Ambulance Q&A
Published 10:49 pm Thursday, December 6, 2007
By Staff
Over the last year the Dowagiac Volunteer Fire Department and Ambulance Service has been working diligently to find a cost-effective way to continue to deliver its traditionally excellent service.
In the final analysis, it concluded that its clientele would be best served by turning that service responsibility over to a different provider that not only had the necessary emergency medical skills but also the professional management skills need to successfully run an ambulance service.
The service area of the Dowagiac Volunteer Fire Department and Ambulance Service (DVFDAS) had consisted of the City of Dowagiac, all of Wayne Township, the southern portion of Silver Creek Township, the northern portion of Pokagon Township and a portion of both Volinia and LaGrange townships.
When the DVFDAS made the decision to cease operations, the six governmental units it serviced decided to create a consortium for the purpose of mutually selecting an ambulance service to meet their needs.
To fill the interim period between the demise of the DVFDAS and the selection of a permanent provider, the DVFDAS contracted with Life EMS, a private for-profit provider based in Grand Rapids.
Last summer this six-member consortium sent out a request for proposal for ambulance service to nine different providers.
In that request for proposal, a number of conditions were noted.
One of those conditions was that the service be provided at no additional charge beyond the cost of the actual ambulance service when a run or a transfer is made.
Of the nine ambulance services contacted for a proposal, the only one to meet all of the conditions was Coloma Emergency Medical Service (CEMS), based in Coloma.
Over the last several weeks a three-member subcommittee, consisting of a representative from Pokagon, Silver Creek and Wayne townships, conducted an extensive review of CEMS.
Based upon their complete satisfaction with the results of their review, they recently recommended to the full consortium that they enter into a contract with Coloma Emergency Medical Service to provide ambulance service.
With this recommendation in hand, Dowagiac city staff and elected officials turned to the task of verifying the findings of the subcommittee and satisfying themselves that CEMS was an appropriate choice for all involved, including those in need of the service and those working for the service.
The questions that follow are those asked by the city staff and officials along with the answers that were received.
Will Coloma Emergency Medical Service (CEMS) have to travel with its ambulances all the way from Coloma to serve the residents of Dowagiac?
No, it will not. CEMS will be based in Dowagiac similar to the existing service.
Will CEMS personnel know the locations/addresses around Dowagiac?
CEMS personnel have been serving Dowagiac and Cass County for nearly 10 years in providing wheelchair transports and transfers from Borgess-Lee Memorial Hospital and are familiar with the area.
Also, CEMS will be encouraging applications for employment with CEMS from Dowagiac's current ambulance personnel.
How long has Coloma Emergency Medical Service (CEMS) been in business?
Forty-one years.
Is CEMS financially stable?
Yes. The city's finance director has examined its finances in some considerable detail and feels it is very financially stable.
Since there is no local subsidy being provided, will user rates increase?
Coloma will charge the same rates it currently charges its other service areas.
Would CEMS hire current local ambulance personnel or would it provide its own ambulance personnel?
CEMS's first preference is to hire existing personnel. Obviously, if there were not enough qualified local candidates to adequately staff the service, then other qualified people would be hired.
What is the length of the contract?
Three years.
What are Coloma's pay rates? Are they less than current rates of pay?
The starting pay rates for CEMS, the current service (Life EMS) and base wages for the former Dowagiac Volunteer Fire Department and Ambulance Service are shown below for 2007:
CEMS – critical care paramedic, $41,860; paramedic, $36,400; specialist EMT, $27,456; and basic EMT, $26,936.
Life EMS (A) as of Feb. 27, 2007 – CC paramedic, $32,176; paramedic, $31,426; specialist EMT, $28,679; and basic EMT, $21,112.
DVFDAS – CC paramedic, $29,808; paramedic, $27,600; specialist EMT, $26,994; and basic EMT, $21,112.
(A) Length of service, performance and annual bonuses as follows: critical care paramedics, $750 annually; length of service, eight years, $275 annually; length of service, nine years, $550 annually; length of service, 10 years, $825 annually; and length of service, 11+ yrs, $1,100.
What areas does CEMS currently service?
CEMS currently serves Coloma Township, Hagar Township, Gobles Village, Pine Grove Township, Bloomingdale Township, City of Coloma, Bangor Village, Bangor Township, Columbia Township, Arlington Township and Bainbridge Township.
Dowagiac contacted each of these governmental units and asked them to rate CEMS's performance on a variety of criteria.
These criteria were scored on a scale of 1-10 with 10 being the highest.
Scores averaged 9.36.
Overall comments ranged from very good to excellent.
No negative comments were expressed.
How many ambulances would be assigned to our area?
The current ambulance company provides two ambulances (one full- and one part-time) for a total of 252 unit hours per week.
These units service the city and portions of the five neighboring townships.
CEMS will provide two full-time ambulances for the same area of coverage for a total of 336 unit hours per week – a 33-percent increase each day over the current coverage in actual ambulance hours serving the coverage area.
Will the city have to build and pay for a structure to house the CEMS ambulance/personnel?
The city offered space in the fire station that is in use by the current ambulance provider.
CEMS would eventually like to build a new station in the Dowagiac area that would house not only ambulances, but also its wheelchair support vans.
This structure would provide sleeping quarters as well as areas for their support and administrative staff.
This building would be used as a major CEMS activity hub for the Dowagiac area and Cass County, thus bringing additional jobs and activity to our area.
Where will CEMS ambulances be located in the service area?
One unit will be in Dowagiac and the other will be in Wayne Township.
Whenever the Dowagiac-based unit responds to a call outside of the city, another unit will be positioned centrally within the service area so we are not left without an ambulance.
How many persons would CEMS employ?
The current service employs 10 people.
Since CEMS is proposing to add additional ambulance hours in the coverage area, additional employees will need to be hired to cover the hours.
What response time can we expect?
By contract, CEMS has agreed to a nine-minute response time.
In the agreement, CEMS states it will provide educational services to the community including CPR (cardio-pulmonary resuscitation) and Medical First Response AED training. Will they charge for this service?
No, Coloma will not charge for training.
Are there penalties for failure to meet contractual obligations?
The proposed contract contains a clause that allows either party to terminate the contract by providing written notice of intent within 90 days of the proposed termination.
The contract may be terminated with 30 days notice if the consortium believes a material breach of contract has occurred or if the ambulance provider loses any license or certification as required by the contract.
If CEMS is going to provide the same or better services at significantly less money than other competing services, how does it do it? As we all now, you can't expect something for nothing.
CEMS is extremely diversified, with a variety of revenue streams – wheelchair transportation, emergency and non-emergency ambulance transportation, community membership programs and technology initiatives.
Coloma does not duplicate the 911 system, it relies on the county 911 system to dispatch ambulances to emergency calls.
Most of its administrative personnel are licensed to work on the ambulances.
As a non-profit community ambulance service, CEMS is not comfortable imposing a tax subsidy "because that is what the market will bear" when it knows user fees will support the operation in Dowagiac.
CEMS has grown by providing outstanding customer service to patients, hospitals and government units it serves.