Full meeting transcript - April 20, 2021

» - Test one, two, check, check. - Okay, so fellows, we'll be talking into the microphone. Go ahead, turn it over to you, sir. - Good morning, council, today we're gonna be presenting you information on the current status of our EMS system, as well as any issues or concerns that they have, so that we'll start with kind of where we are, then we'll get into those issues that are facing them, and then we'll let council take us wherever you wanna go, with whatever direction you want us to go in.

» - And so just context, we're a single agenda, and uh by our rules we can't go outside that agenda secondly um our next budget event is first reading is that correct um first reading is may 11th yeah so we'll we'll have another we'll start having a budget workshops before we have um okay that so i know these guys are going to have a bunch of questions based on what we're here for so i'll turn it over to our ems director uh Gerald, you take it on. Thank you, sir. Chairman Burns, Council, thank you for having me today. I appreciate the opportunity to speak to you. I'm just going to be going over the current, what EMS is facing, how we're dealing with what's going on in an ever-changing healthcare world. Some of these slides are going to look familiar to you.

» We talked about them a couple of months ago, and some of the problems and some of the things that we face every day is not changing. it is what it is. So let's get started. All right, our workforce. Currently, we have 39 full-time team members, or 39 FTEs, 21 paramedics, seven advanced EMTs, 11 EMTs. Part-time, 22 members, 12 paramedics, one advanced EMT, and nine EMTs. Over the past 24 months, we have lost, 18 to 24 months, we have lost 14 full-time staff, but we'll talk about threats here in a few minutes. The workforce, currently we're on a 24-48 schedule, which means we work approximately 246 hours a month.

» We require each certified individual to have at least three hours of continuing education, as well as with paramedics having to have their ABC courses, such as ACLS and stuff of that nature. Total for the year is around $29.56. Annual salary for a paramedic is around $34.04. ANT is $40,000, and the average salary for the annual salary for paramedics is around $50,000. As you guys know, because you've been willing to fund the purchase of these vehicles, these are our two platforms that we use. We have the Dodge 5500 Type 1 ambulance, which is one of the best ambulances on the market, through AEV Traumahawk. And we have two QRVs, one that primarily serves the west side and one on the east side.

» Their responsibility is to provide backup for time-sensitive emergencies and command and control otherwise, supervision. Our deployment scheme, we have five stations. Station 1 is on Church Street, serves the Camden area. Station 2 is currently housed inside the government center here due to some issues that we have with our old Station 2. Station 3 is Mesa Lane. It says Camden there. I apologize. Mesa Lane is actually in Lugoff. Station 4 is in Elgin, and Station 5 is Porter Road up in the Bethune area. Just to give you some reference, we've talked about this before.

» There's two basic standards for the industry providing EMS ambulances to the citizens they serve one is one ambulance per 10 000 population and the other is one ambulance per 100 square miles so based on the demographics you guys see where we're at there workload fall volume continues to climb fiscal year 17 18 87 88 the following year and then we see a pretty good jump there 1920 to 9179 and right now we're projected based on our call volume uh since july to be up around the 9400 mark so we're going to see an increase you get the idea that it just continues to climb the number of trucks have stayed the same station one uh as i said earlier camden uh they run the bulk of our uh our calls 29 percent station two around 18 percent station three twenty station four elgin eighteen percent and th

» en station five is notably the slower station in our county in the bethune mount pisgah area uh eleven percent our qrvs run four percent of total volume but as i said earlier therefore cardiac backups time sensitive emergency backups and command and control station two is the one that's located we've had to move that station to the uh the camden area because of mold in the station and since that time since we moved in september we are starting to see some of the balance there of call volumes because what we've done is we've had unit two and unit one go into a rotation the one goes out and two immediately goes out to the next call in the camden area so that's balanced some of that workload we did that because of some of the safety issues with station one carrying the the bulk of the calls tr

» ying to make a good thing out of that, you know, lemonade out of lemons, I guess. Outcomes, 65% of the patients that we come in contact with or the calls that we respond to, we transport. Treated refused transport around 12%. That's important because out of that 12%, you're getting a reduced amount of revenue generated from those calls, but you do still get something out of that, the wheels turning for those calls. Treated transferred to air and medical, 1% of the volume, Canceled in round, around 6%, and canceled on scene, around 8%. Treated and transferred, around 4%. Those treated and transferred are when our QRVs come in contact with the patient and then turn them over to an ambulance. And then, of course, your DOAs are around 2%.

» Yearly revenue, we have been very fortunate that our yearly revenue has been on a steady upward trajectory as well, based on the call volume and the documentation that our crews make sure that they put into their records. They do a fantastic job there. 17-18, as you can see, 1.5, 1.8, almost 2.1. And this year, we're going to be talking about that a little bit more further in the presentation, but we're going to be around 2.1 again, 2 to 2.1 again this year. The fee scales, BLS 400, the number that you see in parentheses there, that's your allowable, all right? So when we send out that $400 bill, we're only expecting to receive 353 from the insurance companies. And that's pretty much set by Medicare and Medicaid, and most private insurers follow along those lines as well.

» - Tell me what BLS, ALS, all that means. - Sure, basic life support is just someone twists an ankle. they go out, they get picked up, and they were taken to the hospital. Minimal care, vital signs, stuff, you know, stuff like that. ALS-1 is where the patient is complaining of an advanced life support type complaint, cardiac pain, respiratory distress, something of that nature. They get placed on the cardiac monitor.

