Petoskey News article on BIEMS
Moderator: Gillespie
ESA millage
Throwing money at broken institutions will not fix the problem.
ESA millage
Throwing money at broken institutions will not fix the problem.
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Campbell60tr34@aol.com
- Posts: 409
- Joined: Mon Jun 28, 2010 12:12 pm
Money and Knowledge Are Needed
Beaver Island is facing one of the normal situations that happens in rural areas. There are many stories and even books written about providing EMS in rural areas.
Volunteers usually begin a service in a rural area with many people stepping up to the plate and beginning a service. After finding out the limitations of the basic level service, someone steps up and arranges a higher level of service, and this continues until the highest possible level of Emergency Medical Services are provided. You can read about this happening in the UP of Michigan, rural areas of lower Michigan, and even Alaska. These volunteers want to help their friends and neighbors as well as their visitors.
Eventually, as has happened on the island, something draws the volunteers away. They leave to get more education in the medical field to support their family. They move on in the field that pays the bills because volunteers usually only have about ten years maximum in the field of EMS before they move on.
Here on Beaver Island we followed the same pattern as shown above with one exception. The others have moved on including some of the best providers of EMS in the state; Mike and Bev Russell, Christie VanLooy, and Sarah McCafferty are perfect examples of excellent EMS providers that had to move on, and could not continue to be volunteers. They all had to support their families, and Beaver Island could not or would not provide the financial support to keep them here by employing them.
It is time for the island to step up and be willing to pay for this life saving service. Volunteers cannot continue to be the basis of this needed service. In 2000, this was able to continue by paying someone a small wage, just about enough to keep them from working a summer job for eight hours per day. This was not raised until the beginning of the summer of 2016. Sixteen years without a raise may be part of the issue, but that's not the main problem.
The main problem is that none of the current resident paramedics can make a living doing EMS year round without the income to be made in the summer. Why? Try working for $4.33/hour and see how far ahead that gets you. What happened to wages going up using the cost of living like everywhere else? No change was ever made until it was too late to keep the paid volunteers on the staff.
Pair that with the almost negative flow of insurance payments, and you arrive at the place the island is today. Politics and friendships are seemingly more important than life saving, resident paramedics. We certainly can't pay someone minimum wage for doing this job! We certainly can't have these people developing the policies for transport of emergency patients, can we? After all, they are just volunteers.
Where did this policy and attitude lead us? It put us in a position where the paid volunteer could either violate the protocols of Charlevoix County Medical Control Authority, State of Michigan legislation and Administrative Rules for that legislation, to keep the politicians happy, or move on to something else.
Where are we today? We are paying someone twice minimum wage to visit the island. Was that wage increase offered to the resident paramedics? Absolutely not! It only happened when minimum increases could not keep the resident paramedics from working other jobs during the summer.
So, the result is this. We can step backwards to the year 1988 where the level of care was Basic Life Support, or we can fund employees of Advanced Life Support in the form of paramedics who work year round for professional wages.
The choice is one that the voters will have to make.
No matter how much some on the BIESA and at the BIRHC want us to step backwards twenty-five plus years, the only choice in my mind, as one of those who put thirty years into building a system that works, is to vote yes on the millage and hope that all of that money will not be needed to get the personnel hired and get the equipment back up to the level it was fifteen years ago.
If the system is broken, you need to help improve the broken parts. I don't believe anything is the cause except lack of foresight by the EMS directors in the last ten years and lack of support for needed changes by the governing bodies of the island. Basic Life Support will NOT allow cardiac arrest patients or stroke patients have excellent outcomes, no matter how much you may believe it or want it to happen.
I spent thirty years doing this work because I wanted better outcomes for my friends and neighbors as well as the island visitors. I retired because the powers that be would not resolve the serious issues facing the paramedic in charge, which happened to be me. I know for a fact that some of the most recent patients seen by EMS on this island would not have had positive outcomes if not for an ALS assessment performed on the scene of the emergency by the paramedic in charge. Due to HIPAA, EMS is not allowed to disclose the patients identity, but, rest assured, the patients know how important the ALS assessments and treatments were.
When and if our medical center ever becomes a rural hospital capable of performing definitive treatments for our common emergencies, such as chest pain, stroke-like symptoms, severe trauma, syncope, etc., this might change, but efficient advanced life support treatment and transport is absolutely essential for positive patient outcomes.
If you don't believe me with thirty years of emergency experience on Beaver Island, read any textbook for EMS. FAST and MEND is the most recent catch phrases for Stroke. STEMI protocols are the most recent standard of care for chest pain. On scene time for trauma is now determined as the Platinum Ten Minutes, which puts the "Golden Hour" to shame. All of these talk about definitive care within an hour of onset of symptoms.
Going back to BLS with a stop at the medical center will put EMS back twenty-five or more years, and decreases the standard of care available on the scene of the emergency and increases the arrival time at definitive care by more than one or two hours. If the patient is someone that I care about, then this is NOT an acceptable solution.
What do I know?
I know that Beaver Island ALS should be expanded to include more Critical Care protocols with more specific protocol-driven treatments of emergencies added. I know that failure to do this will result in more of my friends and neighbors leaving this world before that needs to happen. I know that the medical center wants to be the leader in emergency treatment of Beaver Island patients, but, until they are able to provide definitive care at a higher level than they provide now, positive patient outcomes will not increase. Everything I've read about EMS in the last thirty years convinces me, and this is evidence-based, not just the "We can do this" attitude shown by some. The facts are that once any advanced treatments are provided at the medical center, the level of emergency transport must be advanced. That can be verified by reading the "National Scope of Practice" for any level of medical certification or licensing.
No one knows the emergency ALS assessment skills better than a practicing paramedic. No one knows the positive outcomes of this assessment better than a practicing paramedic. So, who do we rely on for gaining this information? Shouldn't the answer be a licensed, practicing paramedic? Shouldn't the visiting practicing paramedic who had just formed and accomplished the organization of an ambulance authority be asked about what a newly formed ESA should do and why and how?
This person came to Beaver Island multiple times and attended the ESA meetings multiple times. Was any of his knowledge even requested?
I'm sure that Jay Peck would be willing to come back and help answer some of these questions. He might even be able to show some insight into how to resolve the paramedic issues here. Or, maybe a couple of EMS agency directors in Charlevoix County could be asked to come and provide some information, so that our local authorities could find out whether their positions are viable and legal and reasonable.
If you were needing information about a plumbing problem, you would not contact a person who specializes in putting on steel roofs and building steel buildings. Why? Because it makes more sense to speak to someone who specializes in the problems that you are encountering.
If you need information about how best to operate an emergency services authority, why wouldn't you call someone who operates an emergency service under an emergency services authority? How does talking to the roofer get your plumbing problem solved? How does talking to the medical center manager and provider resolve the emergency medical issues?
Talk to someone in charge of an EMS service, and you'll find out how to manage an EMS agency. Talk to someone who functions under medical control, and you'll find out how that medical control must work. Talk to someone who operates under an authority in the medical field and not a primary medical provider..
And last, but not least, stop, stop STOP, alienating those that are trying to help resolve the problem. Talk to them instead of ignoring them.
Please vote YES for millage to maintain Advanced Emergency Care for Beaver Island!
This shortage of paramedics has spurred a very creative way of attracting paramedics to some communities. Some are offering $5000 sign on bonuses. Others are offering a $35,000 bonus after five years of service. Some creativity may be necessary to attract paramedics to come here. These are just some examples.
Joe Moore, retired paramedic instructor and emergency provider on Beaver Island for thirty years
Volunteers usually begin a service in a rural area with many people stepping up to the plate and beginning a service. After finding out the limitations of the basic level service, someone steps up and arranges a higher level of service, and this continues until the highest possible level of Emergency Medical Services are provided. You can read about this happening in the UP of Michigan, rural areas of lower Michigan, and even Alaska. These volunteers want to help their friends and neighbors as well as their visitors.
