EMT policy to be deliberated

by Cat Urbigkit

The Sublette County Rural Health Care District board met last Wednesday night in Daniel to discuss policy and procedure issues, including the emergency medical technician policy the board had voted at its last meeting to enact, but then reversed itself outside the meeting once board members were informally polled.

Board Chairman Walt Bousman, who had been absent from the last meeting, said that after the board adopted the policy, he felt it prudent to re-examine the process used to hire fully compensated EMTs. Bousman pointed out that the original agreement between the Pinedale Emergency Management Service and the district called for the district to hire EMTs to cover the hours of 5 a.m. to 5 p.m. five days a week, while the partially compensated or "volunteer" EMTs would fill the other hours.

Bousman said it was his understanding that the intent behind the policy adopted last week was to try to fill a hole in the schedule with the paid staff.

"That was part of the intent," Board Member Jerry Jensen confirmed.

"As far as the hole in coverage, we have received an application from a qualified EMT to fill in for that," Bousman said.

Bousman continued that the original agreement with the EMTs was for the full-time EMTs to take call four days per week, with the part-time EMTs to work two days per week, with the schedule to be worked out among the EMTs.

Bousman said the new policy, since suspended, mandated the full-time EMTs work five days a week (instead for four), and the part-time EMTs would work three days (instead of two).

The new policy also mandated that the paid Pinedale EMTs stay at the ambulance barn waiting for calls. This idea apparently originated after Dr. Judy Boyle, the Pinedale EMT's medical director, expressed her concerns to the board in an executive session.

Board Member Bill Barney noted that the Big Piney EMTs work in close connection with the Marbleton Clinic, in contrast to the Pinedale arrangement.

"To date, the Pinedale clinic has not expressed a strong interest in such an association," Barney said, adding that he felt that was a detriment.

Board Member Mary Lynn Worl responded that Boyle does not elect to choose to have the Pinedale EMTs work in the same capacity that Dr. David Burnett has done in his clinic. Worl said this difference comes from these medical directors and their differing philosophies.

Pinedale EMT Cori Laster questioned the need for the new policy at last week's meeting.

"I don't see why we're trying to alter something that has worked really well for our community," Laster said.

Jensen explained that he "couldn't see where the board was getting its money's worth" from the EMTs, when the board pays for more hours than the EMTs work. Jensen also said he has heard complaints that the paid EMTs were taking calls instead of allowing the volunteers to sign up.

"Everybody knew right off the bat that this was a pilot program and it was going to change," Jensen said.

As far as the EMTs needing to be at the ambulance barn, Jensen said the sheriff's department has called and needed information, but no one was at the barn, and deliveries couldn't be made either, with no one there to accept them. In addition, Jensen said, "We found out not too long ago, there are things missing" from the ambulance barn, and paid staff based in the barn could keep a better tab on things.

"It has nothing to do with anybody personally," Jensen said. "It's just getting more bang for the buck."

Barney also talked about the need to allow the volunteers sufficient call time. He suggested that the volunteers get first shot at the call sheet, with the paid EMTs getting next priority.

"If you want volunteers to have the skill level and the enthusiasm, they've got to have a chance to play," Barney said. He added that the paid EMTs are there to support the volunteers.

"At the core, we still have to have the volunteers," Barney said. "Without them, it all falls down."

Worl said she hopes the EMTs realize their individual importance to the service, and that the board appreciates the time and effort provided.

Worl said the board has a responsibility to be accountable, and if the board pays for 40 hours, it expects 40 hours of work.

"What we're asking is basically standard," Worl said.

Bousman said the board could increase the tasks required of the EMTs if it is justified, but said he supports the EMTs being within a five-minute time period of the barn, rather than stationed at the barn itself.

Worl responded, "I am not content with that five minutes. You are there so you can respond quickly."

Worl said she certainly wouldn't want to be sitting on the board in the event of a critical accident and not have the policy in place, when "a matter of a few minutes might have made a major difference."

Barney said that the point is that Boyle, as the medical director for PEMS, drew the board's attention to the need to make some changes.

Jensen told the Pinedale EMTs that the board can either dictate what it thinks will work, "or you guys can propose something."

Jensen said, "The way that things have been run in the past, it isn't going to be that way anymore."

Laster said that the EMTs would like to discuss this issue amongst themselves and with Boyle.

Barney, without being critical to anyone in particular, said he's disappointed with the lack of communication on the issue. He said it would be far preferable that Boyle and the EMTs bring a proposal back to the board that addresses the concerns raised.

The board was unanimous in its support of Barney's motion for PEMS to initiate contact with Boyle to resolve the issues between the service and the clinic. The concerns involved coverage, staffing the ambulance barn, backup and response time, the board said. The group is to report back at the board's next meeting.

The policy approved at the last meeting, which was suspended after the meeting, had its implementation delayed until the board hears the report from the EMTs and Boyle, and takes action.

Board Member Garry Eiden was not in attendance at the meeting