» They may receive one to two drugs, medications, such as aspirin nitro and then that gives you permission to to bill for als1 als2 is when the care of the patient is more extensive it requires additional medications maybe an advanced airway of something of that nature the 12 dollars per mile that's what we're allowed to bill uh the patient once the patient is in the back of our ambulance and inbound to the hospital gerald quick question what is our cost based on our fee what is our cost uh in other words if it's like bls if there's a 400 fee we collect 353 from insurance what is our cost actually i've never done a cost analysis like that uh or just right it would be your basically it'd be easy enough to do it'd be your call volume divided by what you what you spent last year staff hours righ

» t yes sir yeah i'm sorry i don't have that no that's fine what's the asterisk hard billing what does that mean uh the the hard billing we we started hard billing towards the end of uh 18. uh it would have been 1718 is when we started it in 1920 there was a windfall of of our basically a new computer system that our billing company was using allowed them to go back and pull buckets from previous years uh bad debt people hadn't paid their bills so they were able to go back and hit those buckets of hard debt now we're on a continuous stream but what happened in 1920 was a windfall and also down here at the bottom most insurance uh companies pay 80 of the allowable so just because the 353.95 for a bls call is what you're charging uh or what is allowed by medicare medicaid they're only going to

» pay 80 of that. So you still have money that is going to be lost there. All right, moving into the current and future threats. Lack of adequate facilities for field staff or command staff. When we had to shut down our EMS station two, that really created a bit of havoc for us. We have seen an increase in response times, as you see there, increased call volume and response times. The Station 2 area moving into Camden has certainly impacted Westville, Shepard, the Barron-DeKalb area, and Liberty Hill. Difficulty recruiting and retaining staff. As I mentioned earlier, we've lost 14 and 18 to 24 months. It's an incredibly competitive market. We're competing with other county-run agencies, 911 agencies, as well as the private sector.

» POTENTIAL IMPENDING SALE OF THE HOSPITAL WITH THE LOSS OF PHIEN LU, I DON'T HAVE TO TALK A WHOLE LOT ABOUT THAT, I BELIEVE THAT'S WAY ABOVE MY PAY GRADE, BUT THAT'S CERTAINLY SOMETHING ON THE RADAR THAT, YOU KNOW, WHEN I THINK ABOUT CURRENT AND FUTURE THREATS, IT'S THE THINGS THAT WAKE ME UP AT THREE O'CLOCK IN THE MORNING AND I CAN'T GET BACK TO SLEEP, BUT THAT'S CERTAINLY ONE OF THEM. INCREASING AGING FLEET AND EQUIPMENT, I GOT THE CORRECT SPELLING IN ONE AREA, I MISSED IT somewhere else, guys. I'm sorry. Increasing aging fleet. We have fallen behind on purchasing of units last year due to the COVID freeze in budget. And we'll talk a little bit more in a few minutes about the rotation schedule that we set up in 17-18. But last year, we were supposed to purchase two units.

» That way, our first dodges that we purchased in 2015 would rotate and we would get some of the high mileage blueberries the blue trucks off the road so just so you know all right so just reinforcing current and and future threats that is our ems2 it's up on lockhart road um it has uh unfortunately it's it's got black mold uh we were advised that we needed to get our crews out of it back in september so that's when we moved out of that station this station going back to that 2017-2018, this station was actually slotted to be replaced when we elected to move from our original replacement schedule to building the station in Elgin to meet the requirements of paid 24-hour fire staff. So this station got pushed back, and unfortunately the mold just got too significant.

» We started receiving some complaints, and then we had a company come in and it was found to have aspergillus and some other uh pretty scary stuff in it projected costs repair fix replace yes sir we talk about buildings uh buildings here um if you will let me continue and then we'll get to it sir thank you um again lack of adequate facilities in the camden area station one when we moved into this station it was understood that this was a three to five year temporary housing situation as you can tell the the facility is not that good if you see the the green mold on the outside there the interesting thing is there's also bubbling paint on the inside where the water seeps underneath the the concrete there and actually floods the bedroom and one of the supply rooms so it's it can be kind of cha

» llenging in heavy wet weather. With the moving of station two into the government center, what we ended up having to do was we had to move our training officer out of the training room. We lost our training room because that became our bedrooms for station two. In the process of moving that truck to this location and then the generator going in, we lost a large amount of our storage capacity.

» so on top of losing our training out area we also lost storage capacity our supervisor has been pushed to basically our what we call our logistics room and that's his workstation this is just um if with the generator they put this little box in here and that comes out about six feet it gives you a little bit of idea of how much storage we have during covid that has been incredibly challenging because of course we have additional ppe that we're having to order we're having to stay ahead of any of the shortages and i can tell you we pretty much set on about three to four weeks of supplies using that room the hallway and also the um the print shop across the street i forgot the name of that building but but over there midlands midlands midlands spring so you see how things are pretty spread ou

» t. All right, the increasing call volume and high UHU, we've talked about this. Okay, acronym deficiency. Right, unit hourly utilization. For every call that you run, you run, you get one hour credit for it, all right? When you start talking about the additional paperwork and everything that's involved in an EMS run, a typical run is actually about an hour and 15 minutes. This length of call over here is from the time the wheels roll to go pick the patient up to the time we drop them off at the ER. That has nothing to do with any of your documentation or anything of that nature.

