Ad Hoc EMS Sustainability Review Group Presentation to City Council. 11 July 2017

Transcription

1 Ad Hoc EMS Sustainability Review Group Presentation to City Council 11 July 2017

2 $ in thousands Why We Are Here Today $2,000 $1,800 $1,600 $1,400 $1,200 $1,000 $800 $600 $400 $200 $ Total Income Total Expense (incl capital) HEMS Budget Changes in the demand for, supply of, and financing of emergency medical services (EMS) in Hudson have led to sustainability concerns Ad Hoc group has worked since March to analyze problems, propose solutions Full report submitted to Council on June 30,

3 DEMAND: HEMS Calls Have Increased Over the Last Five Years 1800 mirrors overall Ohio trend for same period Trauma Medical Misc, Assist Standby 3

4 DEMAND for HEMS Services Will Continue to Grow As Hudson Grows As Hudson Ages % 65 or older 4

5 SUPPLY: HEMS Volunteerism Now At Lowest Point in Its History Full Time Part Time Volunteers more than 60 in 2005, less than 25 in

6 SUPPLY: Reasons for Decline Major drop in all US volunteering US Red cross volunteers down 61% since 1970 Those under age 35 today are among the least likely to volunteer Hudson Housewives who founded HEMS are mostly working now Less than half of married mothers working 1976 (US) Over 70% working 2016 (US) Health care sector least preferred among those who volunteer today < 4% of those who volunteer in greater Cleveland area do so in health sector (includes EMS) 6

7 SUPPLY: Fewer Volunteers Means A Smaller Overall Emergency Response Force Full Time Part Time Volunteers 7

8 FINANCING: Components of HEMS Income $1,600 $1,400 $1,200 $1,000 $800 $600 $400 $200 $ Income Tax Revenue Billing ($ in thousands) Two Revenue Streams support HEMS 1. Funds from city income tax revenues. This amount has grown over the past five years, but has not kept up with the demand for HEMS emergency services 2. Billing for emergency calls which result in patient transfers 8

9 FINANCING: Part-Time Personnel Costs Drive Increases in HEMS Overall Budget Non-Personnel Expenditures ($ in thousands) Part-Time Personnel Expenditures $1,200 $1,200 $1,000 $1,000 $800 $800 $600 $600 $400 $400 $200 $200 $ $ Supplies & Services Capital Expenditures Part-Time Personnel Expenditures 9

10 Options Considered, But Not Recommended outsourcing combining forces reduced staffing 10

11 Recommendation #1: Re-Slice the Current Tax Pie Beginning with FY18, combining the separate Fire and EMS funds into a single allocation of 24%, with distribution between the two services recommended annually by the Chief of Fire and EMS, would buy some time. This would require passage of a no new taxes measure by the voters. August 9, 2017 is the Board of Elections deadline for filing to place such an issue on the November 2017 ballot. 11

12 Recommendation #2: Adequate Coverage by a Reliable Staff The Ad Hoc group recommends hiring 2 additional part-time paramedics at 24 hours per week each and 2 new full-time paramedics. The additional salary and benefits required would increase 2016 HEMS personnel costs by approximately $200,000, partially offset by a reduction in budgeted overtime costs. Should the combined Fire and EMS income tax allocations be reallocated as described above, it is possible that these additional personnel costs could be absorbed without additional funds through FY21. 12

13 Recommendation #2, con t: Further Loss of Volunteers Might Lead To A Worst Case Scenario If volunteerism continues to drop beyond current levels, personnel costs would correspondingly increase In order to safely and effectively meet the projected level of need without volunteers, the Ad Hoc Group would recommend the appointment of 5 new full-time paramedics plus 6 additional part-time paramedics at 24 hours per week each. Such a scenario would further increase HEMS personnel costs by approximately $600,

14 Bucking the Trend: Avoiding the Worst-Case Scenario Create and present a coherent recruitment message consistently across the community use of social media Update current orientation requirements into on-line format which recruits can complete on their own time Recognize and reward staff for their willingness to put themselves in harm s way, and for their commitment and dedication 14

15 What Questions Do You Have for Us? 15