Well, there is a lot of talk about the city budget, and none of it is any good. How will this affect those of us in EMS. For starters, we see the city tightening the purse strings on everything from overtime, fuel, equipment, take home vehicles (for the higher ups) to staffing.
One area that might rile a few feathers is when they start looking at duplicate services. I know what you are thinking, we really don't want to go there, but if we have our information right, there may be something to this. Health and Hospital Corporation is mandated to provide EMS service in all of Marion County. That is not to say each fire department is not free to provide it for themselves if they wish, but they are not required to. No where is it written that IFD has to provide ambulances. By operating ambulances, IFD is billing for the service they provide, but by being a fire department, they cannot be a for profit business. So, IFD is running ambulances, eating up a huge piece of the budget, but cannot do better than break even.
Wishard hospital can make a profit, and hold onto that money. The money could also be used to help finance the hospital, therefore decreasing the dollars needed from the city/county to pay for indigent care.
Then there is the billing end. If we are not mistaken, Wishard was granted special status a few years back in a bill, sponsored by Sen. Evan Bayh (D-IN), that allowed it to bill medicare/medicaid at a higher rate. We have also heard that Wishard is eligible for certain federal grants for indigent care that the fire department is ineligible to receive.
Lastly, there is the IU School of Medicine. They pump a lot of dollars into Wishard, money that might not be there if EMS was taken over by IFD.
Say what you want, but in times of budget crisis's, you just never know. Talk all you want about service, hiring, training, response; but when it comes down to it, WAS has been around for a long time and IFD EMS is still very new.
We know there are going to be some upset people over this one, so let us have it. Just remember, keep it clean.
Stay Safe
Dee
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Indy EMS, your local 3rd service blog. We are not the police, and no matter what our uniforms say, most of us are not firefighters. This is our site. This is where we can come to exchange ideas, develop plans, and yes even vent. Please keep it clean, on point, and respectful to others and their ideas. Oh yeah, and don't forget HIPPA. We wouldn't want to end up unemployed or in court for a slip of the tongue. Read. Post & Enjoy.
15 comments:
Here we go again. You and I both know there is no way in hell Wishard can run a county-wide ambulance service, regardless of what the statues say they're supposed to do in Marion County. They can barely staff and equip the people they've got. And if they're billing at a higher rate, where is that money going. Certainly not for raises, better equipment, better staffing, etc. At least the former Warren folks are under contract, meaning yearly raises for longevity, uniform allowance of 600/year and much better equipment in working environments. And now you're trolling on other blogs with this ridiculous idea. You make it sound as if Wishard taking over somehow solves the financial problems of local government. Maybe, but only on the backs of the employees.
200% of medicaid is the wishard charge with IFD being120%
One overwhelming item is that IFD EMS changes IFD from a cost center to a possible revenue stream. The money that is brought in from EMS runs goes to the city general fund.
WAS would not only stop that revenue stream, it would raise the amount of funds diverted from the city/county budget to WAS to operate in a larger area.
IFD EMS may not be able to apply for the same grants that HHS can, but HHS can not apply for assistance to firefighter grants or other FD only grants so I'd say that issue is a push.
There are alot more concerns than just who has been around longer. IFD has been around longer than WAS. Perhaps it is time for a change.
Brad
"IFD has been around longer than WAS. Perhaps it is time for a change."
As an organazation maybe. How long has IFD had ambulances? I remember when they weren't required to be emts. Wishard has been around transporting patients since 1887...yes with a horse drawn ambulance. I really don't want to get in a pissing match. If anyone counts Wishard down and out they a making a mistake. The collapse of fire based ems will start in the townships first.
EMS is the future of fire departments. With increasing technology and decreasing cost of in-home fire suppresion (like sprinklers) and increasingly stringent building codes fewer and fewer fire fighters will be needed. Older homes are burning / falling down and replaced with new technology. Don't believe me? Look at Washington township.
Township fire based EMS will collapse first? I seriously doubt it. Its the only item in the forseeable future that keeps fire departments where they are. I dont count Wishard down or out. It will definitely be a spiritied couple months till the next budget cycle.
Brad
First a few things that people may not know.
1. WAS is a hospital based service. Under the law they cannot bill for as much as a 3rd Party provider. I know other hospital providers write off alot of the bill if the patient is admitted.
2. WAS's income? Where is that? I am sure it goes back into supporting other operations in the hospital. When the Ambulance Service had its own billing it was making a profit now it isnt. Fuzzy Math there.
3. WAS will never be able to provide service to the City. They have tried and got kicked out of every township except Decatur. Their service just was that bad.
4. Chuck Ford.....enuff said.
5. Look at the trend. EMS systems are going fire based. WAS simply cannot be trusted to do the right thing. How many new trucks have they added? How many times do you hear private medic calls now?
1) What??? Your healthcare law knowledge isssss?
2)Another assumption magically a fact
3)Wishard provides services to the township areas out of need, not purely want. They are required to provide ALS for any area that goes without. Although Wishard is a business, they also are a goverment provider, and do things to support the system. Trust me, Wishard isnt earning much if anything off of decaturs run load, they are there to provide ALS for when their ambulance is BLS. If these areas are able to provide their own ALS then of course Wishard is going to move their trucks to a more suitable area.
4)Ever talked to him? Wishard took some hard budget cuts in recent history leaving him an easy person to blame Wishards problems on.
5) Trusted to do the right thing? I think this just proves your ignorance and obvious closed- minded bitterness.