» So when you start talking about, when you start talking about running 9,000 calls divided by the five units, your UHU for the service as a whole is probably somewhere in the neighborhood of 23 to 24 percent, which is not high. But when you think back to station one, running that 20, 29% of the calls, that truck's UHU will occasionally bounce up to 32 to 35%, which is a safety hazard when they're there on a long duration shift. So just keep that in mind. And 2021, it only gets better guys. Patients transported, transported out of county and totals for the first quarter, we've already run 2391. For the year, we're going to be up around the 94 to 9,500 runs. So like I said earlier, the call volume just continues to increase. Yes, sir.

» And that doesn't, that call volume doesn't count the time they have to reset their truck. Is that right? That's exactly right. So if you have a very traumatic call. Yes, sir. You could be, what, hours resetting your truck. Yes, sir. There's a difference between unit utilization, hourly utilization, and time on task. Okay. When you start talking about, and that's why when your UHU gets over 30 percent and then you include your cleaning of your truck after every run, you're checking the truck off. It takes about 30 minutes to an hour a day to make sure all your equipment is there, make sure everything's working appropriately. That's where your time on task starts to creep up. So you start to see how easy it is that these guys are not down very long and they're not getting a lot of sleep.

» In fact, station one, very, very seldom do you ever have a six hour break between calls to actually get any kind of real, real rest. And that's why it becomes unsafe. So that will be important as we as we move forward. All right, difficulty recruiting and retaining. As I said earlier, we've lost 14 and 24 months. Out of those that we've lost we've lost nine paramedics one advanced EMT and four EMTs what that tells you guys is we're losing the top clinicians that are supposed to be taking care of our citizens this right here losing nine paramedics that that's another one of those things that keeps me up at night trying to find a way to to make sure that the guys are engaged and they they feel appreciated and wanted, because we may not be able to hit these targets down here.

» We conduct exit interviews with our team when they decide to leave us. And so far, what we're finding is schedule, pay, call volume, room for advancement in a small service. Not a whole lot we can do about that. We're a small service. And then you start breaking down into like your volume and so on and so on.

» how many vacancies do you have currently we currently have no vacancies we have been incredibly fortunate um over those 18 months um and i i commend the supervision the frontline supervision the team um xo and carrie for uh for keeping morale incredibly high through challenging times no vacancies no vacancies at this time that's amazing now with with that being said just so you know we have no vacancies but we have two individuals deployed we have one that's still out on a medical from her return from afghanistan a paramedic and we have an emt that is with the south carolina national guard and he's engaged with vaccines so so that's the reason why we still struggle to make sure all the stations are up because we have those two folks deployed I guess, I'm sorry.

» I guess the real question, Gerald, that I would ask is out of those nine paramedics, how many of those have been replaced? We think we're down two paramedic slots. We've replaced seven, seven of the nine. What we have done is we've educated and sent a lot of our EMTs through advanced EMT school. So they're capable of doing some cardiac monitoring, but they're not capable of diagnosing what they're looking at on the cardiac monitor and then immediately addressing what they're looking at. And I used a bad word in pre-hospital. I said diagnosis. We don't diagnose. That's a mid-level or higher. We do field impressions.

» So a paramedic can make a field impression and immediately start treating what's in front of on standing orders advanced emts are a little bit more uh controlled by the state on what they can and can't do does that make sense yes sir okay on pay on these four items is that an order of priority or just random recruiting and retention oh no no no actually sir that is the majority of people complain about the schedule 24 48 really yes yeah the majority of people leave us to go somewhere else for schedule or pay we found more for schedule than we have pay they want the 72 i'll be darned what is the pay say again what is the pay scale for a paramedic and emt we start around 50 000 for a paramedic uh emt starts at 34 4 and an amt starts right at 40 okay is that close to industry standard or is th

» at high or low or well actually we i sort of hit on that in a few minutes um we have we have been very fortunate to stay competitive through reacting to what's going on around us not proactive but more reactionary you can go to lancaster county and and start out as a paramedic about five thousand dollars more than what you can in kershaw county um now that's the pay side what we're seeing is more services are going to a different they're staying on what they call a long duration shift a 24-hour shift because it would be very hard for rural services to be able to pay 12 hours it's just more difficult all those all those bodies so most services have have gone to 24 72 or some services are going to 24 72 and that 24 72 uh is starting to to really hit us um florence county um you wouldn't think

» that we would compete against florence county because they're so far away but you take a medic that lives in lee county and there's an opening in florence they're going that direction um calhoun county and it's in a future slide but calhoun county has recently gone uh to 2472 we've lost one medic and we have two in the batter's box we have two that are looking and have applied uh to go to calhoun county and um there's no way for us to be able to compete with that a question um so that i can compare apples to apples if lancaster county is paying five thousand dollars more as a base what is the number of calls per paramedic in kershaw county versus there i know you probably won't have the answer right now that's something i'd be interested in yeah if you're getting paid five thousand dollars

» more because you're handling whatever percentage more calls as an individual paramedic or a team i guess yes sir team and they're certainly running more calls than we are but they have more trucks on the road i and and i wish i'd have talked to clay um about that i want to say that they are currently up to nine or ten units on the road today because i know the the growth up there is exploding it's exploding and and again their tax base is completely different. And I'm a realist. I recognize that, you know, Lancaster County's tax base is totally different. The Indian land, even Clay will tell you that the Indian land area and the growth up in that part of the northern part of their county pays for the southern part of the county.

