Osceola EMS director updates county officials on system status

REED CITY — Osceola County Emergency Medical Services Director Jeremy Beebe needs more data on how to provide the best response time to residents and be cost efficient.

When one of the county’s four ambulances receive an emergency call between 10 a.m. and 10 p.m., system status is put in place, and the three other crews are deployed to strategic locations in the county in hopes of improving response time in case of a second emergency call.

Following more than a month of questions and concerns from county commissioners about the department’s system status plan for the month of December, Beebe met with officials at their Committee of the Whole meeting on Tuesday morning to share what data he had gathered.

“System status only occurs when one of the ambulances goes out on a call during peak times,” he said. “The goal is to redeploy the remaining ambulances so we have better coverage of the area.”

Beebe told officials system status has been used in one way, shape or form in Osceola County since the 1990s.

“The important things with system status are cost and response time,” he said.

Comparing data from December 2016 with December 2014, December 2015, and March, July and October 2016, Beebe said the department spent an additional $875.84 more, with increases in fuel and maintenance, with a 25 percent increase in calls.

“There are quite a few factors that contribute to that cost,” Beebe added. “There was an increase of loaded (when an patient is in an ambulance) miles and an increase in billable calls. That would make sense with an increase in miles.”

Other factors that increased mileage was attendance at an employee potluck, as well as non-typical transfers to Ann Arbor and Detroit, Beebe said.

“Our ambulances were on the road an average of two hours more a day,” he said. “System status is going to contribute to some of that cost. How much of that $875 cost, I couldn’t tell you.”

The director explained that when one ambulance went out on an emergency call, the other three ambulances were on the road as well, and that contributed to the increase in costs.

As far as response time, the department’s en-route time increased because crews were already on the road because they were in system status, Beebe said.

Measured in 5-minute, 10-minute and 15-minute brackets, Beebe said response times for emergency calls remained relatively similar in December 2016 to those other months.

“In my opinion, if you have 25 percent more calls and have the same response time with harsher weather, I consider that a win,” he said. “What did we find out about how this worked? It is to be determined. One month of data with a bunch of contributing factors that we can’t weed out, I couldn’t tell you.

“I don’t think it hurts,” he said. “I still believe it’s helpful. I believe it needs more study, more time. I don’t believe what we’re doing is unreasonable.”

Beebe said a committee comprised of two union employees and a lieutenant have worked on setting the systems status model for January, as well as locations where ambulances will be.

“We’ve change the plan for January, and are trying to keep our coverage in Evart and Reed City because those are our two biggest populations and our biggest call volume areas,” he said. “There will be significantly fewer ambulances out on the road and back at their stations.”

Lakola Medical Control Authority Medical Director Harold Moores, M.D., supports the system status plans. Covering both Lake and Osceola counties, the authority supervises and coordinates an EMS system.

“I think it’s important for safety and service to the community to minimize the transport time,” he said. “Keeping our fastest transport times possible and system status provides that, especially for things like trauma, stroke and heart attacks. Those things are critical when five minutes makes a difference.”

Moores agreed with Beebe in needing more data before making any decisions.

“If we can just do some data studies, and try to do it for six months, to see what kind of transport time, what costs are generated and how much more it is costing us to do this, until we have that absolute data, we can’t make a decision. Just because other agencies do it, we have to do what’s right for our community.”

Larry Emig, Committee of the Whole chair, said he and other officials were more concerned with having the information available to them, and that it comes down to making sure department heads stay within their budget.

“John Q. Citizen would have no idea what’s going on with system status,” he said. “When they call for an ambulance, they want to get to the hospital as soon as possible.”

Beebe said it’s important for officials to remember nothing has been put in place.

“I realize the December plan was not going to be the final plan of moving all the ambulances,” he said. “However, we needed a number to know if we moved all our ambulances how much was that going to cost.

“The important thing to remember is it’s almost impossible to compare month to month in the wintertime for response time, when you look at all those factors in December. I can’t find a month historically, that has the same call volume, same billable miles and same weather, to weed out all those factors to find out which response times are better.

“We’re going to finish system status in January with more data points and will not start it back up until spring, in April and May. There will be a lot more data I can look at and find a month that has comparable factors. Then, we can look at the nitty-gritty of it — the cost and response times — and see what’s better.”