Morrow County Commissioners will have a big job on their hands when the dust settles from this Spring’s bidding process over 911 and EMS services for the county.
A new service proposal with specific requirements and an invitation for any interested agencies to submit a bid has caused angst and concern among medical personnel currently providing services, as well as confusion over the terms of the proposed service.
EMS in Morrow County are funded by a 2.0 mil operating levy and revenue recovery (billing), and 911 dispatch is funded by improved parcel tax and surcharges to land lines and cellphone accounts. Every parcel of land in Morrow County (over 15,000 of them) pays $25 on their tax bill and that goes to 911, Commissioner Dick Miller explained at Monday’s commissioners’ meeting.
The issue at hand
For forty-one years, when the EMS contract was due to expire, a bid was submitted by the Morrow County Firefighters and Squadsmans Association for the whole amount of revenue generated by the levy, and the board of commissioners accepted it. This year, the commissioners decided to solicit proposals for EMS and 911 services with requirements they feel will allow for growth, modernization, performance benchmarks and community transparency, among others.
“We have opinions and a notion that nothing can be improved and everything is working as efficiently as it could; that [the current service] is so thrifty and really doing everything they can to work efficiently,” Miller says. “As a result, we have no idea whether they are or not. We don’t know what it should cost or what to compare it to. When you say you can’t afford to pay people a reasonable wage and provide some benefits, how do they know? So we asked for that in the RFP (Request For Proposals). You ask for the improvements you see on the horizon and what a growing county needs.”
The RFP requests all contractors submitting a bid to provide an annual cost to operate and manage EMS and 911; a complete five-year business plan including possible station re-locations and service consolidation initiatives; forecasted revenues and expenses; and to provide revenue sources and transport volume upon written request. Additionally, the contractor will develop and propose a vehicle and capital equipment modernization plan over the next five years.
And that’s just for starters. There are eight more pages of requirements. Several agencies have already held pre-bid meetings with the commissioners to field questions and get feedback.
Concerns that have arisen
In a separate press release issued February 19 of this year, the commissioners required bidders to retain the county current EMS and 911 personnel and to provide a competitive benefit package. Commissioner Tom Whiston acknowledges it is ‘difficult to allay the fears that people have when there’s a possible change.’
“Can we guarantee all those people will continue to be employed if another entity took it over? No,” he said. “From the standpoint of management basis and personnel, if you have someone who’s not performing, we wouldn’t want them to continue there. If you’re qualified and can demonstrate you’re qualified, people want to hire and keep people like that. Is Morrow County going to lose seventy jobs? No, because I don’t believe we’re going to have people in Michigan responding to EMS calls.”*
Whiston noted there was concern voiced over a ‘big delay if we have someone else (an outside agency) dispatching.’
“Last time I checked, when you dial 911, it doesn’t matter where the call goes: there’s no delay from the standpoint of getting the call,” he responded. “If you’re in Iberia, the dispatch office in is Mt. Gilead - it wouldn’t matter where it was; it’s not going to create a delay. Technology-wise, the 911 (dispatch) can be anywhere. People just need to understand the mobility of what we’ve got.”
Miller said when 911 was first organized, the commissioners appointed a technical advisory committee and laid out what was supposed to take place. The technical advisory committee is supposed to advise the commissioners of 911 issues. They had not met for two years until this year, Whiston said. The new proposal requires the contractor to provide a full time EMS Director and Communications Director who is managed by the contractor and reports to the county commissioners. The commissioners will establish an Independent Advisory Committee for EMS and 911 comprised of multidiscipline community leaders. Meetings will be held quarterly to review predetermined performance benchmarks established by the commissioners.
Rumor and speculation has been abundant and increasing on social media sites online about the possibilities and consequences of changing what many emergency personnel feel already works just fine.
“Our current EMS service cannot adapt to the requirements in the RFP, because they do not receive enough funding,” said a Morrow County Public Safety Officer (PSO) in a telephone interview Saturday. “A big corporation can afford to take a loss for three or four years then go to the commissioners and say, we cannot [operate] on just tax dollars.’ People will not want levy money to go to a big company.”
The PSO said EMS personnel work very closely with firefighters in the county and feels the camaraderie and years of experience working together will be lost in the interest of money.
“The focus will fall on who will pay rather than patient response,” he said. Noting what would be required to relocate and build new station houses, he said, “A feasibility study was not done. This is so haphazard, it’s unjustified and baseless. To make an informed decision that will affect 35,000 residents, [the commissioners] have blatantly refused to speak to the medical individuals in this county to explain or share the total picture so [they] are better informed in this decision.”
“We have open meetings,” Whiston said. “If people have questions, contact us! The fear I have is the half truths and innuendos and misinformation that’s out there - I have concerns about complete untruths people are stating. If people truly have the best interest of the county and people who are doing the great work that they do at heart, the people that are saying these things should hesitate before they do. It’s not only attacking us, it’s affecting the [emergency repsonders’] ability to do their job and their credibility. If people have questions they need to ask us - that’s the forum they need to have. I get concerned when people have discussion and complain about the commissioners - but they don’t talk to the commissioners. It’s easy to talk behind someone’s back - it’s different when you have to face them. Let’s have a transparent discussion - honestly is always going to prevail.”
