature of what they are being asked to do. At its root this isn't a charitable service, a profit is being made. A profit is being made by a business in this situation and a portion of the contracted workload is being shifted away from the business, and it is being completed at a cost to these local entities; these townships, these rescue organizations. A great deal of advantage is being taken and accepted under the premise that they are just there to help out. At some point the privatized ambulance service, regardless of who it may be, needs to be held accountable at the managerial level for it's service agreement.

-- Posted by spiritof56 on Tue, Nov 17, 2009, at 9:29 AM

I foresee alot of growing pains with switching services. I'm more interested in what burden the city takes since the BFD doesn't take or assist on medical runs that I'm aware of.

-- Posted by huh on Tue, Nov 17, 2009, at 9:32 AM

I'M citizen of Brazil we have rescue personal assisting trans care in brazil weather its the BFD or not the problem is people like "huh" trying to deviate from the problem and make a personal attack, so "huh" the burden is in clay county as a hole, from the sounds of your attack you are aware of the situation going on in the emergency services in clay county, So when you are waiting 30 min. or it takes you 30 min. to aide a person in need in clay county, the person needing aide has a voice to and depend on the services they as tax payers should get

-- Posted by 4 the People on Tue, Nov 17, 2009, at 11:08 AM

First responder units are a valuable and necessary asset to our community. That being said, in my opinion they have been used to almost bankruptcy here. It takes tax dollars and fund raisers to keep them running. God bless them for what they do, but to call them out for every run is a completely unnecessary burden on them. Tiered response should be just that. Mr. Pennington has spent a long time in EMS both as management and on the street. He knows how things should be run as is apparent from his many years in the business. I am very much in favor of looking seriously at a change. Thank you Clay County Commissioners for your dedication to our community. I urge anyone interested in this matter to be at the next meeting and have your voice heard!

(I am not at this time nor am I intending to be employed by either EMS service)Just a little qualifier.

-- Posted by RickS on Tue, Nov 17, 2009, at 12:01 PM

I think they should consider rural/metro. The worst thing that happened to Clay City was on Rick & Kathy when trans care took over they were the best.

-- Posted by confused33 on Tue, Nov 17, 2009, at 3:11 PM

Confused is an appropriate name for you. While Rick and Cathy were nice people, they were elementary service providers when it comes to providing care on an ambulance. All you simply need to do is ask the hospital staff how many lives have been saved by Trans-Care paramedics over the past several years. Confused, you need to define best. If you are talking about Rick and Cathy as being the best of loading up an ambulace and driving fast and having good bedside manners, then I will agree. If you are talking about Rick and Cathy being able to perform emergency medical procedures like administering nitro or invasive procedures, then they were not qualified. I for one want a paramedic at my door if I have a heart attack. Rick and Cathy were nice people but not qualified in todays demands of emergency medical management.

-- Posted by Lafin on Tue, Nov 17, 2009, at 5:14 PM

Thoughtful...I wonder how much thought you have put into your comments about prefering Rural Metro. Nobody but the commissioners know what each proposal contains. Why would you be in favor of one company over another when nobody knows the details that are being proposed.

Spirtof56- I agree with you on some points. I do believe that local fire departments are being stressed by the number of calls. But whose job is it to determine the need to go on a run. Dispatch simply notifies the appropriate agency of an issue. It is each local fire department's responsibility to determine if they need to make the run. It is unfortunate that in today's environment of civil litigation that everyone has to cover their rear end. Consequently, everybody gets dispatched on every call. It is up to us as members of our firedepartments to decide if we need to respond. But get ready to bend over and kiss your rear good bye if we don't respond and there is a negative outcome with a patient.

In summary if we can take the emotion out of the process, Trans-Care has done a good job of providing medical service to Clay County. I like the thought of Rural Metro providing three or four ambulances in the county but I will bet a dollar to a donut that Mr. Pennington is talking without authorization from his company. Not even an elementary ambulance company like Athens could warrant three or four staffed ambulances 24/7...but it is easy to make promises until you have to pay for them.

-- Posted by Lafin on Tue, Nov 17, 2009, at 5:25 PM

I hope the commissioners talk to some of the people that work closely with the ambulance services before making a decision. Talk to the ER nurses, the nursing home nurses and staff, people who have called for an ambulance, etc. I work in a nursing home and we have had horrible experiences with Transcare. I know ER nurses that say the same. It is not necessarily the EMTs that work for transcare, but how it is managed that causes some problems. Please research this and make an informed decision.

