Officials continue ambulance talks

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Commissioners vote to pay if they cancel contract

Managing Editor

Editor’s note: The Perry County commissioners discussed at length April 8 a contract under which Perry County Memorial Hospital provides ambulance services to the county. Much of that discussion was reported in Monday’s edition and is continued here. Also reported here is a continuation of those talks that occurred Tuesday at Cannelton High School. The hospital’s board of trustees is scheduled to meet Wednesday and the participants hoped to have details worked out they could agree to.

PERRY COUNTY – Commissioner Tom Hauser works as a paramedic and has largely stayed out of the discussion to avoid a conflict of interest.

“I’ve been trying to put different hats on to separate my roles as … an employee of Perry County Memorial Hospital and as commissioner,” he said at the April 8 meeting, conducted at Perry Central Community School. He has heard some rumors about himself, which he accepts as part of being a public official, but said, “I support Perry County Memorial Hospital to the end. I did when the proposal for the new hospital was made. I tried to make it as clear as possible that I think it is a huge asset to our community and we should support it. I agree with (Commissioner) Randy (Kleaving) that the hospital is the entity that should manage the EMS.”

“Our enemy here is the lack of funding, period,” he continued. “Can we afford to put on another crew? I believe that there’s a solution out there.” Some have been suggested “and I think they need to be explored … I truly believe that we can do this if we all work together.”
He apologized for possibly having “stepped on anybody’s toes” in some things he has said. “I may have brought up some things that looked like I was attacking people. I apologize if that’s … how it was perceived.”

Audience member Fred Weaver asked if the hospital would manage the EMS station at their new facility and the north station.

“Yes,” Hauser answered. “It’s one service.”

People “keep saying it’s for the northern part of the county,” Kleaving said. “It’s for all of Perry County” and ambulances will be dispatched from either location to wherever they’re needed.

The highway-department garage “is in the dead center of the county, which is the ideal place for a second ambulance,” Hauser added. He said previously it was built there intentionally with the ambulance-crew accommodations intended as a future addition. People have offered opinions on whether the primary crew should be at the new hospital or remain in the existing building, he also said, and that’s an issue that should be examined.

“What it all boils down to at the end of the day is we need to … increase our EMS coverage,” he continued, “not the quality but the quantity.”

Joe Stuber, hospital president and CEO, said uncertainty entered discussions about the north station when someone mentioned “alternatives to the hospital running the ambulance station, even the possibility of the county taking it over.”

Kleaving said he made that comment several months ago, and while the number of ambulance runs here wouldn’t be attractive to any company, the commissioners had a duty to consider all alternatives, which included running the service themselves.

“We did not look at anybody else running this,” he added.

As was reported Monday, hospital officials hoped to have the contract signed for five years because they’re spending $500,000 to add an ambulance station at the new hospital under construction along Indiana 237. Kleaving said again, however, “I don’t see a problem with a two-year” contract and suggested it would provide time for both sides to rebuild trust he said had been lost. The two years would be this one and 2015. Hospital board member J.B. Land asked if the commissioners had any plans for the current emergency-medical-service building.

Hauser and Kleaving both said no.

Kleaving said that was among some issues that became the subject of miscommunication, with someone suggesting “we took the building away from the hospital.” When the EMS station was built in approximately 1993, he and Hauser explained, the county borrowed the money from the hospital and repaid it at approximately $19,500 per year. The deed transfer was requested in 2012 after it was paid off, Kleaving said.

“It just fell at the wrong time,” he said, “and rumors got started … and there was miscommunication that we took it away.”

 “We couldn’t build a building like that now,” he noted. “We couldn’t afford it.”

Existing-building options
Hauser added the facility has been discussed with the Perry County Development Corp. Its compliance with the Americans with Disabilities Act makes it attractive, he said, and there’s been talk of different opportunities possibly coming in the near future, but no definite plan has been developed.

“What is the down side of maintaining the current EMS building, staffing the north station and not committing the half-million dollars to the hospital?” Irv Rueger asked from the audience.

“We’re not committing any money to them,” Commissioner Bill Amos replied.