» And guess where we're at? So, you know, we're down that side. Yeah. But if you could get that to us or for me, that would be helpful because I just want to see if we're at parity or being competitive. Thank you. Yep. Yes, sir. All right. And this is the difficulty in recruiting. This is exactly what we were just talking about. Another company that has taken a couple of our paramedics over the past 18 months is First Priority. First Priority is a transport service here in Kershaw County. Well, actually they're based out of Columbia, but they do keep a truck and they have the contract with the hospital. And they start their paramedics annually a little bit around $1,500 more than we do. They also run a 2472 at First Priority.

» So we're competing with these three folks right here just on schedule. So what would you, what would you need to do to be able to change your schedule and adapt? 24-72. Right. There's, there's several different options. One is, and we'll talk about those here in a moment. Okay. This gentleman right here worked for us for quite a while, Scott Dunham, excellent paramedic. You probably saw him out on the road years ago, Sammy.

» He is with first priority now and uh schedule and pay uh captured him so and first priority is not even they don't run trauma that's exactly to your to your degree there that's all that's right they're a inner facility um doctor's office kind of transport only and you're saying their pay scale is higher yes sir and and it's again trying to compare apples to oranges is is difficult but we're all competing for the same workforce, right? But you take a private service like a first priority because it's not an emergent call. They have no legality or legal responsibilities to the citizens. They can pick and choose who they want to respond to, or they can set up the contract. Like with the hospital, they respond to the hospital to pick someone up that doesn't have insurance.

» They're probably, and I don't know the details of their contract by any stretch of the imagination but they're probably receiving some kind of stipend which is close to your allowable all right all right so the elephant in the room that I have no control over this is definitely on on y'all's plate though but like I said it is definitely out there guys the we dodged a bullet with the Prisma deal the potential sale of Kershaw Health with the loss of PN Lou that is 25% of our of our revenue so that's uh that's that's a chunk let me just say we supported we didn't dodge a bullet we supported the sale of prisma okay so but the issue was if that happened they were a non-profit and therefore we would lose the fee law sure yeah and that is from an ems perspective correct whether it is one for us an

» d we support the local hospital coming from his perspective. That's exactly right. I should have clarified that. I apologize. That is certainly something that was keeping us up at night. We were worried about it. But you're right, sir, that the hospital certainly needs to be competitive in their market. And reality is, it's only a matter of time before it happens. All right, the aging fleet and equipment right here, that's unit 14. We're setting it 170, basically 176,000 miles. EMS has been unable to successfully meet the replacement schedule set forth in FY 17 and 18. EMS 2 was supposed to be replaced in 1920, but instead to facilitate 24-hour fire service, we ended up building the station there behind the Blaney Fire Station.

» EMS Station 1, if I remember correctly, was slated for this upcoming year. We were hoping to be out of that building sooner than later. EMS 13, we still have it as a primary backup. You've seen it on the road, and the reason being is because we did not purchase those two units last year to be able to get it out of our inventory.

» EMS 14 this year was scheduled, if i remember correctly to go for a remount because we would have started remounting 14 because of the mileage so we'll have a dependable backup fleet and we are still running one tahoe with 283 000 miles so yes sir just for some reason with with going to the dodgers i thought we brought a little bit more life expectancy out of our out of our units what's what's average for a unit on mileage that we normally get because i thought it was over 200.

» it is it is absolutely the the key is is our original plan was to um those first two dodges that we had to rotate them as as very good backups they were going to stay in our backup fleet for five to six years or if i remember if i remember and i've got it here somewhere uh we weren't going to look to actually push it out of our fleet until after 250,000. Okay. So. Because I think that was the reason of deciding to go to them when we did. Absolutely. Okay. And I can tell you, they are workhorses. I mean, we've been very pleased with what we're getting out of them. Maintenance costs have been relatively low. But again, once you start getting up to 180, it's time to start thinking about rotating that to a good, solid backup. Mr.

» Tucker, our maintenance costs on those vehicles are much less than the other costs were. So we're not spending the money to maintain them at this point that we would have spent on the other vehicles. So the dodges are definitely a good investment for us. Thank you. Yeah, I have a question. First of all, by this thing here, it shows them listening to a Columbia radio station.

» to fm 97.5 no just to summarize where i am right now uh is uh schedule pay fleet facilities those are the four messages i'm picking up without any commentary and then the fifth one might be equipment are we going to get to equipment later on yes sir we are okay i'm not asking you to get in front of your briefing okay thank you sure sure thing um i do have some other mileages but they're they're equivalent to 176 so we do have uh other units right in that ballpark so if we can again get back on schedule a year later and start rotating these trucks into a backup type role would be real good um as far as the equipment uh question that you had chairman burns that's actually in solutions uh further on in the discussion but okay i just wanted y'all to sort of take the time to ask any questions th

» at you may have on threats i i i do thank you which you said this was out of your wheelhouse and i understand that but the potential loss of dan lewis is a huge factor we've got to think about uh but i would think and this is just me that the mold in your building and to make sure they're safe living quarters or work quarters would be a top priority or probably the top priority wouldn't you think or am i missing something no no sir you're not missing anything buildings are are certainly important if you got mold in there that that station is down we cannot go back into that station we're we're running the crew out of the government center that has that has worked but it's not ideal we've seen an increase in call or increase in response times those areas i mentioned earlier of two to three m

» inutes on average um so that's my next question with you moving in we're making we're making due with what we have um and it's going to be a a cost reward decision that y'all the council has to to figure out as far as priorities because buildings are certainly an issue well i would what i would think is the priorities would come from vick and you to us well i mean we're not the experts on ems right and well and and mr jones that's what we're doing first of all is make sure you're aware of all the situations that we're dealing with um and understanding um from the councils we present the budget to you we're definitely going to have have for you solutions gerald's going to go into some of them yeah he's going to go into some of the possible solutions right now so you can be chewing on them um

» none of them are necessarily what we're saying this is the best solution or the worst solution but we want to give you the understanding of what we see solutions are and then as we get into the budget itself then council can kind of chew that up and we can end up with where we're going yeah but you're also dealing with with a capital issue which is different than an operational as you know so so the source of funds for capital is one thing um again we we put a pause on all spending um 15 months ago when covet came and and so you know that was the immediate threat to us is would we have revenue coming in to to cover budgets and so we cut all capital spending we we cut all all costs that were not absolutely necessary and and so you know it was a priority then um we carried that budget into th

» is year and we started relaxing um those those issues but but that's why we're behind but seeing that we're so far with with the code pandemic with everything that has happened and the priorities that are up there especially with stations you know we can do some temporary things to carry us for a few years such as you don't have to always build a taj mahal you could get another mobile home unit out there for less money because we're dealing with fire we're dealing with you know the sheriff's department we're dealing with ems i mean and there is no money and and those are are some of the solutions that i hope they right and so so putting them downstairs was our our temporary solution at very little cost to the taxpayers but still being able to deliver 98% of what we're doing beforehand but i

» t's just my thought you can take that mobile home tear it down and put something else up brand new or decent there and sure it wouldn't be something you won't forever but at least it would carry us through a few years while we're trying to work on the fire and other things because we've We've also put a lot of money into EMS the last couple of years, and it was definitely needed, and I support those efforts. But I'm just saying that I would hope that instead of just always getting Taj, and I don't mean to be disrespectful, I say Taj Mahal, but you know what I'm saying. Sometimes you have to kind of crawl before you walk or run, you know, and I think this is certainly one of those years that we're in.

» But I'd like to see some solutions coming back from you and your staff, maybe, you know, A, B, and C, Plan A, Plan B, Plan C, to include something that I just spoke about. Thank you. Mr. Chairman, I'll go ahead, Mr. Chairman. I, you know, go ahead. Okay. Thank you. A question on financing. So the topic was brought up about the fee in lieu of possibly going away if something ever happens in a transaction with the hospital. Are there restrictions on EMS funding like we've been familiar with in FIRE? We've got a big education on that, and millage is restricted. You can't pull from particular areas for operation costs. Are there any limitations on EMS we should be aware of for funding as we consider that? Yes, there are limitations, but not like with FIRE.

» Our EMS millage covers the entire county, so every taxpayer pays EMS millage, which is not the case with FIRE. So the limitations are not the same as FIRE. So general fund money can be expended on EMS expenses. Okay, thank you. that's what's coming from now anyway yeah two-thirds of it um my question um do we own this land or do we rent this land we own this land okay and how many uh what's the size flat out there yeah i can get it for you okay not a huge parcel okay the market's crazy right now though you go to build anything and it's compared to three years ago when we were building some of these stations you're looking at a 50 to 100 percent markup on some stuff due to labor and materials it's just nuts yeah most of those are cabinet makers i understand i wish it were i wish it were we'v

» e been hit hard we've been making adjustments i can agree and we're still getting help from uh mr cobb correct over at light point yes sir yeah that's a that's a wonderful partnership i'm very appreciative of that sorry go ahead have you seen since you've moved this you had to move out of that station looking back when we plan to rebuild whatever that looks like is that still the ideal location for another station or has the last two years taught you well maybe you know it needs to be because i mean if we're going to do something it's good to evaluate your locations and are they strategically in the right spots absolutely and dating back to when um like i was saying 1718 when this discussion of replacing station 2 started creeping in uh gene and i had several conversations and and vick was

» included in some of those about the location of station two um it would be very good to be able to push station two um either up highway 97 long term um or further down flat rock road giving us a slightly better jump on some of the outlying areas right um so it is not an ideal position okay no but but also let me say one of the things that we're going to have to be cognizant of is going back to that volume at station one. Station two is the primary backup for station one. And the statistics back in, I think it was 2016, 2017, showed that, I want to say it was like 65% of the time when that truck left station two, it was turning to the right. It was going back into Camden.

» That's where the bulk of the calls are coming from so if you push it too far out then you lose your strategic right backup to station one's area unless we're going to attack the call volume for station one by looking at an additional rig that was my question yes sir what i i would be interested to know in kind of almost like a heat map of station one and two so we know that's good volume but where in where in camden where in camden and or the area is those two stations going um just i'm just just thinking out loud you know you got you know you as you head towards the northeast part of camden east camden i mean that's a highly that's a densely populated area and just as as an observer who has an office on highway one i see you i see you guys rolling by a lot yes and so i just and i'm sure yo

» u're rolling a lot of blue golf too so i'm not saying that i'm just yes sir i would just be curious to know that it might be worth looking into trying to be able to strategically put something where it could get to that part of town i don't know it's funny that you mentioned that because um robert johnson um director from many years ago when station two was first built or put up on that piece of property robert recognized that the location of that station allowed him to go down and hit sanders creek road right and get back over to us-1 and back into town on the on the east camden side So, again, strategically speaking, it's not an awful location, but you've got more growth taking place up in the lake area, and what we're seeing right now is response times to Liberty Hill.

» That's our longest response time. You're talking 27, 28 minutes up to that area. You'll cut 10 off just moving back up there. Say again, sir? you'll cut probably 10 minutes off just moving back up to that location if we if we push the truck up 97 or even up further on flat rock road you could cut that that down yes sir but again the problem is uh volume uh just like we faced with um the truck in the bethune area your volume and then cost versus you know improvement of service yeah let me let me ask a question if i may yeah if you if you had it your way where would you put it strategically we were we were looking to do it every day what what makes sense to you yes sir we were we were looking at some property and i you remember the name of the we were looking in the gaines church road area of

» highway 97 yeah back this side of gaines church road so again we could jump back into camden if we had to so isn't that close don't we have a fire station up there we do we have a fire station on baron dekab baron dekab station um it's probably it's on flynn hill road about gosh i used to drive that when i was on on the qrv a lot i want to say it's probably about five miles further up i mean is it potential to put a small station on that parcel do we have any land available to build on next to the fire station or is it all filled up with parking lots and buildings i'm not 100 sure of how much land is in that area um i will say again though unless you're going to address the volume in in camden where we only have one truck pushing that truck too far up to the lake is jeopardizing uh response

» back in the camden area yeah but that's pretty close to where you said at flint hill right uh the back side of you know gains gains kind of wraps around we're we were definitely talking the the mr kelly has some property up there uh if i remember correctly steve kelly up 97 um and that was kind of the area i just can't remember the name of the road but it was it was back this side of gains church sir yeah i was just thinking of something we already had that it would work combine the two stations that was close like a blaney sure is that that was before my time is that what we did there no yeah recently yeah we built one right behind uh blaney fire station you got ems there and next to solid waste so it's all yeah it makes sense well we're not going to i don't think we're going to be pushing

» stations anywhere because certainly make recommendations to us uh this goes back to council why i said wouldn't it be great instead of building these stick buildings put some mobile units there because if if the call volume changes and population changes and you know you're constantly having to move to different locations different stations different locations i just think it'd be great to look at some mobile units and look at land we already own in some type in that vicinity and i think that would be a smart way for us to move ahead until we sort of get our feet on the ground a little bit better throughout everything we've been through the last year yeah i know that made good sense like a like a mobile let me just say one more thing too this is our head floor robert johnson y'all may want

» to do a resolution or a proclamation for him because he saved my life years ago yeah i wouldn't be here today if it wasn't for robert johnson really what happened i'll talk about it later but it's a true story but i figured y'all might want to do something for him because i wouldn't be here if that wasn't the case um what what i want to recommend is just you know without hearing what YOU GUYS HAVE TO SAY YET IS THAT UM THE PROPERTY THAT WE ALREADY HAVE UM I KNOW COUNCILMAN JONES IS TALKING ABOUT MOBILE UNITS BUT IF YOU BUILD SOMETHING OUT OF STICKS MORE STABLE WE CAN PUT THAT PART OF THE EQUATION AWAY AND THEN INSTEAD OF MOVING AROUND LIKE WE'RE A MOBILE UNIT OF EMS YOU ADD UNITS TO THE UH LOCATION AND THEN YOU CAN REACH OUT FURTHER BECAUSE YOU'VE GOT MORE UNITS THAT DON'T HAVE TO RAPIDLY R

» ESPOND LIKE YOU WERE TALKING ABOUT IF YOU PUSH THROUGH 497 YOU'RE GOING to have to add another truck down here to station one um i kind of like those ideas because of um it's easier to manipulate a truck than it is a building or trailer okay i don't necessarily disagree with what you just said thank you sir i'm still into schedule pay fleet and facilities and turning the dials right on these means a budget that as mr jones is saying is both the current and a future look it's based on a good strategy okay thanks moving forward fiscal year 21 22 areas of discussion and focus of course are going to have to be based on the revenue issues that we have hanging over us growth loss of possible fee in lieu personnel recruiting and retention i'm a firm believer that people always come first we have t

» o make sure that we're taking care of our folks so personnel recruiting and retention and then operational readiness um a little funny that's one of our jump kits believe it or not with our training officer hiding behind it anyway uh revenue all right um projected revenue property seven thousand seven hundred thousand delinquent taxes fifty thousand inventory replacement right at four thousand this is just the breakdown of what the the millage uh is getting us go back please yes sir that's the current millage that's on the books our ems mill was 5.1 right what's that total right there uh to be honest with you i'm i'm not sure but i did i can't show you what uh with the fee and lou added uh miscellaneous revenue there and then the payer mix uh the total is four thousand four million three hu

» ndred thousand you gotta back up you're going too fast for us yep i was under a mail then i thought it was three million dollars as we talked about 976 000 miscellaneous revenue the debt set off projected for this year is going to be 70 000 the aa building that we share at station one that's rent for the aa building side right there to get how much ems is actually going to bring in you have to have a little bit of an understanding of what the The payer mix for Kershaw County is commercial insurance is around 51%. We're pretty lucky there. Medicare is around 27%. Medicaid 7% and private pay around 13%. Resulting projected revenue for this upcoming fiscal year is right at $2 million. So we're bringing back in $2 million through our fees. Right now, you were asking about Russ Cobb earlier.

