Hospital exploring future of EMS
Alexis Barker
NLJ News Editor
The Weston County Health Services board of trustees voted on Feb. 18 to allow administration to hire consultants to set up emergency medical services for one year. The vote followed a lengthy discussion with representatives from the board, the Weston County commissioners, Newcastle City Council, and emergency responders from various counties in the state. The board of trustees also held an executive session before the vote.
During the discussion, members of the hospital board voiced several concerns, many of which focused on the services provided, the costs associated with providing the service, employment needs and revenue.
“All of that information seems to be inexplicably withheld,” said Lanny Reimer, a doctor and member of the board. “I think we need
that explained.”
Reimer was referring to minutes from a committee meeting held the previous week, with representatives from Newcastle, Upton, Weston County and the hospital present.
According to Connie James, chair of the WCHS board of trustees, the committee was formed to look at the feasibility of having hospital or government-run ambulance services. The present ambulance and EMS service is owned by Roger Hespe, who will be retiring in June. The group had previously discussed the most feasible route to providing the service after Hespe retires.
“We talked about financing, although it was not the full scope of how much it would cost. I agree with Lanny. … We don’t have any numbers; feasibility is a biggie,” James said. “It was recommended that the hospital house the money and be responsible for it. We don’t have numbers, and we don’t have commitment about who will be responsible for what, but we do have a general consensus that there is a desire to have commitment from all of the entities. How much that is, I don’t know.”
According to Mayor Pam Gualtieri, Hespe was not very forthcoming about costs associated with purchasing and operating the Newcastle Ambulance Service. James said that he wanted earnest money.
Hespe, however, said that he has had very little contact with any of those involved in the conversation and that he would have shared numbers with prospective buyers who signed a confidentiality agreement. Earnest money would not have been needed until a price for the purchase was established between the two entities, he said.
Purchasing an ambulance service that is already established may not be the way to go, according to Phillip Franklin, Cody Regional Health EMS director, and Luke Sypherd, Washakie County Ambulance Service director. Both men attended the meeting via Zoom and provided insight into starting an EMS service.
Franklin told the board that he has worked in hospital-based EMS services for 12 years and that the venture can be successful. Both said that they would need more data on patient mix, types of calls and the types of payment before they could properly give recommendations on how to structure and budget for the service.
“The key is that you guys drill down to get the right fit for Weston County. I think where things are going in EMS, hospital-based services are going to be the way to go,” Franklin said. “Someone needs to take ownership of the service, and it is definitely doable. You can make money with it, but leadership is key.”
Both Franklin and Sypherd said that a hospital-based system has several benefits, including streamlining services and billing, as well as guaranteeing that the facility sees as many patients as possible, and the ability to utilize EMS staff in other departments when feasible.
“When you talk about EMS, there are a lot of layers,” Franklin said.
“I commend the hospital board for addressing the EMS service and not just looking for a private business to take it over. If you build from within the county, you create careers, excitement and community support,” Sypherd said. “It sounds daunting, but the benefits are enormous.”
Warren Shaulis, an ER provider and part of the Crook County Medical Services District, agreed that, in his opinion, hospital-based EMS services are the way to go. He noted that the setup allows for the providers and clinicians to work more directly with the EMS staff and for the EMS staff to be integrated into the hospital.
“There are lots of learning opportunities
and the staff understands each other better,” Shaulis said. “It does need to be approached carefully, though.”
According to Shaulis, the costs of equipping and staffing an ambulance varies from $500,000 to $1.2 million a year, depending on whether the truck provides basic services, intermediate care or if paramedics are employed.
As for purchasing the equipment, all three men suggested that the hospital avoid purchasing used equipment and/or trucks because their history is unknown. While starting from scratch may seem like the more expensive option, all three men said that, in the long run, the hospital, city or county could expect to spend less money if starting from scratch.
Shaulis advised that support from surrounding communities should be sought because memorandums of understanding to provide service to surrounding communities could lessen the costs for Weston County. He noted that it is also important to be aware of the staff available.
“An ambulance is just a fancy U-Haul; it is the people that make it work. You can’t do anything without the people,” Sypherd added. “You can utilize nontransport EMS personnel in places like Osage and Upton (to) stabilize until an ambulance arrives. You guys are working on a countywide system. You have the unique opportunity to do it right the first time. To have the right equipment in the right place and save money.”