There is a big difference between urban and rural ambulance services. Urban communities have a higher population density that leads to more calls and perhaps a justification for private/professional companies to take the lead in providing ambulance service. Higher populations also give the edge to more chances of volunteers and higher tax dollars to provide needed services.
Then there are the rural communities. With a less dense population, fewer calls, but still the need for life-saving responses.
In the early years rural communities, like Wayne County, depended on the kindness of strangers, or a funeral home hearse/director to simply scoop up a patient in need and transport them to the nearest hospital, without medical intervention.
Volunteer fire departments and exclusive volunteer ambulance corps were formed to provide rural communities with the needed services as time passed. At its peak there were 22 community fire and independent ambulance services operating in Wayne County. Now there are eight left including Macedon, Ontario, West Wayne, Eastern Wayne, Silverwaters in Sodus, Lakeshore and Newark.
The future outlook is not promising for most of those remaining as costs, staffing, insurance, maintenance and supply costs escalate.
Excessive training required by state mandated ambulance services increased precious personal time and the number of volunteers began to dwindle.
Medicaid and Medicare reimbursements, along with insurance and private use pay fail to keep up with the costs of ambulance services.
Local ambulance services are also often constrained by the lack of back-up when rigs are out on calls. To ensure coverage ambulance companies were often asked to cover other towns, or districts known as mutual aid.
Problems on local levels are also hampered by medical transports, where individual patients, in not necessarily emergency situations, must be transported to other facilities.
Several years ago Wayne County began to investigate means of full county emergency response. The ALS (Advanced Life Support) ‘Fly Car’ system was put in place where instead of a full ambulance response, a trained person in designated vehicles was dispatched to provide for situations of life-saving protocols and skills such as cardiac arrest, stroke, myocardial infarction, and other conditions.
County’s lack of full coverage is not unique as other rural counties are investigating, or prescribing to form county-wide coverage.
Strategic locations in for Fly Car coverage were established in Lincoln (Walworth), Williamson, North Rose and the County Fire Training in Lyons.
The County established a two phase plan to supply full ambulance coverage. Phase I of the County Plan includes a new ambulance facility at the County Complex off Route 31 in Lyons. Ground breaking for that building is next week, with completion expected in August of 2024.
In Phase II of the plan includes the purchase and construction of ambulance facilities in Sodus at Routes 104 and 888, across from the current Reed Eye Center; in the Town of Walworth just east of Ginegaw Park on Route 441 (Walworth/Penfield Road); and in the Town of Rose, where two possible locations are in the running.
Once the permanent ambulance facilities are established, the County ‘Fly Car’ program will also be located at these locations.
With the waning volunteer staffs, fully trained EMT (Emergency Medical Technician) and the more highly trained ALS will staff all the county run locations.
According to Wayne County Administrator Rick House, the new County contracts pay has increased allowing a decent living wage and benefits for professional ambulance personnel. Besides benefits, based upon experience, EMTs salary is between $24.11-$25.73 and paramedics $30.03-$34.78. This does not include $1 more per hour for weekend and overnight shift differential. A 4% wage increase annually is also part of the new contract through 2026.
When both Phases are complete, each new facility will be outfitted with two ambulances, full crews (51 full and part time employees) and a fly car for adequate county response times.
All this comes at a cost to taxpayers. House estimates that he would be happy with patient contributions coming in at 50%, but admits that is "wishful thinking".
In 2023 County contributions came in at $3.4 million and 2024 operating costs are estimated at $4.8 million, with an anticipated billable revenue of $1.2 million.
On the capital side of the equation the County outlay will be $15 million and another $1.5 million for six new ambulances.
Both House and County Ambulance Direct Jim Lee said the overall costs are necessary in providing Wayne County residents the needed medical services and response times for the future.