» we're actually collecting, capturing right at 76% of the allowable. So that's pretty good. There's a lot of EMS services in the nation that would love to have that number. So that's what we're pushing out there. But you're saying right now you're about $2 million a year. That's the projected for next year. Right. The current year's projected is $1.67 million. So that's the current budget. He's talking next year's projected. Right. So if I may, we really want to be as bodacious is the word I'm going to use.

» We can put about roughly 12 mils onto you, that's on the millage, take the fee and loot that we're getting, let it go into the general budget, and then your 2 million, and it may be a little bit more than 12, and kind of even out your budget where you'll have a steady flow of every year growing as the county grows.

» And I say that because that's not a tax increase, that's a shift, if you follow me my colleagues you're saying turn current revenue projections and all in and change it to a millage like we did central carolina can we get a copy of these slides and if you could supply some of those numbers i'll be able to total up the um the the fee millage that you had there that's easy enough but so with 12 mills what are we fixing that's interesting concept mr tucker yeah the idea is 12 mils what are we trying to fix with 12 mils that was mr tucker's idea ems ems is that assuming philo or no philo well the philo is going back to the general fund but if it happens if it happens to fall off it's going to fall out of our general budget it's not going to affect ems yeah i see what you're saying so regardless

» of philo you're talking about having a more stabilized millage base instead of a stop gap so at this point it's not stop gap anymore it's not a one-off year we've been doing it for years because we have to right so you're saying stabilize it with a mill and then we deal with the fee in lieu when we lose that million dollar revenue in the general fund when i say we i'm talking about council and staff so it'd be a more consistent budgeting process instead of each year we're kind of over the scramble and figure out how do we pull from the general fund that that makes some sense because it's already funds that you're expending and why not budget for it yeah and we should remember how we got here and i think i think those who remember that when we took over ems we took a 2.3 million dollar uh fe

» e from the health services district russell so they gave us two and two point three million dollars i believe something like that 2.6 2.6 uh so that would ease the transmission transition of ambulance over to us and the ambulances were in terrible shape and thank goodness we have these two gentlemen here that led us through it and then as a part of the deal for the hospital we impose roughly a million dollar filo every year so we've been living off of that uh for these many years so did i summarize the situation as you all remember it yes okay 2.6 right jimmy right but and that's a one-time pay from the health services district okay but still what what we did russell it did to give you the whole story uh it was a 2.6 jump start okay that's what uh the health district or the hospital board t

» he time gave to us so we did that with a 17 month commitment that we would run through that money before we did anything else to see what we needed where we need to go but within nine months of that 17 months we put a new station up and did some other things so you know we sort of moved forward a little bit quicker than we told them we were going to and um you know i have a question has anyone else talked about the fact of shifting these monies and going to 12 is this the first time everybody's heard of this yes okay good no no i was just wondering just wondering yep i just had a question there's nothing really broke yet um is it what's broken because i'm a little bit curious as to i mean if we went to 12 mills we will be doubling the millage rate which would cause a tax increase if i'm not

» mistaken tell me again how it wouldn't okay you got x amount of MILLS THAT COMES INTO THE COUNTY NOW. SO YOU FIGURE OUT WHAT THE MILLAGE IS TO OPERATE EMS. SO THE REVENUE FUNDS WILL GO IN, THE 2 MILLION, AND THEN THE MILLION OF WHAT WE CALL FIOLU. SO THAT'S 3 MILLION. HE SAID HIS BUDGET IS $4 MILLION BUDGET. SO I'M GOING TO HYPOTHETICALLY SPEAK SAY IT'S 16 MILLS TO OPERATE EMS. THAT COMES OUT OF WHAT YOU'RE COLLECTING YOUR GENERAL FUNDS.

» but the offset to some of those mills is going to be the fee of lieu and the revenue that is generated by ems so there's going to be a shortfall but you're not increasing taxes it's going to be in the general fund where we have to figure out what we're going to do about that and administrator but it's not a tax increase it's a tax shift i promise you it's not a tax increase okay yeah i'd be happy to look at that but now you're saying there's going to be a shortfall if if we lose the fee in lieu agreement is that what you're saying it'll be a shortfall as a whole because you're taking more millage out of the general fund and directing it to ems and i don't know exactly what that number is because i don't know what we're subsidizing exactly right now or asking vic to cut right so yeah if you

» can't find more revenue sources but it's going to be on us not on ems it'll stabilize ems but we did some the similar we did i can't hear you well we did uh something similar we um you can ask me nicely the next time uh when we took back in 2012 you weren't here a lot of you weren't here i'm not saying i were but back in 2012 we had what i considered a balanced budget with the solid waste but we took it out created a line item for it and then we ended up having 25 50 and now an 80 fee for that so i just want to look at this very carefully when we start talking about oh we can neutralize this neutralize that and and i do commend you uh brazil for seeing you want to see those numbers you know and understand what you're talking about before we move forward with anything i'm not asking anybody

