In 1993 most fire departments did not staff as many paramedics or lifesaving equipment as they do today.
Staffed by paramedics, an advanced life-support services life squad has the ability to begin advanced-level assessments and potential life-saving treatments while also transporting patients to hospitals. A different report is filed with each such call, and a different dispatcher, with advanced training, is tasked with fielding 911 calls and dispatching the specialized life squads.
Today, however, according to officials overseeing the emergency system, the county’s advanced squad system operates under a different set of guidelines than a first responder vehicle, and that is creating an overburdened and often conflicting system of service.
When Lucas County took over EMS operations in 1993, after REMSNO (Regional Medical Service of Northwest Ohio) went out of business amid a scandal, it was necessary to ensure that residents throughout the county would receive the same level of emergency care.
A 0.25 percent “piggyback” sales tax was then approved by voters to ensure the financial stability to operate 10 life squads, which were then placed strategically throughout the county to provide emergency advanced life support services. Fast forward to 2023 and those life squads continue to operate throughout the county with five housed in Toledo fire stations and one housed each in Sylvania Township, Springfield Township, the village of Whitehouse, Maumee, and Oregon.
The county also provides $13 million to fund the purchase of vehicles and equipment as well as training for those squads through an agreement with each participating jurisdiction. With the agreement, the county pays $804,000 to supplement the cost of each vehicle while the hosting jurisdiction pays the cost to staff them.
Many first responders, which are considered basic life squads, are also capable of offering that same level of care because those vehicles are often staffed with paramedics, which have advanced training, and the vehicles are equipped with critical lifesaving equipment.
Current protocol, however, prohibits a basic life squad, which is always dispatched and arrives first on a scene, from transporting a patient or administering certain care if a county advanced life squad is also called. That makes the system outdated as described by local officials.
Toledo Fire Chief Allison Armstrong said during a meeting with several other chiefs Thursday that she was seeking to make all of the basic life squads advanced ambulances.
With more than 260 paramedics on staff, she believes the change would enhance efficiency for the Toledo department, which realizes a majority of advanced squad runs.
“To cover the huge volume of runs that we have in the city, I am asking to be able to provide more resources so that I can efficiently respond to these runs and streamline patient care and streamline patient reporting,” she said.
Discussions advance
Matt Heyrman, deputy Lucas County administrator, said that discussions about potential changes have been ongoing for the past decade but have become more focused in the past several months.
While a new model could be implemented next year, nothing would happen unless all parties are in agreement, he said. In addition, because any change would involve either a new contract or amending the current contract, approval would also be needed from elected officials in each jurisdiction.
A preliminary proposal calls for distributing funds equally to six regions and allowing the fire departments within those regions to work collaboratively on a plan to provide EMS service best suited for their coverage area, he said.
“In the model being discussed, we would try and keep the same allocations of money in those regions because we want to make sure that those residents are getting the same level of financial investment into their [advanced] system in that region,” Mr. Heyrman said Thursday. “Money that is provided in the hope of providing a system that works better” is a “stimulus to provide that system to work.”
The 0.25 sales tax that supports the county EMS has increased over the past three years, said Mark Reiter, spokesman for the Lucas County commissioners. The tax generated approximately $20 million in 2022, which was up from $19.6 million in 2021 and $17.4 million in 2020, he said.
While in 1993 voters approved the sales tax to fund county EMS, the ballot language specifies its use as “general debts and services” meaning there is no legal obligation to fund a single service such as EMS. The commissioners, however, made a commitment that it would create a common level of EMS service county-wide, and therefore the county will not reduce such funding, Mr. Heyrman said.
“If the county made a commitment in 1992 to fund [advanced] services, there is no perspective from the county to defund the Lucas County system in this respect,” he said. “Right now, we’re just talking about how long contracts need to be. Our commitment is to stay at that level.”
Suburban reaction
Sylvania Township Fire Chief Michael Ramm, whose staff of nearly 75 are all certified paramedics, remains cautiously optimistic, but he is waiting to see any potential contract changes.
“We’re listening to them [Lucas County] but anytime you do an assessment there’s always something that may not fit for certain departments and jurisdictions,” Chief Ramm said. “But right now, we’re very happy that we’re openly having good conversations. I’ve always said that we can fill a room full of very smart people to figure this out and I think that’s what we are trying to do.”
Springfield Township Fire Chief Barry Cousino believes the change could help his department reduce response times to the outlying areas of Spencer and Harding townships.
Oregon Fire Chief Clayton O’Brien said the change would allow him to maximize staff and make additional emergency response vehicles available including a fire apparatus and two basic life squads.
“This would actually have a drastic impact on Oregon to the positive in response times and transport,” he said. “This is long overdue and a win, win for Oregon.”
But not everyone is convinced that it will benefit their communities. Maumee Mayor Richard Carr said the proposal being discussed will lead to decreased funding for Maumee. He is convinced that this change is the beginning of plans to eliminate county EMS funding altogether.
“Maumee will likely go from $800,000, even though it costs $1.6 million to operate the life squad, to $400,000, and then we won’t receive anything else in the next two to five years,” Mr. Carr recently said. “It’s a con job, because basically what they are doing is gutting the county EMS system. It’s horrible what they are doing.”
Funding and staffing issues have prompted Maumee city officials to seek voter approval on May 2 of a 5.6-mill tax levy to fund fire and EMS service.
While the county has no plans to reduce overall funding for EMS service, it is possible that Maumee’s portion of those funds could be reduced, Mr. Heyrman acknowledged.
“I can tell you the same dollar amount will go out county-wide, and the same dollar amounts would stay in the same regions,” he said. “And we are working with them to figure out how those dollars should be allocated that will keep that same level of service but will be done in the most effective way possible.”
First Published February 5, 2023, 9:43 p.m.