Personally, I think IFD has several things to worry about besides their EMS, and I suggest circling your own wagons instead of worrying about how many new trucks Wishard maintains. With the TV-news stations attacking the IFD OT and Kelly days I can promise you that when it comes to picking what to keep EMS will be dropped in a heartbeat if it comes down to it. I'm sorry to break it to you but you guys aren't on IFD and never will be, you are civilians, and therefore when it comes to saving their own or losing you I'm sorry to say you will be gone. Instead of spending your time on these blogs trying to portray yourselves as superiors to what are truly your peers wouldn't it be better to work towards maintaining your job security? During these times of strained budgets I wish you good luck.
Face it, if given the choice between civillain employees or merit employees, the merit will win out. If push came to shove and one of the FF/Medics was given the choice of layoff or going to an ambulance, I believe they would stay and go to the bus. If a FF/EMT was given the choice of layoff or ambulance, same answer. The FF's give the department the option of dual use, amb when needed, fire when needed. Civillain employees don't give them that option. So if worse came to worse, Civillian EMS is going to be the first thing to go. Sorry to be a realist, but face it. Merit wins every time, all the time, no matter what!
G
G...You may want to speak with Chief Sanford before you start running your mouth. You see, the thing about him is he believes EVERYONE on the department from chiefs to secretaries plays a role on the TEAM and wiil be treated as EQUALS. He refused to play favorites at Warren and will do the same at IFD. A good rule to live by for you and all the other people spreading RUMOR on this blog goes like this.
"Tis' far better for people to question your wisdom than to open your mouth and prove your lack of it."
it also cost's a lot more, and causes a bigger shortage then what they already have leading to more OT
and you think going with a dual role firefighter/emt/emt-p will help ifd out in the overtime arena? civilian ems is saving the city money by not paying as much and by making them pay for their own benefits. i highly doubt that 60 some people accrued over $800,000 in overtime in less than 1 year.
Hey anon 3:02, I have no doubt that Sanford does not play favorites. However with the current budget, the decision may not be his alone. He may be forced to make cuts. Yes, cuts he doesn't want to make, but cuts that may be required. There is a budget crisis, and when it comes down to it, if someone has to go, remember it is IFD, Indianpolis FIRE Department. If given a choice, firefighters will come first. EMS is a bunch of civillains, and civillians will be the first out the door; janitors, secretarys, mechanics, EMT's and paramedics.
Secondly, I am not spreading any rumor. I am just stating my position from a different point of view than yours. Quit whining and crying. I am not attacking you personally, don't keep taking it that way. You don't know any better than I do as to what will happen, but anything is possible, and to say anything different is quite naive. You may have the correct prediction, and it may just as easily go my way. When it all goes down, we will both know. Until then, chill out and quit being so uptight.
G
Wow it is easy to tell who is a firefighter and who is not on this site. First off, I have to agree that WAS would almost fall under its own weight if it tried to provide a county wide service. Right now the service is getting s%&t on and no one will stand up for us, not even Chuck Ford, all he is concerned with is padding his pocket. As well as bending over and saying, yes! As for IFD, they need to get this chip off their shoulder that they are so great and superior. Because for the most part IFD would rather sit around and do nothing for 24 hrs than to take an EMS run.
So then I ask you who would provide the service. We all need to work together and stop these pissing matches. Instead of spreading rumors how about waiting to see what happens because I would be willing to bet that not even the higher ups know what in the heck will happen.
Lots of negativity here. We need to remember that we do not have a vote in this. It is likely that some day all EMS providers serving in a 911 system in Marion County will wear the same shirt. What will it say on it? Wishard? IFD? Rural?Metro? CARE? AMR? Marion County EMS? Remember that there are scarier alternatives that wearing a shirt that says Wishard or IFD on it. We as a group need to come together, and try to work for what is best for the citizens of this city and creates a good work environment for us. I will say this that as far as work environments go neither side has a perfect world. Wishard crews in many parts of the city must still sit in their trucks day and night, IFD crews face that sworn vs civilian pissing contest. Neither group has that perfect world yet. The battle must be fought and won with us working together to find solutions and present ourselves as professionals. WE must make ourselves invaluable to the community and we do that by providing a superior service which means taking good care of our patients, their families, nursing staff and the community at large. Many people need to get over the attitude that our patients are all "drunks" or "cones". Our patients deserve a pillow - n its not hte Holiday Inn - the Holiday Inn is cheaper!
The bottom line is that financial times will be even tougher in the next few years and worse that I have seen in my 28 years in EMS. If we are to survive as a species we must on a daily basis prove our value and be loved by the public. Look at Phoenix FD, they are loved by their public. Why? Because they do things that caters to the public eye. Their budget is well taken care of because the people love them.
Now go out there and do something to impress the public and show them your value IFD, Wishard, Rural/Metro, it matters not, WE ARE all EMS providers, be proud!
I am disgusted with everyone verbally bashing Wishard, IFD, Rural Metro. Wishard is full of problems, lord only knows, but so is the rest of the services as well. But the one thing that everyone has in common is the good employees and the employees that are fed up with all the politics. That is what it really comes down to here people, is politics. The higher up will do anything to cut corners and make themselves look good. So you should not be surprised to see any of the services to take over. It is sad to think that a human being would worry so much about cutting financial costs to jeopardize a humans health care rather than spending the extra money to make sure the citizens get quality people and equipment. I believe someones health care should be #1 priority over cutting funds to hire any warm body, purchasing not top notch equipment, and cutting corners just to say you saved money. So I apologize about my ranting, but I really think instead of people arguing over who works for the better company, everyone pulling together to make the city the best city to be and fight for better higher ups to take care of us and the citizens of Indianapolis.
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