Commissioners respond to letter, clarify misconceptions about future of county EMS

Commissioners respond to letter, clarify misconceptions about future of county EMS

[Tiffin, Ohio – April 15, 2021] – On April 1st, we received a letter from Rick and Dorothy Bouillon, of Alvada, related to the future of Seneca County EMS. We’d like to thank them for their correspondence, as we always enjoy engaging with constituents. The letter raised some solid points, but we also believe there is a disconnect on some matters. During Thursday’s board meeting, Commissioner Mike Kerschner suggested the initial letter and the board response be published online.

“Anyone that has any questions can call us,” Kerschner said. “I think there are some misconceptions out there as it relates to the direction we are trying to take EMS across the county. There are also some concerns that are valid … We want to answer those questions as professionally and transparently as possible.”

To read the initial letter, please click this link. Our response is here, and also below. 

April 15, 2021

Dear Mr. and Mrs. Bouillon,

Thank you for reaching out to our office, we always look forward to engaging with constituents. After reading your letter, we thought you raised some solid points, but we also believe there is a disconnect on some of these matters. In this letter, we will attempt to provide some clarification.

The future of emergency medical services in our county is an issue that we have each identified as one of utmost importance. We feel it is paramount that we begin planning now to make our system more sustainable in the long term. In 2014, Seneca County EMS boasted 140 volunteers. At the end of last year, that number had dwindled to about 74. Among those 74, about 40 were actively making runs across the five joint ambulance districts in the county. These statistics are a sobering reminder of a truth that is not exclusive to our county: for a myriad of reasons, volunteerism is fading across the nation.

Since the beginning of these discussions about the future of EMS in the county, our goal has been simple: to do what is in the best interest of the taxpayers by providing quick and professional pre-hospital care to all people in our service area. We know that our volunteers are doing an incredible job to get that done, but if you spend some time talking to some of them, you get the sense that their backs are beginning to break from carrying such a massive responsibility for so long. Even though they may not want to admit it, we as a community are not only asking for them to make major sacrifices, but we need them to make them because our health and safety depend on it. We’ve heard stories of volunteers missing out on family functions, time with their loved ones and even delaying medical procedures to make sure they could keep the squad in service.

Make no mistake, these folks are getting the job done, and every county citizen owes them a debt of gratitude for saving not only taxpayer money but for saving the lives of our neighbors. Our question though is not about today, but about the future. When our children or grandchildren call 9-1-1 in rural Seneca County, will we have built a system to make sure that their lives are protected?

We believe we can do that right now, without increasing taxes on anyone within the system. The only way we can accomplish this goal, however, is to have complete cooperation and teamwork between the county and our joint ambulance districts. We must rise above the petty squabbles for power and control and recognize that there is much more that unites us than divides us. The day when we can look at the system we’ve built together as Seneca County EMS, and not just Bascom, or NBS, or AVR, etc… is the day that we can finally do right by our taxpayers. We all want the same thing, to provide adequate pre-hospital care in a quick and timely fashion to all who need it in our service area.

According to information from the Seneca County and Sandusky County Auditor’s offices, nearly $1.1 million is generated annually by levies in Seneca County townships, villages and joint ambulance districts for emergency medical services. By law, this funding MUST be used to provide ambulance services. According to the same set of data, between the five joint ambulance districts alone, about $1.2 million sat in carryover entering 2021.

The county has also provided $320,000 annually to Seneca County EMS to make sure vehicles, equipment and training are up to par. This year, the commissioners agreed to add another $300,000 to its EMS funding to help bridge the way to some paid personnel to improve out-of-service times that have increased due to the lack of available volunteer personnel over the past few months.

Given all of this information, by just being more efficient with levy funding and by using the tax money that our voters already agreed MUST be used for EMS, we could improve our EMS system by leaps and bounds without increasing taxes or asking any township, village or joint ambulance district to use any discretionary funding. We just have to maximize the resources we do have to assist the volunteers and to set ourselves up for long-term sustainability. We are better when we work together, and if we maximize our existing resources, we can improve service without increasing the burden on taxpayers or local governmental entities.

The rest of this letter will serve as a response to some of the specific claims made in your letter

1. “We strongly oppose a countywide paid EMS system.”

* We appreciate hearing your opinion on this. Our Emergency Services Director Ken Majors has said time and time again that the NBS district is in great shape and could likely continue to function successfully with just volunteers for decades. We are happy to hear that you are satisfied with the service you receive, but we want to clarify a point you make about voting to pay your volunteers a stipend. In the NBS district, as of Jan. 1, 2021, there was a carryover balance of $344,535.95. The district also is projected to receive an additional $149,905 in levy funding this year. At a $3.50 stipend for two positions for the entire year, the cost would be about $61,320. That would be if the district was in service 100 percent of the time. NBS is not the only district in this position, as each joint ambulance district has a higher carryover figure than what they generate in one year. As a board trying to represent all Seneca County taxpayers, this financial situation is concerning. The voters approved a levy to provide EMS services within this county, but funds are accumulating and not being used to work toward improving the system of which NBS is a part.

2. “Hiring an EMS service is bad news.”

* In this portion of the letter you mention the situation in Green Springs/Adams/Pleasant area. I think we agree, generally, on how private ambulance services hook communities with a low price at first, then have a blank check once competitors/volunteers/infrastructure fades in the following years. If you followed the discussion about five years ago, our EMS director and the commissioners mentioned some of these exact same things. Given all this, we can’t change the past and we still have some responsibility to try to facilitate EMS service to all Seneca County residents who aren’t covered by another EMS agency. Given that, it is a tricky situation for our neighbors in the northern part of the county and we are attempting to exhaust all options to come to a decision that makes sense for everyone.

We also think we need to clarify, at no point has the county considered contracting with a private ambulance service to run EMS. We’d like to expand upon our current system that has been built by volunteers over the past 40+ years, by augmenting those folks with some paid squads. We would much prefer to build and own our system, as opposed to paying a private company from outside of the community to “rent.” We are not talking about going to an entirely paid system, we are proposing that we become more efficient with the current resources we have, thus taking some of the load off of our volunteers while improving our system. Each district is in a different position and we recognize that and want to offer up solutions that work for everyone.

3. “This would be a raw deal for Seneca County residents. A few stations is not enough to cover Seneca County.”

* In the scenario we are laying out, in which we add paid personnel into the mix to assist the volunteers, there would be no tangible effect on taxpayers financially or operationally for the foreseeable future. The coffers of each ambulance district, along with an increased commitment from the county’s General Fund could pay for these employees. Although it is an option to consolidate the number of active ambulances at a given time, we would still be able to respond with volunteers from other areas, outside of the areas where paid personnel are sitting on station. It would not be much different from how it is now when at times, only two or three ambulances are in service.

4. “When there is an emergency it’s much more comforting to have people you know come to your aide and into your home than strangers who are strictly employees of an EMS service.”

* The first two people we hired as full-time EMS employees live in the area, and one of them has volunteered for Seneca County EMS for about 30 years. We agree that “neighbor helping neighbor” is part of what makes our EMS system as good as it can be. This is why, no matter what we do, we will never turn our backs on volunteers. We are fortunate to have them, and we would like to pay them to become employees if they are willing.

5. “Volunteers have a passion for what they do and sincerely care about the service they provide and community members they serve.”

* We agree and from years of working closely with these volunteers, can confirm that their selfless spirits are second-to-none. We do take exception to your line of thought in some ways though because professionals who “don’t feel committed but will be there for the paycheck” will be held to very high standards. If they don’t meet the standards of Seneca County EMS, we will find someone else that will. If a volunteer doesn’t feel like working that day, they aren’t obligated to show up, and that’s where we run into issues that tax our system. This may not seem like a major problem today, but if current trends hold up and volunteer numbers continue to fall, what do we do if a volunteer doesn’t have another volunteer to call to ask if they can cover their shift? Accountability is important, we must be accountable to the thousands of citizens who have voted and agreed to help fund our system with their hard-earned money.

6. We feel that some people get caught up in the idea that a paramedic will provide a higher level of service.

* We also agree with you on this notion. Being a paramedic is just indicative of the level of training you have received, it doesn’t mean that you are going to provide better service than an EMT-Basic or an EMT-Advanced. We must consider, however, that there are some complex procedures a paramedic is certified to do that EMTs cannot, such as inserting IV lines, administering drugs and applying pacemakers. EMTs also can provide more medical procedures than Emergency Medical Responders from the fire departments. Stating this is not meant to belittle any of these folks, as they all have a pivotal role to play to make the system work.

