Tuesday, February 14, 2017 - Updated: 2:43 PM
By Rachel Keller Collins
The Marshall County Fiscal Court last week heard from one of two organizations interested in managing the county’s ambulance service. Judge-Executive Kevin Neal said Jim Duke, president of Com-Care Inc. in Beaver Dam, was expected to attend the meeting but was unable due to inclement weather. But Jeremy Jeffrey, Executive Director of Mercy Regional Ambulance Service of Paducah, agreed to talk about the service his company could provide even though he said he had only planned to attend and learn about requests for proposals.
Jeffrey said the entire country is currently facing a shortage of EMTs and paramedics; it’s not an issue that’s specific to Marshall County or even Kentucky. He said one of the ways his company is addressing that shortage is by offering in-house training through a program called, ‘Training Education Institution.’ He said TEI also allows for the required continuing education, ensuring their EMTs and paramedics maintain certification.
Regarding a potential merger and the ease with which it could happen, Jeffrey said the transition would be “pretty simple.” He said his company managed Livingston County’s ambulance service from 1999-2002 and once the ambulance service “got their feet underneath them” and “became solid,” the service was transitioned back to the county. He said Marshall County’s ambulance service currently utilizes the same protocols as Mercy Regional so it would be a matter of learning his policies and procedures and standard operating guidelines.
Jeffrey confirmed all of his employees are also offered 401k and a retirement program as well as health insurance that includes dental and vision coverage.
Commissioner Rick Cocke asked for an approximate turnaround time for an estimated cost if Mercy were to take over management of the county’s ambulance service and Jeffrey said considering his numbers have to pass through three accountants, it would likely take 45 days.
Jeffrey confirmed Mercy is interested in the ambulance service saying, “The reason we are interested is, again we’re owned by Lourdes and Baptist Health of Paducah. They both have interest in Marshall County as you are all aware. I’m interested in it because it’s a contiguous county and I live here.”
One of the concerns expressed by the commissioners during the Jan. 21 meeting of the Fiscal Court regarding terminating the contract with the hospital was the concern that none of the bids would be suitable and the county would wind up managing the service itself. Neal said he “didn’t want to talk about the numbers in detail openly, but [County Treasurer Emily Martin] did run the numbers and we are positive that if the county were to get stuck with the ambulance service it wouldn’t be a negative.” He said he would be happy to share the specifics of those numbers with the commissioners after the meeting.
Neal said another concern he wanted to address was making sure people understand “the relationship with the hospital would be the same.”
He said, “To think the service being managed by a company like [Mercy] the hospital would have problems, that’s not the case. We’ve sat down, I know, in the past, members of the administration sat down with David [Fuqua, CEO of Marshall County Hospital], and his message was clear both times. I know when he talked to Jason [Darnall, Assistant County Attorney] it was the same message, that they’re losing money and if the county wants to take the ambulance service back they can but it’s important that people understand that the management piece for the ambulance service, there will still be that relationship with the hospital. Actually, it’s encouraged that they maintain a good relationship with the hospital. So I just want to make sure people, if they’re being told otherwise that’s not actually the case.”
Neal went on to say that he believes “this is a good business decision” because he believes the county can get a better management cost from companies like Mercy Regional or Com-Care.
“I think that’s where we as elected officials need to look into that to see if there is an opportunity to save some money. And really, in my opinion, get a company that deals with ambulance services,” he said.
Neal looked to Jeffrey and added, “I know when I was a police officer you were in the street so you’ve worked your way up through the ambulance service so when someone comes to him with a need you know exactly what their frustrations are and what their needs are. I’m not saying the hospital doesn’t do that but here you have a company that works specifically in managing ambulances.”
Cocke said since the last meeting he had been conducting research and learned that Com-Care Inc. manages four counties in Kentucky: Ohio County, Logan County, Todd County and Caldwell County. He said he and Commissioner Johnny Bowlin were scheduled to meet with the judge-executives of Caldwell, Logan and Todd Counties last Wednesday to discuss the details of their contracts and learn not only the cost of the contracts but also the levels of satisfaction with the service.
Cocke said during the brief conversation he had with Caldwell County Judge-Executive Ellen Dunning, “it was her advice to Marshall County to make sure that you give yourself time to know what you’re getting into and know what you’re giving up before you give in to the masses.” He also said she reported spending six months conducting research before signing a contract.
Cocke said he asked her how much the county was spending on management of the service and she said the contract, which began in Dec. 2016 and ends June 30, 2017 at the end of the fiscal year. He said she reported the county is paying out $25,800 a month, which would equate to a little more than $300,000 a year. Marshall County pays $202,000 for the management of the ambulance service to Marshall County Hospital.
Neal asked if Caldwell County owned their capital because that would make a difference and Cocke said it was his understanding that Caldwell, just like Marshall, owned its own building and equipment for the ambulance service.
But, Cocke said, he wanted to ensure they were “comparing apples to apples” and reviewing the contracts and customer satisfaction with the three judge-executives should give him a better perspective.