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County works on new agency for Emergency Medical Services


At the August meeting of the Board of Commissioners in Castle Dale they approved the Cooperative Agreement by Public Agencies to Create a New Entity to Manage Emergency Medical Services and Provide Rules of Governance. The Articles of Incorporation of the Emery County Emergency Medical System were approved along with the bylaws for the new Emery County Emergency Medical System.
After these actions were approved, the commission began getting some push back from the cities. County Attorney Mike Olsen attended the Castle Dale city council as well as the Ferron City Council to inform them of the formation of the new agency.
Some of the mayors wanted more input into the new agency, it was decided the matter would be discussed in the Council of Governments also know as COG which is a meeting involving all mayors in the local communities.
Commissioner Ethan Migliori as well as County Attorney Mike Olsen were present for the discussion with the mayors. “We want to make sure as we move forward that we meet with the cities to explain what we’re doing. The documents are a foundation as we move forward. In some of the conversations I’ve had their concern is some of the language isn’t clear.”
Commissioner Migliori explained if the EMTs get over 130 hours in a month’s time, the Affordable Health Care Act comes into effect. This added expense would cost the county approximately $400,000 to cover these volunteer EMTs. In order to avoid these extra costs, the county commissioners have looked at possible solutions that would be advantageous to the local EMTs as well as the county and they settled on moving forward with a separate, stand alone agency. Doctor Engar will oversee the program and Commissioner Migliori said they would maybe add him to the board of directors. All of the cities have received the articles of incorporation as well as the bylaws and a cooperative agreement and rules.
If a city chooses not to participate they would not be allowed a board member on the board of directors. The board of directors would include a commissioner and one other representative from the county, each city would name a representative to be on the board.
There has been talk of having a garage manager where each ambulance is housed. Someone would also be needed as a director for the new agency. Commissioner Keith Brady said under the new agency, Jim Gordon’s current position with the county as the Emergency Medical System manager would be eliminated. The new agency would be in charge of hiring a director or manager.
Commissioner Migliori said the paperwork creates the foundation for the new agency, but the board itself would be able to structure the agency into what the cities and counties need. He said the county would continue to have a role in the EMS until the end of the year. This would give enough time to work things out.
Commissioner Brady said it is his hope this new agency would create the environment conducive to bringing back EMTs that no longer run, in recent years the number of EMTs throughout the county has dropped from 100 to around 70.
Attorney Olsen said he was instructed to create the new agency by the commissioners. In doing so, he talked to other cities to see how they operate their EMS systems. He thinks it’s a good idea to have the Emery County cities involved because they know about budgeting. EMS is a crucial need the government provides for the people. He said one of the rumors was the county would push any shortfalls onto the cities. That’s not the intent of the county.
Mayor Hilary Gordon from Huntington, said she thought if the cities weren’t on board, the county wouldn’t have anything. She said Commissioner Brady visited their city council in April and since then she hasn’t heard a word. The documents now are different than the ideas presented at that time. She thinks the cities should have been more involved in the planning process. She suggested waiting until after the general elections to see if Obamacare might go away. She for one didn’t want to see the EMS moved away from the county.
Commissioner Migliori said there’s been much complaining about the EMS department. “We have to do something different than we’re doing.”
If there were more EMTs spread throughout the towns, then maybe the hours they are on call could go down. Mayor Mistie Christiansen from Emery said with their limited force in Emery, they would always be over hours.
Commissioner Migliori said the shortage of EMTs is a reality, especially in Green River. They have had a hard time even when offering other EMTs pay to go down and cover Green River. On call EMTs receive $1 per hour.
Leonard Norton, EMT and Huntington City councilman said they are always short staffed, because people have lives, weekends and holidays are always short staffed. The EMTs present said maybe if they received a salary, and didn’t have to work two jobs they could be more available for runs.
Orangeville mayor Roger Swenson said he would like to see the financial history of the EMS because he has no idea if they make money, break even or if there are shortfalls in their budget. Commissioner Migliori said there is only a shortfall on years ambulances are purchased. Revenue from a good year should be saved for future expenses like ambulance purchase. It’s estimated every 10 years an ambulance should be replaced.
Revenue for 2015 was $554,000 expenses were $459,000
Revenue for 2014 was $493,000 expenses were $425,000
Revenue for 2013 was $466,000 expenses were $430,000
Commissioner Brady said the new agency would also be able to apply for CIB grants for help with ambulance purchases and equipment.
LaMar Guymon from Huntington city council said he read through all the paperwork and was confused. It doesn’t state in there how the director and treasurer will be compensated. The new agency is going to require a staff.
Commissioner Migliori said some parts of the documents are vague because he believed the new agency board would want to work out these details together. Those who know the EMS system. He said obviously the county doesn’t get how to run the EMS because there have been so many complaints.
Guymon said, “It worked for 30 years. I don’t think we need to create an agency where it’s all new to them. The county has done it. For instance if Elmo or Cleveland has to compete for an ambulance, they are going to get left out.”
Commissioner Migliori said yes, he sees holes with the agency that need to be worked out, it can’t stay under the county with the current requirements for Obamacare unless there are budget cuts elsewhere in the county, do the citizens want potholes in the roads, less fire protection, less police protection. The county could spend the $400,000 needed to keep the EMS within the county, but it would come with consequences.
Mayor Trent Jackson said his objections to the new agency stemmed from not having enough involvement in the process. When the documents were sent out to the cities, they were signed and dated. This gave him the impression it was a done deal. His city council kind of liked the proposal that was presented earlier in the year. They could be OK with it if the holes are fixed. He said he understood there would be a new draft at this meeting which addressed initial concerns from the cities. But, the city factor was taken out of the document passed in commission meeting and created the agency. If a district was created they could become a taxing entity. Mayor Jackson wondered who would make up the shortfalls that will come in the budget. Is it the cities or county? When the document had already been signed it sent up a red flag with him.
Mayor Christiansen said she has never know the EMS to run smoothly. She drove ambulance for 12 years. There have been issues. She thinks everyone should work together to make it right. Put the agency together and make it work. “If you don’t have input, then you can’t complain,” said Mayor Christiansen.
Norton said he knows what the EMS entails from the state level down to the ambulance garage. He suggested getting the people involved that know the EMS system. Clear cut rules are needed.
Commissioner Migliori asked for volunteers to meet to resolve issues with the agency. He wants to bring people to the table to see what’s missing and get working on it. Commissioner Migliori said they will look at the language in the document to make sure no financial burdens are passed on to the cities. Guymon volunteered to be on the committee as did Stoney Jensen, Mayor Casey Lofley from Elmo and Julie Johansen from Castle Dale City.
Commissioner Migliori thanked everyone for their attendance and willingness to be on the committee to continue to move forward and resolve problems.
Editor’s note: Commissioner Brady was not at the COG meeting, his comments are based upon a telephone conversation I had with him the day after the meeting.

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