On November 7th, 2017, the Community EMS District (Garrettsville Village, Freedom Township, and Nelson Township) is asking for the continued support of the residents of the District. The District is proposing a levy of 3.5 mills to IMMEDIATELY REPLACE the current 2.7 mill levy that has been maintained since 1999. Upon the passing of this new levy, the 2.7 mill levy would be immediately terminated, and the increase in millage would only be 0.8 (not 3.5 additional mills).

What is the EMS District?: The Community EMS District is a 3 representative board (one delegate from the village and each township). This board oversees and maintains the provision of emergency medical services to the EMS District. This includes 24/7 full-time around the clock staffing of paramedics, advanced EMTs, and EMTs. Outside of the occasional instance of multiple concurrent calls for service, Advanced Life Support is always available on every ambulance. The EMS Station is located on Forest Street in Garrettsville, and has three ambulances and one support vehicle in service. The District employs three full-time paramedics, and numerous part-timers (roughly 25) of all certifications. The District received 969 calls for service in 2016. The District only provides response for emergency calls (tax dollars are not being allocated for routine trips, interfacility transfers, or for-profit activities).

Why: Why would the Community EMS District be in need of an additional 0.8 mills when District residents are used to receiving outstanding service, response times, and the department has safe and modern equipment and technology? Didn’t we recently purchase a new ambulance? These are great questions-please take the time to hear the details. The increase in millage is simply to accommodate three capital improvement issues that will all directly benefit the taxpayers. It should be noted that the 2.7 mill levy was passed in 1999 and has remained a static value accounting for 62% of all income. The last levy replacement was in 2005. The last increase in the actual cost for service was 2010 (after reviewing local costs, the bill for service and per mile for transport was updated). It should be noted that the EMS District uses “soft billing” for residents with insurance. Insurance is billed, and whatever is paid is accepted. The resident receives NO balance bill for any under-payment by insurance and the additional cost is written off. Uninsured patients receive a very meager flat rate fee, one time bill that the State of Ohio may assist the District in recouping. The District is a non-profit entity.

What are the three needed capital improvement issues?

ITEM 1: Two ambulances (2004 and 2006) that are the oldest in the fleet will need to be either replaced, or “remounted”. A remount is using the old “patient box” off the back and placing it onto a new chassis. The E-450 chassis that remounting would use are in the process of being discontinued (forcing the District to act sooner than later)-and remounting these two squads would save $100,000 dollars by avoiding replacing the vehicles outright. Spending a bit more up front would actually save this amount of money, as well as put the three ambulances on a more regular replacement schedule once again. It is the desire of the District to make this happen; should the ballot show that taxpayers agree, this is a beneficial and financially sound plan.

ITEM 2: Three LifePak 12 heart monitors have reached the end of their service life. They were purchased as state-of-the-art in 1999, and have served us extremely well. However, just like our cell phones, advances in software, features, and abilities have made them obsolete to the point where service contracts are no longer offered. The District desires to replace these monitors with three LifePak 15 heart monitors. (LifePak monitors our ambulances carry are capable of monitoring heart rhythm, all vital signs, exhaled carbon dioxide (confirming airway tube placement as correct), acquiring 12-lead EKGs, transmitting these EKGs to any facility we transport to, defibrillating, cardioverting, acting as a temporary pacemaker, and recording medication times.)
What is the benefit of upgrading to LifePak 15s? The upgrade would obviously put up-to-date monitors in the ambulances that are able to have “service contracts”. They would possess all the new state-of-the-art technology. This includes things such as increased screen visibility in daylight, more sensitive EKG measurements and data, increased memory and upgradability, and would be projected to serve the District for the same length of service as the old LikePak 12s (18 years).

A major advance in technology, the new monitors would all have “biphasic” defibrillation as opposed to “monophasic” defibrillation. This means that the defibrillator no longer just applies one large shock from point A to point B…..it actually pushes AND “pulls” between A and B. How does this benefit the patient? A decreased dose of electricity is often able to be used, producing less cell damage to the heart muscle. It also has a higher “chance” of doing what we want it to do on the first shock. Less energy, fewer shocks, less cardiac strain, better defibrillation on the first shock (emsworld.com/node/175719). A public YouTube video that promos the Lifepak 15 may be seen here (please excuse the manufacturer’s dramatic music): https://www.youtube.com/watch?v=YhuMgL2wJ5U
These cardiac monitors cost $35,000 each. The District has submitted FEMA grant applications for financial assistance to replace these monitors for the last five years. They have all been denied.

ITEM 3: Unit 2926, the SUV that acts as a staff response vehicle, is simply in need of replacement. This vehicle is a 2004 Ford Explorer that has served us very well, but will need replacement in the future.

Financially relevant information:

*LifeForce medical billing specialists handle all insurance billing. They received roughly 46% of the billed monies; this is at or above the industry standard.

*FEMA grants are submitted annually to request assistance with needed projects.

*Much vehicle maintenance is completed in-house.

*Grant secured from Ohio Bureau of Worker’s Comp to upgrade to power-lift cots, decreasing injury risk to patients and staff. This grant awarded $40,000, and is only available every ten years.

*Community EMS District was found eligible to receive a “LUCAS 3” CPR device from University Hospital, worth $15,000. (The passing of this levy would also allow the District to trade-in the two currently owned first-generation “LUCAS” devices and bring them up to date with the current technology. These now can operate on self-contained battery packs instead of large bottles of compressed air.)

*Firehouse Subs awarded the EMS District a grant for $24,000, allowing us to now obtain a Polaris Ranger (outfitted for medical care and patient extrication) to provide care and rescue off the beaten path, such as in wooded areas. It will also act as a first response vehicle at activities such as Garrettsville Summerfest.

*See item 1 detailing the proposed double-squad remount, which would actually save $100,000 in funds.

*A trend in increasing annual call volumes places higher costs on fuel, payroll, equipment, etc.

2004- 645 runs 2005- 616 runs
2006- 703 runs 2007- 798 runs
2008- 847 runs 2009- 777 runs
2010- 794 runs 2011- 832 runs
2012- 890 runs 2013- 853 runs
2014- 881 runs 2015- 1,004 runs
(2015 Nearly doubled from a decade prior!)
2016- 969 runs

What would this cost?: The Portage County Auditor’s Office has determined that the 3.5 mill Community EMS levy would cost a home owner of a $100,000 home just $122.50 per year.

In Summary: The Community EMS District is asking for a 3.5 mill levy (that must legally be called additional) to immediately replace the current levy of 2.7 mills. This is only 0.8 mill in “new” or “additional” monies. 62% of the District’s income comes from the current levy alone, and the remaining portions have either been maximized (billing collection while maintaining soft billing) or are unable to be modified (donations and grants). The proposed increase would cover all the recommended improvements to capital equipment, referencing items that have proven to last us 15-20 years. This levy is an investment in the future of EMS services in the District; where time and time again the ballot has shown that our generous taxpayers recognize that not all EMS systems are created equal. It has been demonstrated that exemplary service best comes from great people with great training using great equipment — the residents of the District expect no less. This levy will secure the capital improvements outlined, that we feel are needed to continue offering state-of-the art pre-hospital care. We ask that on November 7th, you reaffirm your commitment to US being committed to caring for YOU. Invest in Your EMS, please vote YES on Issue 36 for the Community EMS District on November 7th.