Updates on staffing and equipment availability at Bradley County’s ambulance service resulted in a decision to keep more ambulances in the county at all times.
Shawn Fairbanks, director of Bradley County Emergency Medical Service, gave updates Wednesday to the Bradley County Commission's Emergency Services Committee.
"We are one person away from being staffed according to our budget means," Fairbanks said, noting new employees get a $5,000 sign-on bonus, per approval of funding from the county commission earlier this year.
Committee Chairman Mike Hughes asked if the bonus has helped with staffing.
"I think it's more of a pleasant surprise," Bradley County EMS Operations Manager Eric Blach said, adding not all applicants are aware of the bonus incentive.
Hughes said he had hoped they would pull from private companies.
Blach said he understands that sentiment, noting the EMS industry "is failing fast" due to a lack of applicants.
"It's a stressful job," Fairbanks said, adding it is also "crazy busy" right now.
Also, people going to school see they can go into other fields, like nursing, and make more money. Fairbanks noted schools are not seeing enrollment in EMS courses.
"When Shawn and I went to paramedic school it was competitive," Blach said.
Commissioner Thomas Crye asked about the starting salary for EMS. Fairbanks said it is about $40,000. AEMT's make $16.50 per hour, paramedics make $17.50 per hour, and critical care paramedics make $18.50 per hour.
"There's a disconnect in there somewhere," Crye said.
Fairbanks said there is an open spot for a paramedic, noting he has to maintain the ratio between EMTs and paramedics.
"If we can get them from the schools, we can usually retain them," he said. "There's not a heart of stewardship anymore to take care of folks" because people are more concerned about earning more money.
"It's a national problem," Blach said.
Fairbanks said Bradley County EMS has eight ambulances in the service rotation, fully staffed.
"If I don't have ambulances on the road, that hurts," Fairbanks said.
Commissioner Howard Thompson asked if the ambulance service is still busy. Fairbanks said it is and they sometimes run out of ambulances, but so do other services.
Fairbanks said the rule in place now is that two ambulances have to stay in Bradley County to handle calls. He added he would like to change that rule, so that more ambulances are available locally, if needed.
"I need something in place … where I say we only take three ambulances to Chattanooga," he said.
A major reason for ambulances to leave Bradley County is because there are transport calls to Erlanger Health Systems and CHI Memorial Hospital.
"We have a hospital here, too," Fairbanks said. “I think three ambulances should be the max we (allow to go to Chattanooga) before we start doing critical stuff.”
Fairbanks added Tennova Healthcare-Cleveland is a controlled environment with medical care; patients can be transported there and stabilized until they can be transferred, if needed.
Fairbanks said he wanted the commissioners to understand the need and reasoning behind his decision, before they start getting calls from people “sitting there smoking a cigarette with their bags packed, ready to go (to the hospital)” and upset their transport is not the top priority.
“... They’re a little spoiled because we’ve always done it,” Fairbanks said of transport requests.
Crye said he thinks the ambulance service does “a remarkable job,” and he supports Fairbanks making the decisions he believes are appropriate.
Thompson agreed, but said it seems like buying and staffing another ambulance may be in order.
Blach said when Bradley County EMS went to 12-hour shifts, eight ambulances went into service.
“We do have more trucks on the road than we used to,” Blach said.
Thompson said he believes another ambulance could “just about pay for itself.”
Fairbanks said it is easy to buy an ambulance, but harder to find personnel to operate it. He added the ambulance service is trying to get people to “definitive care” but also needs to keep ambulances in Bradley County, for true emergencies.
“I need to have some say-so,” Fairbanks said, adding he wants the commissioners to understand he is trying to keep ambulances in Bradley County, but “if they need to go (to Chattanooga) we’re taking them.
County Mayor D. Gary Davis noted the purpose of the ambulance service is to provide services to the people of Bradley County.
“We’re not a taxi service,” he said, adding Bradley County EMS always follows its protocol for treatment. “We’re going to take them where they need to go …”
Thompson suggested they need to look into options because “the county’s growing.”
Davis said that is true, but if they don’t limit the number of ambulances that can transport to Hamilton County at one time, it’s possible all eight ambulances could be outside Bradley County.
“We’ve got to put some limitations on this,” Davis said.
Fairbanks said per capita, Bradley County should have 12 to 14 ambulances on the road to serve its 105,000 to 110,000 residents.
Commissioner Bill Winters asked in the meantime, is there a “step approach” EMS could take. Fairbanks suggested limiting the number of ambulances that can be out of Bradley County at any one time to three; once there are three ambulances outside the county, no non-emergency transports would be made outside the county.
“After three I want to stop being the taxi service,” Fairbanks said. “I just want your blessing.”
Winters reiterated the commissioners have confidence with the decisions Fairbanks makes, to which Chairman Hughes agreed.
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