“That was already in the plan” for the new hospital. He added that people in the medical field have told him they like to have their ambulance stations located with hospitals because paramedics are often needed there.

Good to be close
Land added that routine actions such as maintenance, information-technology services, training, providing help in the hospital and daily replenishment of drugs mean “it makes a lot of sense to have them both on the same campus.”

Donna Weaver asked how many emergency medical technicians and ambulances serve the county now.

“We have one primary crew, which is on (duty),” Hauser said. “They work 24-hour shifts and are manning the ambulance. Then there is a ‘call’ crew that when the primary crew goes out of town … has 20 minutes to get to the station to take (any) second call.” Any third emergency would generate a call to a neighboring county for help, he added.

He said 80 to 90 percent of ambulance runs are within the Tell City-Troy Township area, “so naturally that’s where you want your concentration of resources. The flip side of that is you’ve got somebody at Adyeville or the northern stretches of the county – it’s a 35-minute response time. Is that fair to them?”

Enhance vs. change
The proper thing to do, he continued, is enhance the existing service.
“We need the primary crew in Tell City, period. I don’t think there’s any dispute of that,” Hauser said, “and the second crew at the Leopold (north) station (which is) strategically located to get to east, west, north and south (areas of the county) and get to Tell City, probably in 10 minutes or less, depending on traffic. A crew there would serve Tell City, also.”

It comes down to money
From the audience, Sheriff Lee Chestnut asked, “why did this start? What’s the real question? Well, money. We need another crew. Period. Take everything else aside, we need another crew … regardless of where it goes, this started because Perry County needs another crew. We’ve got to stop being reliant on Spencer County and Hancock, because they’re quitting on us.”

The commissioners talked previously about Spencer County canceling an agreement to provide mutual support.

“Where do we find the money?” Chestnut asked, “to answer the question, we need another crew.”

The commissioners should look at all the available options, he added.

Hauser said people have become emotional about the issue, “and quite frankly, that is good news. Emotions got involved because people are passionate.” The county owns four ambulances and “we’ve got some things in place that will be helpful to solve this issue,” he added.

“We’ve got two stations now,” Kleaving added. “We could have three when the hospital builds theirs. We’ve got a lot that other counties would be envious about.”

Pike County faces similar struggles, Hauser said, “but they’re starting from scratch. They don’t have a building, they don’t have the ambulances and they don’t have the staffing. They don’t have anything. We’re fortunate that we have some things we can work with.”

Kleaving offered a motion to correct a mistake that had reduced to two weeks before a contract expiration the notice either side would have to provide for termination. Because it was so far into this year, the commissioners had agreed to extend the contract through 2015, and he included that in his motion. Amos voted in favor of the motion. Hauser abstained, saying because he’s employed by the hospital he didn’t want to do anything that might be seen as a conflict of interest that could “take us backward.”

Agreement, in part
Land said the hospital trustees would support the 90-day component but would have to discuss the commissioners’ refusal to sign a five-year contract.

The contractor building the new hospital was looking for a decision about keeping an ambulance station in the plans, the hospital officials said.

Action needed soon
“We’re under a lot of pressure right now,” Stuber said.

“They may be demobilizing the crew that’s hanging the steel,” Land added. “We don’t want to have to remobilize them to come back in.”

At Tuesday’s meeting in the Cannelton High School cafeteria, Kleaving provided an overview of the situation and explained amendments to the contract the commissioners had adopted. In addition to other changes previously reported, they wanted to add that Perry County’s is entirely a paramedic service, “which it is, but we wanted it in the contract,” he said. He also explained that the service draws enough revenue to nearly cover its costs and reiterated that he thought the hospital should continue to run the service but still couldn’t support a five-year contract.

What he could offer, he continued, was to “put the county on the line” concerning the ambulance station at the new hospital. If the county officials decide within five years not to have the hospital run the service, the county would pay to have the building modified to meet another purpose. The same two commissioners approved a motion to that effect and Hauser abstained again.

Hospital board member Tim Harding was in the audience and said he couldn’t speak for the entire board, but “speaking for myself, I can support it.”

County attorney Chris Goffinet said he would add the change to the contract and provide it to the hospital board in time for their meeting.