-- Posted by funnynurse on Tue, Nov 17, 2009, at 5:34 PM

Funnynurse: I understand your frustration. As a former employee of Trans-Care and Athens, I can sympathize with your frustration. But hospitals and nursing homes need to understand protocols: The commissioners would be irate if an ambulance in

Brazil was used to transport one of your stable, non-emergent patients and during that time, a 911 call would come in. Medical protocols and commissioner demands require that the 911 ambulance stay free for emergency responses and that a non-emergent ambulance be transfered in from out of county when one is free. This may result in a 45 minutes to 2hr wait for a stable, non-emergent patient.. Few people understand why there is a delay when we can look out our hospital window and see an ambualnce sitting there. I hope that provides some clarification on why the medics can not run everytime the ER calls or a nursing home calls. If the patient is not stabilized, then the 911 ambulance should respond immediately. That is one thing that Trans-Care offers Clay County...the ability to utilize Vigo County vehicles for non-emergent transfers while leaving the 911 vehicle ready to respond to an emergency in Brazil. I am interested in seeing Rural Metro's proposal on paper to understand how they plan to respond to a 911 call while their ambulance is on a non-emergent transfer. I can guess how they will respond. They will have no other choice but to call Trans-Care or another service provider to see if they have a free ambulance available...that will add to the response time.

-- Posted by Lafin on Tue, Nov 17, 2009, at 6:16 PM

4 the People, I apoliogize if you took my comments as an attack or personal. Please allow me to clarify.

"growing pains"

I know that trans care has been in the area for a while and are established. I'm sure both services are more than capable. If response time is the biggest issue bringing in another service from out of town and expecting faster response times right from the get-go I think is a bit unrealistic.

"burden"

My point on BFD was not a bash or attack or anything else other to say that I wonder if a cost analysis has ever been done for one less contract ambulance vs. staffing a city run ambulance out of BFD staffed with properly trained Firefighters. Maybe it saves us money maybe it doesn't, I know that individuals are still billed in addition to what tax dollars pay so this may even make money or be a wash. Maybe it lets us throw some more money their way. I just don't know if it has ever been considered.

These were my first posts here and I will be sure to make myself very clear from now on.

I also am not at this time nor am I intending to be employed by either EMS service.

Thank you.

-- Posted by huh on Tue, Nov 17, 2009, at 6:27 PM

Lafin, I don't know if you remember but Athens did staff three (3) full ambulances 24/7. So yes it can and has been done.

-- Posted by RickS on Tue, Nov 17, 2009, at 8:47 PM

Regardless what company gets the contract this is a good time to look at other avenues to solve response times, priority of utilizing volunteer assets, and compensation/resupply of volunteer assets that offset or support the paid services responses. These volunteers not only bust their butts to provide services, they give an amazing amount of personal and family time to provide the means to provide those services. In this economy it is even tougher to get the job done.

I believe there could be a multifaceted approach that enhances services to the people of Clay County, possibly saves money and resources and enhances the readiness of those organizations who provide those services.

I know the article can't contain all points of the meeting so I'm sure there is more to this discussion than we who did not attend are aware. We have experienced people in this county that should be listened to when looking at any scenario. Any contract that is awarded should be for a short term with the understanding that results are what is going to get a longer term contract in the future. Following that, this discussion should be opened at a much earlier time in the ending contract year so that a more comprehensive approach can be taken. It seems like its in the time frame where we have to hurry and pick something, anything, even if its not the fit and form that we are looking for.

I am not in EMS nor do I desire to be. I do want good, reliable EMS.

-- Posted by michael.galloway1 on Tue, Nov 17, 2009, at 11:02 PM

3 STAFFED TRUCKS NOT 2 TRUCKS AND ONE ON CALL CREW WITCH WERE WORKING IN DISPATCH WHILE ON CALL

ANY WAY THE YEAR IS 2009 NOT 1960. THE CO. NEEDS TO WAKE UP AND QUIT BEING SO GRUMPY. ALL OVER THE COUNTRY EVERYONE IS COMPLANING ON HOW LNG IT TAKES TO GET AN AMBULANCE BECAUSE AS AN AMBULANCE THEY HAVE TO RESPOND AND TRANSPORT PEOPLE IF THE CALL 911 , AND YES THAT IS FOR ANY REASON AND BIG OR SMALL BROKEN TOES, BLOODY NOSES, TOOTH ACHES, NO FEELING GOOD, FLU, AND SO ON . AND THATS WHY IT TAKES 30 MIN FOR AN AMBULANCE TO GET THERE BECAUSE THEY ARE ON NON-EMERGENCY RUNS AND HAVE TO TAKE THAT PERSON TO THE ER BEFORE THEY COME GET YOU. AND IF YOU OR YOUR FAMILY ARE SHORT OF BREATH OR A HEART ATTACH OR MAYBE A BROKEN LEG AND CALL 911 (OH YA AND YOU LIVE 10 - 20 MIN FROM BRAZIL OR CLAY CITY) I THINK YOU WOULD WANT THE FD TO RESPOND AND EASE YOUR PAIN UNTILE THE AMBULANCE CAN GET THERE.

-- Posted by FIREMEDIC on Wed, Nov 18, 2009, at 12:16 AM

YES I AM A FIREFIGHTER IN THE CO. AND I AM A FIRST RESPONDER AND YES I'M TIRED OF GETTING UP AT 3AM TO GO TO "A SICK PERSON" BUT THAT SAME SICK PERSON COULD BE HAVING A COLD OR HEART FALURE, YOU NEVER KNOW AND THE LIFTING ASSIT. CALLS ARE NOT FUN EITHER BUT THE PERSON COULD BE 700LBS AND THE TWO TECHS ON THE AMBULANCE CANT PICK THAT PERSON UP. I WISH EVERONE IN SCANNER LAND WOULD JUST TURN THEM OFF AND LET EVERONE DO THERE JOBS, BECAUSE MOST OF THE PEOPLE ON HERE DONT KNOW WHAT THEY ARE TALKING ABOUT. AND IF YOU ARE A FD MEMBER AND DONT LIKE THE MED. RUNS DONT FORGET YOUR ON A VOL. FD ALL YOU HAVE TO DO IS NOT GO!!! BUT AS FAR AS MAKING THE CALL OF WHATS A GOOD RUN TO SEND THE FD TO AND WHATS NOT WELL I'M NOT GOING TO TAKE THAT LIABILTY FOR WHEN SOMEONES DIES BECAUSE I THOUGHT THAT THE FD WAS NOT NEEDED

-- Posted by FIREMEDIC on Wed, Nov 18, 2009, at 12:27 AM

I AGREE WITH LAFIN 100%. THEY KNOW WHATS REALLY GOING ON.

-- Posted by FIREMEDIC on Wed, Nov 18, 2009, at 12:28 AM

I DONT CARE WHAT COMPANY GETS IT AS LONG AS WHEN THERE ARE 4 911 CALLS THAT COME OUT IN 30 MIN. (AND IT HAPPENS A LOT) THEY ARE NOT SENDING AMBULANCES FROM INDY OR WAITING ON THE ON CALL MEMBERS TO GET TO STATION .

JUST KEEP THIS IN MIND WHEN THE TWO CLAY CO TRANSCARE TRUCKS GO OUT THERE ARE 6 OTHER AMBULANCES IN THE "NEXT" CO OVER THAT ARE GOING TO COME TO CLAY AND COVER

-- Posted by FIREMEDIC on Wed, Nov 18, 2009, at 12:32 AM

Fire Departments should not have any obligations within a county wide Private Ambulance Service Contract. These ambulance service providers are two businesses, competing for revenue. Basing their selling points on what they as companies have to offer this county. It shouldn't be based on what or who they can use for free. As professional companies they need to provide for reasonable response times and adequate manpower on their own. It shouldn't be left to their regular employees, emergency dispatchers, deputies, town marshals, police officers, volunteer firefighters, or other citizens to fulfill these obligations or decide how to handle the frequent short comings of the company in these areas. It needs to be handled by the management and ownership of the private company. The upper echelon of County officials need to hold these government contractors accountable at that level. Because as long as they are saving money by not staffing the county adequately, and our local emergency responders feel the obligation to just "help out", it will continue to happen.

-- Posted by spiritof56 on Wed, Nov 18, 2009, at 3:58 AM

I am not speaking of "stable patients" or "non-emergent patients". I have seen full code patients that are in cardiac distress have to wait that 30 min because it is "assumed" they are non-emergent because they are in a nursing home. Not all residents in a nursing home are "old and no-code". Because of confidentiality I won't go into details on here, but if the commissioners talk to the people in the trenches in hospitals and nursing homes they would get an earfull. And yes, we have voiced our opionion to them before. This is not to say TransCare should not get the contract, but changes need to be made. Nurses in all areas talk to each other and the comments made regarding the ambulance service currently are not positive.

-- Posted by funnynurse on Wed, Nov 18, 2009, at 6:29 AM

funnynurse,

Totally agree with you!I use to work in a nursing home,I actually was there 13 yrs.In the years I was there right off top of my head,I can recall losing a coworker who went into cardiac arrest and we had to call 3 times just to get an ambulance because they assumed it was a patient after being repeatedly told that it was an employee.Of course we had nurses performing CPR but the employee may have stood better chance had the ambulance came in a timely manner to tranport to Hospital with more equipment and a doctor to provide additional care.I just know there need to be provisions somewhere.

-- Posted by westsidemom on Wed, Nov 18, 2009, at 8:00 AM

RickS, You are correct..partially. When I worked at Athens, we had two full time staffed non-paramedic (BLS) ambulances. One with your parents staffing it in Clay City. The other in Brazil. The third was our "stand by" ambulance which was unmanned. I had to sit on standby without pay from Dennis Rose many times just in case it was needed. By the time I would get dressed and to the ambulance station if the thrid ambulance was needed, it was a fifteen minute delay if I was called in to respond to the stand-by ambulance. In the same 15 minutes, Trans-Care has the ability to put several ambulances in Clay County as they did in Brazil a couple years ago. I think even you agree that the paramedic status we are at today is much better than the BLS the county was at five years ago. Like any company Trans-Care has problems they need to resolve. But overall I think they do a good job.

-- Posted by Lafin on Wed, Nov 18, 2009, at 10:51 AM

Let's ask the Commissioners about the phone calls regarding the transports for patients that would be dead if not for Transcare. Rick and Cathy could not have saved most of these people. Let's give credit where it is due and thank Transcare for the step up in performance that they have brought to the table for Clay County. I appreciate their work and will continue to support them.

-- Posted by whynotlook on Wed, Nov 18, 2009, at 1:50 PM

Please change ambulance services commissioners!! Listen to the people who vote you in!

-- Posted by Criminology08 on Wed, Nov 18, 2009, at 2:24 PM

Boys & Girls

Who is the professional in this subject? I would have to assume the ambulance service doesnt tell the FD how to fight fires, dispatch or other. No matter where you live, today, fires are far and few and Rescue and EMS is what supports FD's numbers. No matter where you live, rural services always have longer response times. I dont know what the run volume is but if the 4.2 is the avg transport, I know from experience a very large percentage is Medicaid and non paying therefore leaving very few per month to pay the bills. If this service is a for profit service, I can assure you if there is merit to add additional units, they would have done it.

Now to backup. You better make D*@+ sure if you choose a company who isnt your neighbor to expect longer response times & less backup. Trans-Care isnt going to be wiling to help Rural Metro if they get the boot. Rural Metro is a huge company and they dont usually work in little rural areas so it sounds like someone has a sideline agenda so I would be very cautious. If I remember right, Rural Metro left Terre Haute years ago because it was to small of a market. And Clay County isn't?

Somebody wake up here.

Originally from Clay County

-- Posted by Local EMS on Wed, Nov 18, 2009, at 2:27 PM

AND................

as stated above, get rid of the emotion and let the facts speak for itself. Sounds to me a few dont like what taxpayors are paying for and they just want to be woke up when its the big one! Well folks, taxpayors are paying for FD's to do more than the big one so if a few of you dont like what the industry ask of you, sounds to me you are in the wrong industry. I would bet the local service is doing nothing more than any other service around the country is doing yet there are few complainers who wants to stir the pot. That lack of working together is what drove me out of town. To much politics trying to tell the professionals how to do their job. Who above has the professional training to second guess the existing service. Thats what I thought, none.

-- Posted by Local EMS on Wed, Nov 18, 2009, at 2:35 PM

Just to make a note here. While I have not had any complaints with Transcare, when making the decision, the commitee may want to also find out if either of the companies are in network with some of the more common health insurance providers. An out of network provider is going to cost the individual using the ambulance service a lot more out of pocket in addition to what it costs to have them at the ready in the area. Of course it could be that neither company is in network with the larger health care insurance providers, but would be nice to make it less expensive for the patient as well if that were possible. No sense paying for something via our taxes and then paying a premium on top of that if they don't also have contract with larger more common insurance companies like Blue Cross/Shield and Sagamore.

-- Posted by Jenny Moore on Wed, Nov 18, 2009, at 3:15 PM

I don't believe a fire department is an industry. It is a government entity. They are not intended to make a profit and should make adjustments to avoid going over budget. They are handling the emergencies that they are in existence to handle. Township budgets are based on those types and frequency of emergencies and are already strained enough with that focus.

Unfortunately private ambulance services are businesses, and health care is big business. They must make a profit to continue to operate. That is why their employees are underpaid for the industry. That is why they operate at the bare minimum of staffing. That is why they need assistance to lift patients, that is why they need first reponders to supplement them. To keep costs low, not to stay within a budget, but to make more profit. Taxpayers do pay for dispatchers, fire deparments, law enforcement, and rescue services. These positions have duties prescribed to them. Money is appropriated and distributed evenly as possible. The ambulance service is different, it is an outside company that requests an amount to provide a service by contract with the county. Similar to contracting with a construction company to build a government building, or a bridge. Contracting with a carpenter, electrician, or painter to make improvements in a government building. All taxpayers will benefit from the building and a portion of their tax dollars will go to fund the construction or improvement of a building. With that said, If the commissioners ask a painter how much it will cost to paint a room in the courthouse, and a painter explains the cost and they enter into an agreement for the painter and his crew to complete the work. Would.. say.. the treasurer be expected to help paint the trim just to help out? Maybe because the painter had another job in a nearby county that required some of his crew to leave the job site.

