AD HOC EMS STUDY COMMITTEE TUESDAY, JANUARY 13, :30 A.M.

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Page 1 of 7 AD HOC EMS STUDY COMMITTEE NOTICE OF PUBLIC MEETING TUESDAY, JANUARY 13, 2015 8:30 A.M. Government Center Chambers Room, 1 st Floor 421 Nebraska Street Sturgeon Bay, WI - AGENDA - 1. Call Meeting to Order 2. Establish a Quorum Roll Call 3. Adopt Agenda / Properly Noticed 4. Approve Minutes: None 5. Communications 6. Public Comment 7. New Business a. Elect a Vice Chair b. Purpose of Committee c. Presentation by EMS d. Review Preliminary Task List - Prioritize List e. Review and Discuss Fact Sheet 8. Matters to be Placed on a Future Agenda 9. Next Meeting Date(s): January 26, 2015 10. Adjourn *Deviation from the order shown may occur In compliance with the Americans with Disabilities Act, any person needing assistance to participate in this meeting, should contact the Office of the County Clerk at (920)746 2200. Notification 72 hours prior to a meeting will enable the County to make reasonable arrangements to ensure accessibility to that meeting. Posted, 2015 by

Board of Supervisors The Government Center 421 Nebraska Street Daniel Austad, Chairman To: From: Re: County Board Daniel Austad County Board Chairman EMS Ad Hoc EMS Study Committee Date: January 20, 2015 The County Board, at its December 16, 2014 meeting, authorized creation of an Ad Hoc EMS Study Committee. Determination of the Committee s particular functions, size, and composition, was left to the discretion of the County Board Chairperson. The general purposes for which the Ad Hoc EMS Study Committee was created are investigation and deliberation of s Emergency Medical Services programs, with focus on the Central Ambulance Station, identifying areas of need, and recommending allocation of resources to areas of identified need. This includes, but is not limited to: 1. Evaluate the current commitments that exist for locations that are in the system now. 2. Evaluate the potential differences in the 4 Station response based on times versus the current 3 station system. 3. Determine future needs in the Sturgeon Bay area for the next 15 20 years. 4. Review the call volume from all stations and the call locations. 5. Determine response time parameters as it relates to mileage circles for coverage. 6. Review other existing locations in Sturgeon Bay that could be considered as future locations. The Committee will report its findings and recommendations to the EMS Committee, the Property Committee, and County Board. The desirable size of the Ad Hoc EMS Study Committee is seven, and its composition is as follows: 1. Susan Kohout (Chairperson) 2. Kathy Schultz 3. David Lienau 4. Jon Koch 5. Randy Halstead 6. Tim Herlache 7. Doug Weimer 8. Dr. John Herlache Content expert advisor 9. Chris Hecht Content expert advisor These members provide a strong group, capable of handling any task that may arise within the province of the Committee. The Ad Hoc EMS Study Committee will go out of existence as soon as it has completed its specified tasks. Respectfully submitted.

Page 3 of 7 AD HOC EMS BUILDING STUDY COMMITTEE FACT SHEET The below format is being used initially and will continue throughout the period that the EMS Ad Hoc Study Committee is active. The purpose of this fact sheet is to establish a method for providing accurate and factual information. There has been much speculation, innuendo, gossip, rumor, various personal agendas and distortion, with regards to this project and has risen to the level that requires a document of this type. The COMMENT/QUESTION: heading represents a question that has been asked, a comment that has been made and/or any other reference to the project. The FACT: heading represents the answer that is the most accurate to be known at the time of development and or revision. COMMENT/QUESTION: New Stations are going to be located at South Y intersection of State Hwy 42 & 57; Sturgeon Bay (at or near the current station) Station in Carlsville/Egg Harbor area; and the current Sister Bay Station. FACT: The discussion that has been taking place within the County about these locations is just that. Those locations were mentioned as part of an answer to a hypothetical question. There has been no proposal or any type of official request to go in this direction. COMMENT/QUESTION: The County has decided to withdraw from the commitment and rescind the Resolution that it approved for a two year commitment to the BUG Fire building project. FACT: There has been no action by the County Board to rescind the Resolution. COMMENT/QUESTION: Why do we need a new Central ambulance station, the current one looks fine to me. FACT: The current central ambulance station was built 25 years ago in a cooperative effort from Memorial Hospital. The hospital provided a portion of their property for the purpose of building and ambulance station. The hospital leased the property to the County for $1.00 per year for 40 years.