Eventually, as has happened on the island, something draws the volunteers away. They leave to get more education in the medical field to support their family. They move on in the field that pays the bills because volunteers usually only have about ten years maximum in the field of EMS before they move on.
Here on Beaver Island we followed the same pattern as shown above with one exception. The others have moved on including some of the best providers of EMS in the state; Mike and Bev Russell, Christie VanLooy, and Sarah McCafferty are perfect examples of excellent EMS providers that had to move on, and could not continue to be volunteers. They all had to support their families, and Beaver Island could not or would not provide the financial support to keep them here by employing them.
It is time for the island to step up and be willing to pay for this life saving service. Volunteers cannot continue to be the basis of this needed service. In 2000, this was able to continue by paying someone a small wage, just about enough to keep them from working a summer job for eight hours per day. This was not raised until the beginning of the summer of 2016. Sixteen years without a raise may be part of the issue, but that's not the main problem.
The main problem is that none of the current resident paramedics can make a living doing EMS year round without the income to be made in the summer. Why? Try working for $4.33/hour and see how far ahead that gets you. What happened to wages going up using the cost of living like everywhere else? No change was ever made until it was too late to keep the paid volunteers on the staff.
Pair that with the almost negative flow of insurance payments, and you arrive at the place the island is today. Politics and friendships are seemingly more important than life saving, resident paramedics. We certainly can't pay someone minimum wage for doing this job! We certainly can't have these people developing the policies for transport of emergency patients, can we? After all, they are just volunteers.
Where did this policy and attitude lead us? It put us in a position where the paid volunteer could either violate the protocols of Charlevoix County Medical Control Authority, State of Michigan legislation and Administrative Rules for that legislation, to keep the politicians happy, or move on to something else.
Where are we today? We are paying someone twice minimum wage to visit the island. Was that wage increase offered to the resident paramedics? Absolutely not! It only happened when minimum increases could not keep the resident paramedics from working other jobs during the summer.
So, the result is this. We can step backwards to the year 1988 where the level of care was Basic Life Support, or we can fund employees of Advanced Life Support in the form of paramedics who work year round for professional wages.
The choice is one that the voters will have to make.
No matter how much some on the BIESA and at the BIRHC want us to step backwards twenty-five plus years, the only choice in my mind, as one of those who put thirty years into building a system that works, is to vote yes on the millage and hope that all of that money will not be needed to get the personnel hired and get the equipment back up to the level it was fifteen years ago.
If the system is broken, you need to help improve the broken parts. I don't believe anything is the cause except lack of foresight by the EMS directors in the last ten years and lack of support for needed changes by the governing bodies of the island. Basic Life Support will NOT allow cardiac arrest patients or stroke patients have excellent outcomes, no matter how much you may believe it or want it to happen.
I spent thirty years doing this work because I wanted better outcomes for my friends and neighbors as well as the island visitors. I retired because the powers that be would not resolve the serious issues facing the paramedic in charge, which happened to be me. I know for a fact that some of the most recent patients seen by EMS on this island would not have had positive outcomes if not for an ALS assessment performed on the scene of the emergency by the paramedic in charge. Due to HIPAA, EMS is not allowed to disclose the patients identity, but, rest assured, the patients know how important the ALS assessments and treatments were.
When and if our medical center ever becomes a rural hospital capable of performing definitive treatments for our common emergencies, such as chest pain, stroke-like symptoms, severe trauma, syncope, etc., this might change, but efficient advanced life support treatment and transport is absolutely essential for positive patient outcomes.
If you don't believe me with thirty years of emergency experience on Beaver Island, read any textbook for EMS. FAST and MEND is the most recent catch phrases for Stroke. STEMI protocols are the most recent standard of care for chest pain. On scene time for trauma is now determined as the Platinum Ten Minutes, which puts the "Golden Hour" to shame. All of these talk about definitive care within an hour of onset of symptoms.