Private ambulance services are relying on the philanthropic ideas of this community and its public safety providers. They are counting on volunteer firefighters, nurses, dispatchers, police officers, deputies, town marshals, and rescue personnell of any kind to carve this issue down to the basics of "why am I a (blank)" insert your occupation, be it firefighter, deputy, police officer. Then hopefully those officials answer with "to help people". It's more complicated than that. This request for "help" occurs on almost every run the ambulance makes. It is not an occasional infrequent happening.

This is an organization, a business, an industry, as has been stated, that is getting tax dollars and insurance money for a service, an obligation that they cannot meet. Not because their budget has been cut by the state, but because they are cutting costs to save money. Not to save taxpayers, but to make a profit. Townships, towns, cities, counties, and their departments,and elected officials, have no idea what the future will bring with their costs or budgets. Yet some of these ambulance services want to gaurantee increases throughout their multi-year contract.

-- Posted by spiritof56 on Thu, Nov 19, 2009, at 8:34 AM

Knock Knock....anyone home spiritof56:

I can tell, you voted for O for President didnt you? Government is no different than the private industry including the Ambulance industry. I just talked to my buddy in Parke County. He tells me the county is still operating it themselves and its costing the county over $500,000. If my math is right, thats around $300,000 more than Clay County is paying now and they stage one station, one ambulance. Let me see, wasteful gov't or the private enterprise? Pay the private $500,000 in Parke and I promise you he will get it done better, cheaper than any gov't body will ever think of doing it and make one hell of a profit. So you dont think someone in Parke isnt profiting from their conditions? Americans have got to wake up. The Parke County example is why our taxes are so high and gov'ts are out of money.

-- Posted by Local EMS on Thu, Nov 19, 2009, at 9:13 AM

I was a Paramedic for over 15 years, and worked in a great many counties, for private and municipal departments. I can tell you this, there are NEVER enough ambulances. When it comes down to it, you just simply cannot staff enough trucks to cover any circumstance, and the best we can hope for is that we have someone managing ambulances in a way that allows for trucks to be available as often as possible.

What a lot of people do not realize is that convalescent runs are the bread and butter of most ambulance services. They are what pay the bills and make the service money to upgrade equipment when needed. This means taking patients to doctor visits and eye appointments, etc.. The problem arises when a service dedicates too much of its time towards doing these runs, and neglects to leave a truck available for an emergency response. This is where the issue arises for many private services. They get caught in this decision making process of trying to decide if they should take those convalescent runs and possibly leave the county open for an emergency run, and not have a truck available. If they do not take the convo run, they risk not making enough money to pay the bills.

Athens Ambulance was a great service for the county, during their time. However, the time had come for this county to see better care for its patients by bringing in Paramedics. It would have been nice if Athens would have been willing to do so, but that didn't happen.

Personally, I would like to see Clay County operate its own ambulance service, and not bother with having to hire an outside private service. By having a municipal run service, you get better response times, better equipment, and trucks that do not have to make a decision about whether or not they can take the last truck out of service to do a convo run. A county based service is run much like the police and paid fire departments, and can actually become a revenue base for the county, instead of yet another tax burden. Look at Putnam County operation Life. That service has operated in the black for 30 years. Although they do get county funds, they also put funds back into the county.

I just think it is about time the gov of this county start looking at building its own service, instead of relying on outside sources that really have no interest here, except to make money.

-- Posted by olmedic on Thu, Nov 19, 2009, at 9:43 AM

LocalEMS: See my post above. Putnam is a prime example of how a service can be gov run and make a profit.

-- Posted by olmedic on Thu, Nov 19, 2009, at 9:47 AM

Sorry olmedic,

Operation Life is subsidized by the College and the County both. When they tell you they make money, they forget to tell you their expenses far outweigh their run revenue therefore needing the subsidy and grants.

Sorry olmedic,

in rural settings, convalescent runs are so few that it isnt what makes the money, its the blend of all that contributes. Conv. runs do not support the infrastructure of a Paramedic program yet occassionally have the need. The majority of Conv. runs are Medicaid/Care which pays little to nothing.

-- Posted by Local EMS on Thu, Nov 19, 2009, at 10:19 AM

I have enjoyed reading everyone's comments regarding the upcoming ambulance negotiations. I felt compelled to add to the discussion as I am probably in a unique position to do so. I am not an expert on running an ambulance service. However, as Clay County Commissioner, I was involved in the decision to make the transition from Athens, a basic life support ambulance service provider, to Trans-Care, a paramedic level ambulance service provider.

Many of the complaints I received from citizens about Trans-Care were from local fire departments being "toned out" on every 911 call. Please understand that Trans-Care does not determine what medical event requires a local volunteer fire department to be dispatched. These decisions are made by national protocols. Trans-Care, nor any other ambulance company can change these protocols. Any deviation from these protocols will likely result in liability for the county, for the fire departments, and for the ambulance company. However, any fire department who does not want to respond has full authority to choose not to.

Response time seems to be another point of contention. I do not know what an acceptable response time is because we did not have documented response times from Athens to compare. However, I believe it is fair to say that the response time in Poland will likely be longer than a response time in the City of Brazil. I can tell you from experience, minutes seems like an hours in an emergency and perception of response times is often greater than reality. Public officials have recently stated the average response time is currently less than eight minutes from the time of dispatch. In my opinion, this eight minute standard should be the mark to improve on as we move forward.

The ambulance contract will probably the biggest decision that will be made by our Commissioners during the next several years. In fact, the balance of life for some individuals may depend on the Commissioners decisions and how they permit either company to operate. Please encourage our Commissioners to study the issue diligently. I have known Dan Pennington of Rural Metro for 25 years and believe him to be a honorable and decent man. I have known Russ Faril for less time but believe him to share those same qualities.

In summary, every citizen needs to demand that a paramedic be on the scene on every call and that backups be readily available. These backup ambulances must be under the dispatch control of either Trans-Care or Rural-Metro. Asking another ambulance agencies to voluntarily send an ambulance when they have one available as a backup without compensation may be a risky practice and could ultimately be a death sentence for someone in need when our primary units have been dispatched. Any deviation from having a paramedic on board the ambulance on every call, coupled with the ability to provide backup ambulances on standby without requiring voluntary cooperation from another company must be a deal breaker in the negotiations.

-- Posted by Daryl Andrews on Thu, Nov 19, 2009, at 10:23 AM

Thank you for stating a few of the overlooked facts that everyone seems to forget while typing away on this heated topic. I do support our Commissioners and hope they will make the best decision for our county and not worry about whether it will effect their re-election possibility. Afterall, that is why we elect them - to make the BEST decision for all of us as a whole.

-- Posted by whynotlook on Thu, Nov 19, 2009, at 11:31 AM

Either way they go I hope we get good service.

I do hope that BPD and BFD step up and start pulling their share of assists. I do agree with that. The city abuses the volunteers and doesn't want to help with any kind of monetary funds to help keep S&R going when about 75% of their runs are in the city assisting Trans Care. I am quite sure that some of the depatment's personnel have been trained as EMR's. Start doing it!

-- Posted by Proud of My Country on Thu, Nov 19, 2009, at 11:52 AM

As a public servant I am speaking here on the behalf of myself only, I am not speaking for, nor do I represent the behalf of the City's firefighters, or the Administration for the Fire Department or City. I am replying in my own name, as a Citizen of Brazil somewhat knowledgeable of the subject, and only to the regards of some of the mis-comments made here. I usually do not follow this forum of postings, and this is my first time in commenting to such.

"Start doing it!" this in regards to both the City's Police and Firefighters assisting Transcare with its operations, or the suggestion that City funds should be granted to subsidize Clay County Search and Rescue (S&R) operations. As I am sure you are aware, State statute requires certain minimum levels of training certifications and minimum equipment placed and maintained on the apparatus itself. The practice of assisting in medical related incidents carries an additional financial responsibility of liability in both insurance and legal risk for the City and ultimately its citizens. The City has review these responsibilities carried in medical assistance, both in the past and now. Understandably the need to help those in need does pose its own justifications, but the insurances needed to keep both the Fire and the Police departments in operations so services that are provided to its citizens are maintained, responsible government. City provided basic ambulance service and transport was reviewed for possible implementation in previous administrations. State affiliated representatives not only advise it was a viable aspect for the City to do so, but advisable for the City. In the process of review, some county representatives meet the City's optimism with a certain amount of dissuasion and reservations. These representatives were the some of the same public officials involved with the contractual agreement with Transcare. Weather the decision made to contract with Transcare for medical service for the county was wise stands outside the issue here. No matter what company was contracted for medical service, County township officials, fire departments or administrating personal thereof, were not advised of changes of protocol or the additional responsibilities that would be placed upon them under the operating procedures implemented by Transcare to the county. I have seen "National Protocol" referred to in these postings, but I am unsure where this referred protocol, or phase rather originates from specifically. I do know the responsibility of maintaining and managing the department rest in the City officials elected and appointed, ensuring emergency services that are provided, such as fire protection, are maintained for the protection of our community. The responsibility in the implementation of new services should not be disregarded in the approach of just "Start doing it"

-- Posted by Tobey Archer on Thu, Nov 19, 2009, at 5:57 PM

How bout "Just Do it" as a slogan, Like Nike. Nike pays next to nothing for their labor also. Then promotes the product they produce as the best you can get...Are there any ambulance companies from bangledesh bidding this year?

