1. Future Ambulance Service
4/27/2019
Shelby County Emergency Services Assoc.
Future Ambulance Service
Shelby County Emergency Services Assoc.

2. Funding Sources Proposal
The Emergency Medical Services Assessment Committee was assigned to examine the funding of future ambulance services in Shelby County, by the Shelby County Emergency Services Assoc.
After examining the issue the committee submitted 2 proposals for consideration of the Association.
The Association voted to accept these two proposals.
4/27/2019
Shelby County Emergency Services Assoc.

3. Shelby County Emergency Services Assoc.
The Proposals
Proposal #1
If funding source stays the same
Proposal #2
If funding sources change
4/27/2019
Shelby County Emergency Services Assoc.

4. Shelby County Emergency Services Assoc.
Proposal #1
The ESA would like to support the continued funding of Medivac Ambulance for countywide ambulance service
Medivac guarantees a minimum of two paramedics and two ambulances are on duty 24hrs a day 7 days a week
4/27/2019
Shelby County Emergency Services Assoc.

5. Shelby County Emergency Services Assoc.
Proposal #1 cont….
Shelby County currently has 5 volunteer transporting services.
These services are not able to provide paramedic level of care 24hrs a day 7 days a week.
4/27/2019
Shelby County Emergency Services Assoc.

6. Shelby County Emergency Services Assoc.
Proposal #1 Cont….
Elk Horn is currently a provisional paramedic squad
They only have 3 paramedics
All 3 work for Medivac
Plus have other jobs to make ends meet
Irwin is currently a provisional paramedic squad
They only have 1 paramedic
He works for Medivac
Plus has other jobs to make ends meet
4/27/2019
Shelby County Emergency Services Assoc.

7. Shelby County Emergency Services Assoc.
Proposal #1 Cont….
THERE IS NO GUARANTEE THAT ONE OF THEM WILL BE AVAILABLE AT ALL TIMES!!!
4/27/2019
Shelby County Emergency Services Assoc.

8. Shelby County Emergency Services Assoc.
Proposal #1 Cont…
Most of the time the volunteer squads are staffed by EMT Basics or Intermediates.
There is no big jump between these levels of care!
The EMT Basic class is 160 hours and the Intermediate is an additional 90 hrs to learn how to start an IV.
4/27/2019
Shelby County Emergency Services Assoc.

9. Shelby County Emergency Services Assoc.
Proposal #1 Cont…
Paramedic Specialists have 1800 hours of training
They can treat patients with over 32 medications based on signs and symptoms
4/27/2019
Shelby County Emergency Services Assoc.

10. Shelby County Emergency Services Assoc.
Proposal #1 Cont…
The EMT Basic can only give limited care and assist the patient with 3 of the patients own medications
They can give you
Aspirin
Glucose
For diabetic reactions
Epi auto injectors
For allergic reactions
4/27/2019
Shelby County Emergency Services Assoc.

11. Shelby County Emergency Services Assoc.
Proposal #1 Cont…
During the day when a 911 dispatcher pages an ambulance the small towns do not always have the ambulance personal to respond
Families need 2 incomes to make ends meet
Some work in other towns
Medivac is around 24hrs a day 7 days a weeks
4/27/2019
Shelby County Emergency Services Assoc.

12. Shelby County Emergency Services Assoc.
Proposal #1 Cont…
If a 911 call comes in that by Emergency Medical Dispatch Protocols needs a paramedic response:
Medivac is dispatched
They meet the volunteers ambulance in route
Jump in the back of the volunteer squad
Which offers the patient paramedic level of care while in route to the hospital
4/27/2019
Shelby County Emergency Services Assoc.

13. Shelby County Emergency Services Assoc.
Proposal #1 Cont….
The Shelby County Emergency Services Association feels that it would be in the best interest for the residents in Shelby County for the Ambulance Commission to continue funding Medivac Ambulance for countywide ambulance services.
4/27/2019
Shelby County Emergency Services Assoc.