Going back to BLS with a stop at the medical center will put EMS back twenty-five or more years, and decreases the standard of care available on the scene of the emergency and increases the arrival time at definitive care by more than one or two hours. If the patient is someone that I care about, then this is NOT an acceptable solution.
What do I know?
I know that Beaver Island ALS should be expanded to include more Critical Care protocols with more specific protocol-driven treatments of emergencies added. I know that failure to do this will result in more of my friends and neighbors leaving this world before that needs to happen. I know that the medical center wants to be the leader in emergency treatment of Beaver Island patients, but, until they are able to provide definitive care at a higher level than they provide now, positive patient outcomes will not increase. Everything I've read about EMS in the last thirty years convinces me, and this is evidence-based, not just the "We can do this" attitude shown by some. The facts are that once any advanced treatments are provided at the medical center, the level of emergency transport must be advanced. That can be verified by reading the "National Scope of Practice" for any level of medical certification or licensing.
No one knows the emergency ALS assessment skills better than a practicing paramedic. No one knows the positive outcomes of this assessment better than a practicing paramedic. So, who do we rely on for gaining this information? Shouldn't the answer be a licensed, practicing paramedic? Shouldn't the visiting practicing paramedic who had just formed and accomplished the organization of an ambulance authority be asked about what a newly formed ESA should do and why and how?
This person came to Beaver Island multiple times and attended the ESA meetings multiple times. Was any of his knowledge even requested?
I'm sure that Jay Peck would be willing to come back and help answer some of these questions. He might even be able to show some insight into how to resolve the paramedic issues here. Or, maybe a couple of EMS agency directors in Charlevoix County could be asked to come and provide some information, so that our local authorities could find out whether their positions are viable and legal and reasonable.
If you were needing information about a plumbing problem, you would not contact a person who specializes in putting on steel roofs and building steel buildings. Why? Because it makes more sense to speak to someone who specializes in the problems that you are encountering.
If you need information about how best to operate an emergency services authority, why wouldn't you call someone who operates an emergency service under an emergency services authority? How does talking to the roofer get your plumbing problem solved? How does talking to the medical center manager and provider resolve the emergency medical issues?
Talk to someone in charge of an EMS service, and you'll find out how to manage an EMS agency. Talk to someone who functions under medical control, and you'll find out how that medical control must work. Talk to someone who operates under an authority in the medical field and not a primary medical provider..
And last, but not least, stop, stop STOP, alienating those that are trying to help resolve the problem. Talk to them instead of ignoring them.
Please vote YES for millage to maintain Advanced Emergency Care for Beaver Island!
This shortage of paramedics has spurred a very creative way of attracting paramedics to some communities. Some are offering $5000 sign on bonuses. Others are offering a $35,000 bonus after five years of service. Some creativity may be necessary to attract paramedics to come here. These are just some examples.
Joe Moore, retired paramedic instructor and emergency provider on Beaver Island for thirty years
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pam moxham
- Posts: 237
- Joined: Tue Dec 01, 2009 5:05 pm
and a bump, as folks say...
did you ( any of you) READ this ?
read Joe Moore's post ? He gave TWO YEARS NOTICE of retirement plans.
attend ESA mtgs ?
ask YOUR twp supervisors what is going on?
attend YOUR twp mtgs to learn about this appalling situation?
know how many OR even who is on the EMS team?
learn what happens if we lose ALS status?
next ESA mtg is thurs 22 at 2pm at Peaine Ywp hall
Sat sept 24 is the last day for our Executive Director , EMT and Firefighter, Kevin White. He gave a months notice.He leaves the ISLAND fri 30th sept.
Handwashing is such a necessary and basic prevention of /protection against cooties. Well folks we have a fecal load of cooties ahead ...hand washing isn't going to help soon...neither will handwringing.
did you ( any of you) READ this ?
read Joe Moore's post ? He gave TWO YEARS NOTICE of retirement plans.
attend ESA mtgs ?
ask YOUR twp supervisors what is going on?
attend YOUR twp mtgs to learn about this appalling situation?
know how many OR even who is on the EMS team?
learn what happens if we lose ALS status?
next ESA mtg is thurs 22 at 2pm at Peaine Ywp hall
Sat sept 24 is the last day for our Executive Director , EMT and Firefighter, Kevin White. He gave a months notice.He leaves the ISLAND fri 30th sept.
Handwashing is such a necessary and basic prevention of /protection against cooties. Well folks we have a fecal load of cooties ahead ...hand washing isn't going to help soon...neither will handwringing.
Please post the detailed EMS budget, sources of all funding and total expenses for the past 3 years. Also please post the total calls received and total number of patients treated and transported by ambulance and air. I think the public can make a better decision when it has all the information.
AE Wirth
Can't Do What you ask
Adam--
I simply can't do what you ask since there is a BIESA policy that does not allow me to represent either the BIESA or BIEMS.
You would have to contact the BIESA Chairman Bill Kohls at the Peaine Township Hall on Thursdays from 10am-2pm to gain access to that information.
I can tell you that the loss of Advanced Life Support service on Beaver Island will cause patients to have less positive outcomes. Specifically, the last three patients would not have survived if they had not been transported to definitive care in the shortest possible time.
So, how much is a life worth?
If you read my post, you would see that this happens in all rural areas, and if it takes someone to die for people to see the importance of ALS, I just hope it isn't anyone that I care about, and that is just about everyone here.
Joe Moore, retired paramedic
I simply can't do what you ask since there is a BIESA policy that does not allow me to represent either the BIESA or BIEMS.
You would have to contact the BIESA Chairman Bill Kohls at the Peaine Township Hall on Thursdays from 10am-2pm to gain access to that information.
I can tell you that the loss of Advanced Life Support service on Beaver Island will cause patients to have less positive outcomes. Specifically, the last three patients would not have survived if they had not been transported to definitive care in the shortest possible time.
So, how much is a life worth?
If you read my post, you would see that this happens in all rural areas, and if it takes someone to die for people to see the importance of ALS, I just hope it isn't anyone that I care about, and that is just about everyone here.
Joe Moore, retired paramedic
First I never asked you specifically for the info Joe. Secondly, can we not get this basic information on the BIEMS expenses and activities? Good lord. Joe maybe it is time to scrap the whole program and get some new people and new ideas from other communities to show us how to run an efficient an effective EMS system here. It blows my mind that when ever anyone asks about anything on the Island that uses tax payer funds to operate that no one seems to know crap.
Joe people are selling off their summer homes in droves. People are losing a lot of money in their investments that they have worked so hard to obtain. I have had 6 of my long time clients tell me that they are selling their Island homes due to the insanely high property taxes already. The complete lack of care and empathy of the fiscal strains caused by "Islanders" who get to vote for tax increases on everyone is pretty sad.
I would like to see some new eyes look at ways that perhaps we could do some major restructuring of many systems on the island. Maybe EMS/FIRE merge, maybe work on ways to have the Nurse Practitioners get certified to fill the gap. How about looking at pay scales, expenses etc and try to come up with the money from other sources to offset a Paramedic. I do not know what the answer is but perhaps there are other options.
At least try to consider alternate ways to fund things without going on auto tax increase mode. People are hurting Joe. This aint about you.
Joe people are selling off their summer homes in droves. People are losing a lot of money in their investments that they have worked so hard to obtain. I have had 6 of my long time clients tell me that they are selling their Island homes due to the insanely high property taxes already. The complete lack of care and empathy of the fiscal strains caused by "Islanders" who get to vote for tax increases on everyone is pretty sad.
I would like to see some new eyes look at ways that perhaps we could do some major restructuring of many systems on the island. Maybe EMS/FIRE merge, maybe work on ways to have the Nurse Practitioners get certified to fill the gap. How about looking at pay scales, expenses etc and try to come up with the money from other sources to offset a Paramedic. I do not know what the answer is but perhaps there are other options.
At least try to consider alternate ways to fund things without going on auto tax increase mode. People are hurting Joe. This aint about you.
AE Wirth