-- Posted by spiritof56 on Thu, Nov 19, 2009, at 8:34 PM

Put a giant blue and white swoosh on the side of the Units instead of the usual star of life...It may even make them faster, improving response times.

-- Posted by spiritof56 on Thu, Nov 19, 2009, at 8:39 PM

What we really need is some type of centrally located emergency medical facility or service. A place to take wounded that will provide quick care and patch people up, stabilize them and get them to more equipped hospital. With a place to land choppers and what not. How bout a MASH unit...like on the tv show MASH. With Hawkeye and Radar. Hey, Local EMS you can be Frank Burns, or Clinger.

-- Posted by spiritof56 on Thu, Nov 19, 2009, at 8:51 PM

Maybe they can hire Doc Marten to staff one of the Med units. Dr scholls would also be a good option. Proud of My Country, I believe you ment to say Trans Care abuses the volunteers.

-- Posted by Erethism on Thu, Nov 19, 2009, at 8:58 PM

Proud of My Country How come the CCSD Deputy's Stop Cars in the City,Arrest people in the City Serve Papers in the City do just about every part of their job in the city and the county.OH Thats right the City is in the county and the people of the city pay county taxes is S&R not in the county budget and if so it would seam that People of the City already pay for that unit also I would think that if 75% percent of your runs were in the City you would want to keep that to prove you are needed if you lose that in this day and age of Budget Cuts some people in Office looking at Cuts may very well look at Cutting a Department that no longer make 3/4's of the runs they made the year before might watch what you wish for. you might just get it.

Like the Man Said if you don't want to go don't go

-- Posted by agar on Fri, Nov 20, 2009, at 4:13 AM

We can have ALL of the things various people have written about here but only if we have the money to pay for it. With decreased tax revenues, restructured and income subsidized property taxes, and a wide area to cover, it's going to add to healthcare cost whether or not congress does its "thing" Transcare is not in network for several of the more common health care insurance companies and I personally found out recently that neither is the physician company that St Vincent Clay Hosp. has contracted to work in ER. So we pay taxes to keep these services in the county as best as we can or will pay and then also pay extra as individuals for the services we receive...and no one has even talked about the air ambulance yet which costs even more. Face the facts. It costs money and we are going to have to be willing to pay for what we get or the companies will contract in other locations. If we don't ask all the questions, we will have more poeple not even utilizing the service due to the cost. Then it will fall even more to the ones who do.

-- Posted by Jenny Moore on Fri, Nov 20, 2009, at 7:51 AM

So is this for the County? Does that mean Brazil has to do its own contract too, like the Humane Shelter situation? Just trying to figure out how one is different than the other, and "golly gee" someone else could double dip on us too.

-- Posted by reddevil on Fri, Nov 20, 2009, at 11:56 AM

agar, I do not have an answer for you as I don't have anything to do with the who can do what where side of law enforcement nor will I pretend to be knowledgeable in that aspect. Ask the Sheriff if you are so inclined.

You also elude to the fact that and to quote you "75% percent of your runs were in the City you would want to keep that to prove you are needed if you lose that in this day and age of Budget Cuts some people in Office looking at Cuts may very well look at Cutting a Department that no longer make 3/4's of the runs they made the year before might watch what you wish for. you might just get it." You might want to direct that to the organization I mentioned, not me because that's not my thing. If it was however....that's a different matter. Just wanted to clarify a couple of things for you. I was not being mean and meant no maliciousness toward anyone or any group.

-- Posted by Proud of My Country on Fri, Nov 20, 2009, at 1:19 PM

KEEP UP THE GOOD WORK SEARCH & RESCUE YOU ARE DOING A FINE JOB!!!

-- Posted by bandmom_63 on Fri, Nov 20, 2009, at 3:31 PM

Tobey, I hope you are not embarrassed down the road by publicly using this sight to admit you do not know what the national protocols are. I do not know either, but it is not my job to know. Before I would admit that on a website, I would call Trans-Care or whoever and ask them for clarification.