The issue of ‘honestly’ surfaced recently when the commissioners learned the Morrow County EMS surrendered their certificate of accreditation in March of 2012 after an investigation by the Ohio Department of Public Safety (ODPS) determined applications were submitted in May 2011 for EMT certification for people who had not successfully passed the certification examination. The result was Morrow County EMS could no longer operate training programs for first responders, EMT-basics and EMT-intermediate accreditations.
“In early 2011 we had a change of training coordinators, the incoming training coordinator felt there were some issues with the paperwork and we requested some assistance from the ODPS EMS division,” said Morrow County EMS Chief Jeff Sparks. “We did this knowing full well of the consequences, but it was the right thing to do. There were flaws and deficiencies that were discovered at that time. These issues are spelled out in the ruling from ODPS. We knew that this was going to affect our initial training program. This program was used to train new Basic EMT’s and to train Basic EMT’s to the EMT Intermediate level. We had several discussions with the ODPS EMS training division and knew these infractions could not be rectified. We entered into the agreement with ODPS so that we could reapply and provide continuing education to our employees. Continuing education is a vital part of the EMS world.”
The ODPS decision stated Morrow County EMS could not apply for reinstatement for a year and, if they applied after that, the case would be reopened. The commissioners implied they were not aware of the loss of accreditation and Sparks told an interviewer that EMS did not inform the commissioners about revocation of its training certificate because “I guess it was never part of the contract. Maybe it was just an oversight on our part.”
The commissioners do not agree.
“Just because something is not in the contract, doesn’t mean it’s not something you should be made aware of,” Whiston contends. “A contract can’t cover all areas of something. Just as we have knowledge now of that, that’s something the public should be made aware of. The fact they had knowledge of it and didn’t feel it was something we need to be aware of concerns me from the standpoint of their ability from a management standpoint to determine what we should and shouldn’t know. If they didn’t think that was an issue we needed to know, what else might be in there that’s not something they need to discuss with us?”
“The Morrow County Firefighters and Squadmans Association Board of Directors was aware of the situation,” Sparks responded. “The training coordinator advised them of any new developments as this process played out. We did not advise the commissioners of this in person, however, they were notified of this via the Morrow County Firefighters and Squadmans Association board reports. These reports have the training reports in them, which show all the discussions surrounding these sanctions. There were thirteen (13) total reports emailed to the Commissioners from March 2011 to August 2012. These reports were emailed to the Morrow County Commissioners using the email given to us, firstname.lastname@example.org. The initial training site was not part of our contracted services. These infractions had no negative effects on our EMS service nor did they have any negative effects on the public that we serve.”
“The notion ‘oh it’s just an oversight on our part’ from a health profession standpoint: your accreditation is everything,” Whiston maintained. “It may not be their accreditation to respond, but it’s no different than a nurse or doctor or pharmacist - if they’re not accredited, they can’t continue to practice.”
“This accreditation issue with two employees working without proper credentials, that’s akin to practicing medicine without a license,” said Miller.
Whiston said the commissioners were not the ones who brought up the accreditation issue and discussed it with legal counsel before they decided it was an issue.
“From my standpoint, yes, I do want people in Morrow County to know those things if there are errors or omissions,” Whiston added. “Is it an issue that should be discussed? Surely. It would be like if we have physicians on call and they weren’t licensed. I think that would be something the general public would want to know, or that we should know.”
Sparks said Morrow County EMS has continued to provide all employees with continuing education during and after the sanctions.
“MCEMS utilized several outside resources, as we continue to use these resources today as well as our own instructors,” he explained. “We have used outside resources to train EMS personnel to higher levels of training, just recently we sent three EMT basics to Knox County JVS for EMT intermediate training. There are several initial training sites surrounding Morrow County that provide excellent training. Many EMS agencies throughout Ohio use outside resources for initial training, as well as continuing education training, this is not unique to MCEMS. These infractions may have actually had positive effects on our services, as we used outside instructors which has brought new faces and new information to our personnel. I want the readers to be assured, Morrow County EMS personnel are highly trained and certified. Our personnel are always dedicated to the citizens of Morrow County and those who travel through our county.”
“From the standpoint of the service we have, we’re fortunate,” said Whiston. “We do have dedicated people that are doing it [now]. Ideally, would it be best to just continue doing that and improve what we have? Yes - that would be my hope. There is speculation that we want someone else to come in and do this: that couldn’t be farther from the truth.”
“Whatever entity runs this thing, whether it be the existing people or not, the education standards and their ability to demonstrate they have taken their continuing education and are qualified to do the task to the level of their licensing is always going to be there in a responsible organization,” Whiston stated. “This is important and affects a lot of people, so we want to go slowly. We’re not trying to do something under the table or behind closed doors. We want this to be open so people can know what things are.”
“On April 9 we’ll see what the market is and what is possible,” Miller said. “Then, whoever has the most of those things we want in their proposal and can demonstrate they’re the most responsible and reliable bidder with the lowest and best price is who will be selected.”
“The hope that I see is, as we get these bids, that we can then work with those qualified vendors to develop a contract so we can then explain to people, ‘here’s the services we want to buy. Here’s the best way we think to do that and here’s what it’s going to cost us when we put the levy on,’” Whiston stated. “Hopefully we have all this ready so when we go to put the levy on in the fall, we’ll be able to educate people and people will be support of that.”
* A Michigan-based company held a pre-bid meeting with the commissioners this month.