Imagine responding to a scene where multiple victims have died in horrific ways... a family member cannot be revived following a heart attack, or a child has died and there was little you could do.

Often an ambulance crew sits waiting for a call, sometimes,  the day never ends and multiple responses run way beyond their shift time.

There is an advantage to its rural setting like Wayne County. The politics and personalities of separate ambulance services is no longer paramount to reality. Back in the early 2000s the Board of Supervisors saw the writing on the wall. No longer could area volunteer fire departments afford both fire fighting services while supporting non-billable ambulance operations. Outdated laws prevented the volunteer label from billing for real ambulance outlays.

The lack of funding combined with the time requirements of EMS (Emergency Medical Services), continual training and volunteer hours was at a breaking point.

Some municipalities developed separate ambulance departments, but that was a short term answer, at best.

On top of the drain of people, ambulance services were burdened with layers of paperwork. Billing became a multi-level nightmare of Medicare/Medicaid, lack or level of insurance coverage by the patient and government form requirements. There was also the inevitable write-offs where a patient could simply not afford the service bill.

Ambulance services required a third party billing/company, and that only added to the overall costs of operation.

Professional ambulance services, especially in more rural settings, became a necessity and had to be established. Wayne County was on the forefront of ambulance service future.

Before the county took the reins of municipal coverage, there were 15 separate fire department-based ambulance services. Today, there are none.

Still, there were roadblocks. Moving from volunteer to paid staff was an uphill fight. Low pay and the burn-out factor made it impossible to look at emergency responder jobs as a lifetime career.

Under the leadership of County emergency guru Jim Lee, Wayne County Emergency Medical Services Director, the totally professional  ambulance response is becoming a reality.

Currently, the County has established three operational ambulance centers in the towns of Rose, Sodus and the main facility off Nye Road in Lyons. The final center in Walworth is under final construction and expected to open in mid-November. Full ambulance response is now a reality in Wayne County.

Jim Lee and his leadership staff are currently conducting interviews to fill the slots for staffing at the Walworth  facility, slated to open for service on November 15th.

The Wayne County Board of Supervisors up-fronted the money necessary to launch a county-wide ambulance/EMS service.

The four modern buildings not only house the ambulances and equipment, but gyms, quiet rooms, meeting facilities and a main area for relaxation and food preparation are part of the new generation of ambulance life.

Along with Jim Lee are Jason Hagg the County’s EMS Educator, ensuring ambulance crews are up-to-date with ongoing trainings and stay mentally prepared for the job.

Eric Dierks is the County’s Operation Manager, responsible for scheduling, hiring and overall  condition of the facilities.

Both Hagg and Dierks, along with Lee have put in the decades as longtime EMS members and occasionally need to wear the hat of back-up crews for the times when it is all-hands on deck. 

The work responsibility and pressures of ambulance responders is often something they have learned to keep at  work, or bottled up inside, as families are often ill-equipped to deal with the emotional sides of the job.

Both Hagg and Dierks said their wives are former ambulance people, who understand the lifestyle pressures.

Hagg indicated that crew readiness mean three principles--equipment ready, station ready, and crew ready. 

He added that it is important for crew members to have an outside life, whether a strong family tie, or hobbies to deal with the emotional strain involved in EMS duties. Bottom line, emotional health is primary to work in the daily grinder of ambulance response. 

Lee said the addition of ‘quiet rooms’, where a crew member could unwind was essential. They also recently added weekly mental health specialists times where crew members could visit at the base meeting room and talk about whatever may be happening in their lives. "It’s okay, not to be okay," in the EMS service, stressed Lee.

As for pay, ambulance personnel were at the bottom rung of many wage scales. Flipping burgers at the fast food place often out-paid emergency health first responders. 

In addition to EMS members burning out, many in the past only used the job as a stepping stone to nursing, or other related public service careers. 

Thanks to the realization of their importance, wages for EMS workers have increased. A new EMT begins at $25 per hour and paramedics make a starting wage of $31 per hour. These wages are on par with county RNs (Registered Nurse). The ambulance EMS crews also have the advantage of full health coverage and retirement packages, including longevity increases.  Still, several of the Lyons ambulance crew members said they must hold down second jobs to keep up with the cost of living.

With all the pressures of the job, EMT Patty Roberts explained that outside life tends to gravitate to those in, or familiar with EMS workers. "Nobody (outsiders) understands where we are, or what we do," she stated. 

She continued by pointing out that it used to be a silent task asking for help, it felt like you were somehow weak, explained the former corrections officer. 

She added that regardless of your mental status,"You do tend to see the faces of people who have died".

All the EMS crew  echoed that the faces of both patients and families is often burned into their minds.

 Cory Best said that over his many years of service he has learned to "cope in his own way". "I don’t bring any of this home."

In her 25 years on the job   Lena Ramsy said she still loves what she is doing, but the stress and memories are always in the back of your mind. 

Town of Ontario resident Robin Medeaugh as 13 years as a EMS She added that she doesn’t need, or rely much therapy, but admits that the thoughts  of past incidents is always there.

Jay Pelton is the old timer of the group with 32 years of EMS. "I started when I was just 16. I used to take it home with me and battled alcohol. It sounds heartless now, but now I shut it off," he admitted. He added that EMS workers live where they work and it may be hard when you encounter people you know while on the job.

Best chimed in that the public sees the uniform and the work and often hold their presence in a higher standard.

The EMS workers also admitted that there is an adrenaline rush to answer calls for service, especially in the more dramatic settings.

Jim Lee stated that the public often misunderstands the premise of billing, especially when tax dollars are used to support EMS programs. He said that unfortunately with the way reimbursements work, only 25% of the cost is covered by the billing service the county uses..

Currently the varying rates for billing a patient is based upon a Board of Supervisor’s resolution and upon the amount of service required for a call. 

The Wayne County EMS program is not a for-profit operation, but must survive as a Wayne County ongoing entity.