14. Shelby County Emergency Services Assoc.
Proposal #2
EMS Trust Management Committee
4/27/2019
Shelby County Emergency Services Assoc.

15. Proposal #2 Each Member of the committee would have 1 vote
4/27/2019
Shelby County Emergency Services Assoc.

16. Shelby County Emergency Services Assoc.
Proposal #2
Shelby County ESA Would Propose that the hospital levy $.27 per $100,000 which would provide $115,772 to the ambulance fund
The City of Harlan has voted to continue the funding commitment of $29,000 for the next 5 years
This would increase the ambulance funding to $144,772 each year and provide some financial help for volunteer squads in Shelby County
4/27/2019
Shelby County Emergency Services Assoc.

17. Shelby County Emergency Services Assoc.
Income
Ambulance Levy at .27 per $100,000
115,772
City of Harlan
29,000
Total Income
$144,772
Expenses
911 Paramedic Services
24 hour/7 days a week 911 response
$80,000
Accounting Fees
300
Insurance
The Agency
1,200
County Ambulance
County contractor vehicle replacement fund
15,000
Shelby County EMS
Volunteer vehicle replacement and training
47,772
Miscellaneous
500
Interest
To County replacement fund
Total Expense
4/27/2019
Shelby County Emergency Services Assoc.

18. Shelby County Emergency Services Assoc.
Proposal # 2
This funding would replace the annual funding from the Commission, the Board of Supervisors and Township Trustees
It will provide $40,000 for volunteer vehicle replacement
$7,772 for Training and Equipment
It will also provide $75,000 every 5 years for the county contractor vehicle replacement fund
4/27/2019
Shelby County Emergency Services Assoc.

19. Proposal #2
The Shelby County ESA was Founded In 1986
It is an Iowa non-profit corp. and Federally exempt 501C3 organization
The Association is governed with By-Laws,
Has Committee activities
One Medical Director
Meets Quarterly
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Shelby County Emergency Services Assoc.

20. Proposal #2 Membership is inclusive of all stakeholders in the county
Fire
Law Enforcement
EMS Training Programs
Lifenet Helicopter
Dispatch
Adjacent departments providing service to Shelby County Citizens
Emergency Medical Services
Hospital Administration
Medical Director
ER Staff
Emergency Management
Board Of Supervisor’s
Public Health
4/27/2019
Shelby County Emergency Services Assoc.

21. Shelby County Emergency Services Assoc.
Proposal #2
Shelby County has a multi tiered EMS system
6 transporting services
5 non transporting
Medivac bills for their calls and assists the volunteer squads by billing for the volunteer squad on tiered responses
4/27/2019
Shelby County Emergency Services Assoc.

22. Shelby County Emergency Services Assoc.
Proposal #2
Patient cost per ambulance trip varies from a small donation to $1,000
Iowa Code states that townships may tax for ambulance services, but most don’t
4/27/2019
Shelby County Emergency Services Assoc.

23. Shelby County Emergency Services Assoc.
Proposal #2
Volunteer Squads must Survive on fund drives, donations and applying for grants
Yearly budgets rang from $100 to $11,000 with theses funds squads must pay:
Fuel
Supplies
Equipment
Training
Vehicle
Electricity
Heat
Insurance
4/27/2019
Shelby County Emergency Services Assoc.

24. Shelby County Emergency Services Assoc.
Proposal #2
Some EMS personnel purchase the equipment and supplies out of their own pocket
The cost of fuel, ambulance supplies, equipment and training are going up every year
4/27/2019
Shelby County Emergency Services Assoc.

25. Shelby County Emergency Services Assoc.
The decisions made today will dramatically effect how these services are provided to Shelby County Citizens,
The Emergency Services Association is a dedicated professional organization consisting of key stake holders, and it is equipped and capable of managing these funds for the maintenance and betterment of the EMS system in Shelby County
4/27/2019
Shelby County Emergency Services Assoc.

26. Shelby County Emergency Services Assoc.
Thank you
Questions?
4/27/2019
Shelby County Emergency Services Assoc.