By Chad Drury
Ottumwa Courier
OTTUMWA, Iowa 鈥� Almost 30 people sat in a packed conference room for a work session at the Amtrak Depot Tuesday evening, all wanting what is best for Wapello County in terms of emergency medical services.
No one left the room knowing what that looks like, and only time will dictate that.
Differing visions were discussed for the future of EMS, but the overall goal is to make it an essential service in the county, which requires a voter-approved levy that 21 counties have passed since 2021.
However, multiple entities are tied to the current service 鈥� the City of Ottumwa, because its firefighters respond to medical calls, and ORMICS, which has operated the community鈥檚 ambulance service for 44 years. ORMICS was running at a $1.6 million deficit over a two-year period, but rebounded to make a $500,000 profit.
鈥淎t the moment, the city and county aren鈥檛 obligated to provide EMS,鈥� city administrator Philip Rath said. 鈥淚 think we would all agree the community expects [us to].鈥�
According to multiple local officials, the for-profit Ottumwa Regional Health Center has wavered over the last couple years whether it wants to keep the service or transition it to another entity.
鈥淎bout two or three weeks ago I was in conversation with (former CEO) William Kiefer, and at that point they weren鈥檛 wanting to end the service, but if they wanted to maintain it, they would want us to be participating in some way to support what they do,鈥� county supervisor Bryan Ziegler said.
Indeed, last October Kiefer emailed four options to city and county officials about how to proceed with the service:
- A full city/county takeover of services
- ORHC maintains EMS service with city/county subsidization
- ORHC maintains EMS service with city/county ownership of equipment
- City/county ownership of equipment and staff, with ORHC maintaining operations
Ottumwa Fire Chief Sean Canto presented a fifth option during the meeting.
Canto, who took on his role in January and has worked in fire-based EMS departments, proposed a six-month pilot program that is a 鈥渢wo-pronged鈥� approach and continues to involve the fire department as well as ORMICS. He cited statistics both nationally and locally regarding the most popular types of medical calls and response times.
鈥淚 think this could be beneficial to not only the county, but also the city,鈥� he said. 鈥淚t would be a two-pronged approach, where the City of Ottumwa would do fire-based ALS (advanced life support) for the city proper, and then ORMICS and the hospital would provide ALS transport and critical care transport for the unincorporated areas of the county.鈥�
Canto鈥檚 vision included each of the two fire stations in Ottumwa staffed with one EMT and one advanced provider on each fire company, so that they would be able to perform EMS service and fire service. He also believed the proposal could 鈥渢ake a load off鈥� the dispatchers.
鈥淚f you鈥檙e having a heart attack or if your house is on fire, do you care if the ambulance is blue or red?鈥� he said. 鈥淭hey only care that somebody gets there in a quick and timely manner.鈥�
Maybe most importantly, he stressed continuity between patients and first responders. Current firefighters would go through EMS training so that the firefighters are interchangeable.
鈥淚n that dual-role model, not only are they performing extrications, but they could be doing hazmat rescue. They also would be trained as emergency medical responders as well,鈥� he said. 鈥淎 fire-based EMS schedule has been shown to limit personnel burnout.鈥�
County emergency management director Tim Richmond earlier this year addressed the board of supervisors about making EMS an essential service, and the board is set to begin three readings of an ordinance next month to do that.
However, he also said whatever the service looks like needs to be a holistic approach in which all entities benefit.
鈥淧artnerships are critical. Unless you鈥檙e in a real big urban center with plenty of money, which we鈥檙e not, we鈥檙e going to have some gaps. But we鈥檝e got to be creative and figure out how we get there,鈥� he said. 鈥淲e鈥檙e going to have to, for a little bit, get comfortable with being uncomfortable. We can鈥檛 afford to make a hasty decision, collapse ourselves financially and lose the service the public.
鈥淲e have to ask for the very least amount as necessary (for a levy), and if we can articulate exactly what people will be getting, the public will support it. But they have to have a clear idea of what it is, and we have a lot of work to do.鈥�
An EMS levy would require 60% of the voters approving it. Another public meeting regarding EMS is scheduled for April 29 at 6 p.m. at Bridge View Center.
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