Retired Rogersville physician Dr. Blaine Jones chaired the EMS Exploratory Committee, which was comprised of non-political representatives with healthcare and first responder backgrounds.
Other committee members are Dr. Richard Michalik, Stacy Mahan, Ralph Darnell, Jackie Charles, Bill Killen, Patrick Shipwash, and Ed Alvis.
EMS panel’s recommendations
At Monday’s Hawkins County Commission meeting, Jones presented the committee’s proposals, the first of which is to award a three-year franchise extension to Hawkins County EMS.
That extension would occur in conjunction with establishing a joint venture between the service and the county commission. Once the joint venture was in place, the franchise would be a moot point.
The county would also add HCEMS employees to the Tennessee Consolidated Retirement System (TCRS) in hopes of helping with employee retention, and the commission would commit to providing more annual funding to HCEMS.
The county would also provide cash-flow support when required, and the commission would be represented on the joint venture board that will be assembled.
With more funds comes more accountability
“The bottom line is this county commission — if this joint venture were undertaken — would have final say in any and all things associated with Hawkins County EMS,” Jones told the commission. “If Hawkins County EMS came and said, ‘We need a million dollars for four new ambulances,’ this commission could say, ‘No. We’ll consider one, maybe two.’ If they come with a personnel request, this commission makes that final decision in the joint venture.”
Why the committee was formed
HCEMS is currently walking a financial tightrope. Projected revenue for the current fiscal year is $2.7 million to $3.2 million, while expenditures are projected at $2.92 million. Jones noted that a random Medicare audit would halt revenue for an undetermined amount of time, which could be devastating to HCEMS.
Under the joint venture, the county would serve as a safety net for HCEMS and in case of an audit could lend it funds that would be repaid when the flow of revenue resumes.
After Church Hill EMS folded, HCEMS took over coverage of the entire county and was awarded a franchise, which comes up for renewal every three years. That franchise renewal has contributed to a staffing, along with lower pay and benefits than is offered in nearby counties.
Jones noted that HCEMS employees are looking for new jobs in year two of that three-year franchise because they don’t know if they’ll have a job when the franchise comes up for renewal.
Five ambulances versus six
Until earlier this year, HCEMS had been maintaining a 24/7 ambulance in six locations: Mount Carmel, Church Hill, Surgoinsville, Rogersville, Persia, and Lake View.
In March 2019, however, the Surgoinsville ambulance was removed due to a staffing shortage, which required overtime to keep the sixth ambulance in operation.
The loss of Surgoinsville’s ambulance upset local residents and officials, but HCEMS stated it didn’t have enough staff to man that ambulance, and it couldn’t afford the overtime pay required to man it with existing staff.
The Exploratory Committee said a minimum of six full-time ambulances is needed in Hawkins County to ensure low response times and adequate coverage.
Purchasing new ambulances
The Exploratory Committee also said HCEMS needs nine road-ready ambulances, six of which would operate 24/7, and the other three would be “hot spares” in reserve. Another two ambulances are needed for convalescent transport, which is a high revenue generator.
Currently HCEMS has 10 ambulances, but four have exceeded 300,000 miles, which is the maximum life expectancy allowed for such vehicles. Four others are over 200,000 miles, and three of those are over 270,000.
The committee recommends that the county eventually purchase five new ambulances estimated to cost $260,000 each outfitted and ready to go.
Home grown EMTs
The Exploratory Committee applauded efforts by the Hawkins County Board of Education to pilot a high school EMT course at Cherokee, Volunteer and Clinch. Students who complete the program would be eligible to test after graduation and become certified EMTs.
“You train these kids in Hawkins County, and you have good job stability. There’s a good chance you’re going to have good, young, qualified EMTs trained in Hawkins County staying in Hawkins County,” Jones said. “That’s what the issue has been with our current Hawkins County EMS. We have a great EMS. We have wonderful guys and gals working for us, most of which have been trained right here in Hawkins County.”
Jones added, “There’s many who have left here, and that’s why our EMS can’t stay staffed at this time. That’s why we can’t have a full six ambulances all the time.”
What’s next for the recommendation?
Budget Committee Chairman John Metz said he will schedule a meeting between the Exploratory Committee and the commission to initiate a second stage of planning.
“We want to ensure proper due diligence and make a solid commitment to get everyone on the same page,” Metz said.