Page 4 of 7 The current station was built to meet the needs that existed 25 years ago, with very little thought to the potential needs of the future. As time has progressed, the make-up of the department changed, the size of ambulances has gotten larger, the mission of the Department has changed and now, with the addition of 6 new staff members, we find ourselves without enough room to operate efficiently. Examples: 1. Garage space for the ambulances is too short. The front of the ambulance is to the garage door and the back is against the back wall. To clean the inside of the ambulance and the cot, you have to move the ambulance partially outside to open the back doors. 2. There is no place to hold a meeting or training. 3. Storage for supplies is inadequate. 4. All of the windows need to be replaced. 5. The roof needs to be replaced. 6. Office space is not sufficient for current staffing. 7. No fitness area for crews. 8. Bunk rooms were not designed for additional staffing. 9. The hospital has advised our department that the property that we are on would have better utilization potential for the Hospital. As the needs of our service have changed, so have the needs of the Hospital. When our station was built, the front of the hospital was on 16 th Place. Now the front of the Hospital is right behind us. They have offered property they own, to our Department on Michigan St., using the same type of lease arrangement as we have now. The advantage of this type of property exchange is that there is no need for land acquisition, saving significant money. Also, the property remains on the tax rolls as opposed to land owned by the County. 10. Currently we have an ambulance that is stored outside because our three stalls already are full with the 3 ambulances at the central station. 11. There is no ability to expand or significantly remodel this location based on the Hospitals right of refusal on changes to the property and their expressed statement of preferring we were located off site. 12. It is anticipated that at some point in the next couple of years our responsibilities will include interfacility transports. This would require space for another 2-3 units.

Page 5 of 7 Comment/Question: Why do 2 ambulances respond to all calls in the southern part of the County? FACT:, by State of Wisconsin Administrative Rule, is what is considered as a two (2) Paramedic service. What this means is that all 9-1-1 calls require an ALS (Paramedic) assessment. The ambulance that is stationed in Brussels and staffed by paid-on call EMT s, does not meet the required rule. Based on this rule, for every call, a paramedic unit is sent from Sturgeon Bay. If the ALS assessment determines that the call is of a lower acuity then the basic level provider ambulance will transport the patient. Reference: (DHS 110.50.1.d; Paramedic ambulance. 1. For an ambulance service provider licensed before January 1, 2000; the ambulance shall be staffed with two EMT-Paramedics and must arrive on scene together) Comment/Question: The cost of 6 new Paramedics of $540,864 is not accurate. FACT: The number that was quoted and is part of the 2015 budget was created and validated by the County Finance. This number does include; total salary, FICA/MED, Protective Pension, Workers Comp, Family Medical and Family Dental. The number is accurate and breaks down to $90,145 per person. (This includes all of the items I outlined in the sentence above and includes the 832 hours of overtime for each person per year) Comment/Question: There was no need to hire 6 paramedics 2 would have been just as good. FACT: This is a simple math equation. There are 17,472 hours per year that it takes to staff ONE (1) full-time ambulance 24 hours a day, 7 days a week, for 365 days per year. At a minimum, with conventional industry standard models of 6 people working 56 hour work weeks, the 17,472 hours are able to be covered. That works out to 2,912 hours per person, per year. Normal 40 hour per week personnel work 2,080 hours per year. So the paramedics work 832 hours more than the 2,080. The 832 hours are at an overtime rate that is factored into their overall salary. There is no schedule that can be created that would allow 2 people to cover 17,472 hours. That would be 8,741 per person, which would require each person to work 365 days in a year at 23.94 hours per day.

Page 6 of 7 Comment/Question: The cost of a second ambulance would be cheaper if it were staffed with Casual Call Paramedics. FACT: To provide coverage of a second ambulance you still have the same number of hours to cover in a year, per unit, 17,472. To make this option cheaper, a schedule would have to be created where no overtime, benefits, etc. would be provided. You would need 14.5 people to cover the hours based on each on working 23 hours per week. Currently our service has 7 active casual call Paramedic s. (This is before the newly hired group is in place) Comment/Question: If more people were hired the overtime could be reduced. FACT: This is a question or comment that has come up many times previously. Yes, you could eliminate or reduce overtime if you had everyone work the standard 40 hour week or 2,080 hours per year. The problem with that is that our service is required to be available 24 hours a day, 365 days per year. Below is what it would like if we went to 40 hour work weeks. CURRENT 52,416 Number of hours to cover (3 staffed ambulances) 18 Full-Time Paramedics 2,912 Hours for each Paramedic per year 56 Hour work week $90,145 Rounded Salary per Paramedic. $1,622,610.00 (Salary includes all benefits, mandatory deductions, etc.) EXAMPLE: IF SCHEDULE WAS BASED ON A NO-OVERTIME FORMULA 52,416 Number of hours to cover 26 Full-time Paramedics 2080 Hours for each Paramedic per year 40 Hour work week $79,500 Rounded Salary per Paramedic. = $2,067,000.00 (Salary includes all benefits, mandatory deductions, etc.) Comment/Question: The numbers that were used to illustrate the number of back-up calls was distorted and is significantly less than what was reported. FACT: It was reported consistently (monthly) to the EMS Committee how many back-up calls the service was getting and how many times the response was delayed or the service was not able to respond at all. The number for the year is over 200.

Page 7 of 7 Comment/Question: The number of calls per year and the percent of increase have not been reported accurately. FACT: The calls are tracked in house and are an accurate account of all calls responded to. The number of calls in 2011 were; 2,101. The number of calls in 2014 were; 2,706. That is an increase of 29%. NOTE: More will be added to this list as the committee moves forward and identifies more areas that need clarification. Developed: 1/9/2015 Revised: Revised: Revised: