By Donald Promnitz
The Oskaloosa Herald, Iowa
PELLA, Iowa — Consultants recommended the City of Pella bring on additional staff and equipment to its EMS service, increase pay and end its coverage of rural parts of Marion and Mahaska counties, but with advanced notice.
At Tuesday’s city council meeting, Robert Hall with Iowa EMS Consultants gave a presentation in which he praised the staff, leadership and service of Pella Community Ambulance — in particular mentioning Ambulance Chief Gregg Higginbotham and Assistant Director Justin Smith for commendation — but said there are improvements and needs for the city to address.
Facilities
Hall said the station itself is in good shape, but needs more facilities in the upstairs area where emergency medical technicians and paramedics sleep between calls.
“We had the city council and the mayor down to the station individually, talked to them and introduced them to the people, to the staff and showed them the station. And a few of them even made the comment that if they had to use the restroom in the middle of the night where the bedroom is upstairs, that they probably wouldn’t make it upstairs to the bathroom.”
A large crack on the main floor where the ambulances are housed was another concern.
“The one thing that desperately needs to be attended to in the near future is the ambulance rig floor where the actual apparatus sit. It is cracked, it’s a financial liability to the city for public member trips — it just exposes you guys to litigation,” Hall said. “And there’s substantial cracks in the apparatus floor.”
Pay
Hall also recommended a sizable pay increase for EMS workers. A paramedic in Pella starts at $19.79 an hour, while a critical care paramedic starts $20.79 an hour, but dispatchers make $23.89 an hour. This is despite it taking two years of training to be a paramedic, as opposed to 40 hours to be a dispatcher.
“We know this because one of the paramedics we interviewed — it was her last day in the ambulance division and was moving to the dispatch center — and her sole reason was $3 and some cents an hour more,” Hall said.
Staffing
In order to address personnel issues, Hall recommended the city add 12 more EMS providers to its staff, saying that despite the “sticker shock,” it was necessary for growth and quality of care and would pay off in the long run.
“To hire 12 new employees for a department is unheard of ... But if you start incrementally increasing the employment, get more people on staff, it’s going to lighten the workload of your chief and your EMS chief, which are working a lot of uncompensated hours throughout the calendar year,” he said. “And it’s going to increase your revenue because they’re going to be able to take the ambulance transfers at night from the hospital.”
Coverage Areas
Iowa EMS Consultants also weighed in on the question of service to the Lake Prairie fire district. In a June presentation by City Administrator Mike Nardini, he said roughly two-thirds of calls to the Lake Prairie district are for Medicaid and Medicare patients, with benefits capped at $150 for Medicaid and sometimes at $350 for Medicare, while it costs the city $780 to bring out an ambulance to the area. It additionally spreads an already short staff thinner. Meanwhile, the district does not pay taxes for ambulance coverage.
The outlying district currently consists of the Lake Prairie and Summit townships in Marion County , along with Leighton and the Black Oak and Richland townships in Mahaska County.
Options
There were three main options for the City of Pella to consider:
— Continue providing the same level of ambulance service to the Lake Prairie district as provided to city residents.
— Provide service to the rural entities only if resources are available.
— No longer provide ambulance services to the Lake Prairie district (the least desired option).
Hall said it is in the best interest of the city to cut off services, but to do so only after giving Lake Prairie enough time to work out a deal with another provider.
“Our recommendation is — with proper notice — you stop servicing Lake Prairie Township,” Hall said. “We have a core belief when we started this firm: What’s best for the EMS provider? And what’s best for the taxpayer?
“It feels like a quandary ... to say: ‘Stop servicing a population just outside of your city limits,” Hall added “But that population, at this point, contributes no money to your ambulance service.”
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