-- Posted by Lafin on Fri, Nov 20, 2009, at 5:14 PM

People should not comment on this suject if you have no idea how the system works. From what I had read only acouple have an idea. The volunteers do get something out of responding. Your township has a contract with the dept. Your taxes pay the dept's to respond and provide fire and emergency services. Each volunteer gets gas allowance to respond also, If they dont want to respond then dont. Thats why it is VOLUNTEER! Check the county response times. Trans-care is on scene before the fire dept's 98% of the time. Rural Metro was in Vigo county years ago and left because 50 runs a day wasnt' enough. You think the 5 runs a day in Clay is going to fly. NO WAY!!!! Every one talks a good game when you want something. Then when you get it who cares. Trans-Care has trucks available to the county in no time. When the church balcony colapsed there was 6 trans-care ambulances on scene in 15 minutes. How are ambulances from Indy going to do that. Now to the nurses. You are the biggest 911 abusers there is. Calling because granpa has gas and grandma fell three days ago and now has a bruise on her arm. Real 911 emergencies come first. Tell the truth about your employee that died. You didnt call three times. Why not tell how long she had been down before anybody even found her at your facility. The county is pretty lucky to have a service like we do. Everybody just wants to complain about something even though they have no clue what its about.

-- Posted by max23 on Fri, Nov 20, 2009, at 7:00 PM

I'm not embarrassed by being wrong or mistaken, or unable to admit when I am. In regards to my professional knowledge and training, I am aware of those protocols, regulations, and standards that apply to the profession I belong, "firefighting". I believe you may have overlooked the point being made, and I do not regret using my name to my words.

-- Posted by Tobey Archer on Fri, Nov 20, 2009, at 7:30 PM

max23 FOR YOUR INFO VOLUNTEERS DO NOT I REPEAT DO NOT GET GAS ALLOWANCE. WE PAY FOR THE GAS OUT OF OUR OWN POCKETS!!! AND I DON'T KNOW WHAT RADIO YOU ARE LISTENING TO, BUT I HEAR THE FIRE DEPARTMENTS ASKING DISPATCH WHERE THE AMBULANCE IS AND SOMETIMES IT'S COMING FROM TERRE HAUTE!!!

-- Posted by bandmom_63 on Fri, Nov 20, 2009, at 8:57 PM

Tobey,Good post at least a few of us get your point.

-- Posted by Erethism on Fri, Nov 20, 2009, at 11:10 PM

I would like to see this "national protocol" in print and a reference to where it can be located? Is this some type of law or administrative code? An OSHA requirement? Or just something that private ambulance companies use to maximize profits?

How can any contracted business operate under the pretense that it relys upon outside help from uncompensated groups not under any contract to fulfill their duties? This is private business and when they reduce their resources like personell and equipment in this county it increases their profits. The public sector of emergency responders, the elected officials, all volunteers, and tax payers need to hold this company and their management accountable, and force them to provide the proper resources to do their job in this community. Clay County should not be secondary, regardless of our size.

-- Posted by spiritof56 on Sat, Nov 21, 2009, at 7:51 AM

Could someone smarter than me, which is most of you, tell me why we can't have a county ambulance service, similiar to the Sheriff Dept?

Brazil could use the former Sheriff Station for starts, it is paid for.

Seems like a lot of nothing for $194,295 dollars and then an ambulance bill later- god forbid, if m family needs it.

Maybe Evan Bayh will help us after he votes for Obaa care.

-- Posted by reddevil on Sat, Nov 21, 2009, at 1:35 PM

bandmom_63 you must be on a bad dept. Read the state laws. Fire depts are required to pay volunteers for gas and clothing from the township funds.I know most dept's do. Maybe you should get on a new dept that isnt keeping money from you. Ive been in this county and other counties as a volunteer and have always been paid my money. When ambulaces come from Terre Haute its because others are already on runs. Just have fun waiting for one to come from Indy. Everyone wants to complain about trans-care just wait if rural metro comes in.

-- Posted by max23 on Sat, Nov 21, 2009, at 3:37 PM

It very interesting how so many who have never managed an ambulance service have all the answers.

1) Counties subsidize ambulance services even ones owned by the county because the run volume isnt profitable enough to afford the 911 needs. Thats why a third ambulance or other restricting contract needs create more cost to the county. Want more, expect the county to pay for it.

2)Response times; has anyone looked at the county map? Can you imagine one of two ambulance able to cover any run under any condition within a short period of time? Especially when more than two runs happen at the same time. Want better response times, expect to pay more.

3) National Protocol: National Academies of Emergency Dispatch is one I have seen. I have never been certified in dispatching but have been around it for a long time. The standards being referred to are those within the EMD-Emergency Medical Dispatch certifications. When certain things are said from the caller, in engages protocols established by experts. If the market utilizing the national standard doesnt have the ability to perform any part of the protocol the call goes on and those on scene do the best they can with what they have to work with. In some markets, residents get the best care while in other they dont due to shortage.

What area do you want to be in when you have your emergency? The one where National Standards apply or ones that dont!

-- Posted by Local EMS on Sat, Nov 21, 2009, at 7:37 PM