In this paragraph, you mention that patients will get to a trauma center faster with the volunteer system. We believe this is a false equivalency. This isn’t a question of volunteer vs paid, it’s a question of how can we use both to do a better job than we are doing today. Ambulances would not be further away in this case, and because our paid personnel would hypothetically be sitting on-station, it may decrease our response time and help us to get the patient to a hospital quicker, if necessary. Maybe on some calls, a volunteer would be first to the scene and would then meet with a paid crew, this is a good situation, not a bad one.

We also feel it necessary to clarify that we aren’t solely hiring paramedics, we are hiring at every level. The Seneca County ECHO Unit is also still a factor, which is an experienced paramedic that provides field leadership on nearly every call.

7. We feel the commissioners are showing very little respect for the great volunteers we have in Seneca County. You could do a much better service by promoting the volunteer service by sponsoring information nights and recognize those who do give of their time instead of talking them down and promoting paramedics.

*We sincerely hope that this is not how people perceive our actions. We have an indescribable amount of respect for what the volunteers do and have done for this community. If they walked away, it would cost millions to replace what they do. Not only this, they’ve literally saved lives and the quality of life of thousands of people over the past 40+ years. We make many attempts to promote them and to try to find ways to recruit new volunteers. As part of our contract with the joint ambulance districts, it has been their chief responsibility to find personnel, while we would be responsible for many other functions necessary to successfully run an EMS agency. Within that contract, it states that the districts must keep an ambulance in service 24/7. All of the districts are currently failing to meet this contractual obligation due to a lack of personnel.

Also, we must clarify that some of our volunteers ARE paramedics. We never want to talk down on volunteers, and hope to find a way to allow them to do what they love, but to relieve them of some of their responsibility so they can have a higher quality of life. These people never complain, and they give and they give until they bleed, we just think it’s time we came together to try and give back to them for once. Especially given the fact that there is funding available and we have a board of commissioners that’s made this a major priority. There’s no guarantee that these great people are going to continue to volunteer forever, and it’s important we have a plan in place to maximize our resources to provide the best possible service to our residents today, and for the long-term future.

8. It’s time the commissioners get behind the volunteer squads instead of degrading them! We take public safety seriously and we feel the commissioners are not looking out for the best for our County when they are considering hiring a County wide service.

* We ARE fully behind the volunteer squads and will do anything we can to support them. Unfortunately, the data is showing us that we may not be able to rely on just volunteers forever. Things are changing and frankly, it’s unfair to ask about 40 people to do so much for so little. The funding is available at the township/joint ambulance district level and the commissioners are willing to continue to partner financially to be able to provide assistance to volunteers via paid personnel. We don’t yet know exactly what that looks like, but with teamwork, we can take what we have and do a better job at no additional short-term burden to our taxpayers. At a later time, we may need to ask for more financial assistance from taxpayers, but for the foreseeable future, our interest is in working together to see how much improvement we can get by better utilizing what is available to us now.

9. “Please think outside the box. Our suggestion is providing the funding to each township individually to choose how they want to proceed…”

* We are certainly attempting to think outside the box. We’ve also done our best to open the lines of communication to others in the community to come forward with creative ideas for the future. Ambulance service is not statutorily required to be provided by counties or townships, according to Ohio law, but this board of commissioners has made it a priority to do the best we can with what we have available to us. Over the past 40 years, millions of dollars have been provided out of the county’s General Fund to help fund the county’s EMS system. We believe it is a joint responsibility of the ambulance districts and the county together to find a way to provide the best service we can to our people.

We have no interest in replacing volunteers, but we want to find a way to increase their longevity and prevent them from burning out. For more than 40 years the volunteers have provided a great service to our community, through better maximizing our resources and assisting them we hope to prolong the use of volunteers long into the future, while also making sure their sacrifices were not for nothing. We can do this by using their contributions as a foundation to build something that is here for the long haul, something they are proud of and something that accomplishes our mutual goal of sustainably providing adequate ambulance service to our community. If we do this, we can cement a future in which our children and grandchildren don’t have to worry about their health and safety when they pick up the phone and dial 9-1-1 in rural Seneca County.

Sincerely,

The Seneca County Board of Commissioners