» to agree with me today i'm just throwing out what's coming in my head on how to how to balance this budget and vice chair please understand i'm not necessarily disagreeing i just too want to see the numbers because one thing i don't want is uh you know take from the left give to the right but we're still empty on the left you follow me and then the taxpayers have the burden of well when i look at the numbers a little deeper i might not want to do it either you know because i don't know the exact numbers yet without so they're not going over yeah i i want to ask a little bit further about what russell said and that is what's broken um what i thought i saw gerald was a concern on facilities that's broken uh secondly we have a full year of not buying ambulances for you and that hurts thirdly w

» e see attrition and recruiting driven by more by schedule but also by pay so those three things to me as i keep mentioning schedule pay and facilities um are come to mind and then the fleet so so that is that how if you can get to mr brazel's point in more detail on those four things i talked about absolutely um comes down to whether or not increased response times are acceptable um with shutting down station two you've got a large sect of the county that is looking at two to three minute increased response times so um you know if council's okay with that comfortable with that then then um then i guess you could say it's not broken from my standpoint from an ems director standpoint i recognize that you know time is very very critical for 10 of every run that we have 10 is about the the numb

» er of time sensitive calls that we run respiratory cardiac stroke trauma and so on and so on okay i have an issue and maybe i just took it wrong but you're talking about reduced response time you're saying if we council is comfortable with that so we're throwing it on us that if we don't do this it's going i i guess i just have an issue the way that was presented to us i'm sorry i certainly didn't mean to because everybody up here cares about life everybody up here cares about response time everybody up here cares about the citizens of kershaw county but what i am not what i don't care about is someone trying to say something that would intimidate or back me in a corner because that won't happen that will not happen but every man up here cares about life and safety every man up here cares a

» bout the fire service every man up here cares about law enforcement everybody up here cares about ems but i am not going to sit here and say if we're comfortable with something that less responsive because a department head or administrator does not get is everything they asked for thank you let me just go back to that again um trying to put it in balance in the context of what mr uh tucker talked about um right now we're not 24 and 7 and your assertion last year was that 24 7 might help us on the schedule issue and that comes with a cost yes so we stick with a current cost procedure for schedule, it's cheaper, but it has risk of losing people if we don't go to a more expensive model, which is, is that 24 and 7? 24, 72. 72. 72, excuse me, excuse me, 24, 72 in the current system.

» So there's a differential there. Absolutely. Okay, and then the other differential is pay. So, are we going to be presented with either or 2472 and current and or pay? Are we going to be given some kind of presentation that you want feedback on? We have suggestions on how to get to 2472. We have three different options. Okay. And we're going to get to that later? Yes. Okay. We're way out in front there. Okay. All right. Is that helpful to everybody? All right. Okay. Okay. All right. So personnel recruiting and retention. There it is. Modified 24-72 schedule. Significantly reduces the number of hours team members are required to work. Again, increasing morale. This schedule for some of the other services has shown to reduce call-outs by up to 30%.

» What's a call-out? Someone who calls out last minute. Seven o'clock in the morning, they say they're sick. All right. which, again, always impacts the coverage of the county. Schedule has been shown to improve recruiting and retention of competent, experienced clinicians in the South Carolina market. Again, I have two incredibly fine paramedics that have applied to go to Calhoun County solely because of the schedule. Modified portion of the schedule in each option provides for one ALS unit covering the county for the majority of the operational time period. So what that means is it's a modified $24.72. Every X number of days, depending on which option you go with, you're actually bringing two additional bodies on duty to staff and ambulance. So option one.

» Option one creates four shifts with 10 members each with the addition of four full-time employees. We're currently setting at 39. We would need 43 or more. That's exactly right. Yes, sir. Now, how do you get to that number? Because you're creating an entire shift. It will require hiring an additional, I'm sorry, that should say four, that should say four, I apologize. Reduce the number of units assigned to each shift to four. So you'll be going from five ALS trucks on the road every day to four. Your fifth is going to be brought back up by your on-call team, which will be working scheduled over time. Keeps the deployed resources at five units and two QRVs. You don't get anything extra, you're not addressing the increased call volume that is also a threat.

» It requires the nominal increase in salary line items, but still allows for a more favorable 24-72. It reduces the number of hours worked from 2-27-15 from the 29-20 to 29-60 that I talked about earlier. And it does not increase the number of apparatus covering the county. Like I said, for the assigned shift, you're going from five trucks to four. So you just have to keep that in mind.

» cost of the additional personnel will be in the range of 120 000 that's for two or for four that's for four because you're cutting some of the other expenses by not having five stations but four okay so basically what i read what's happening here and i don't mean to sound like i don't care because i do is um this is a morale booster because the 2472 is certainly going to be a morale booster what this doesn't do is address the increased call volume right and that's that is unfortunate this is this is option one it's the cheapest of the four op or the three options um but it gets you less and if i can go into option two i'll explain that to you all right option two it creates the fourth shift but with 11 team members the assistant supervisor will come off of a qrv and assume a senior paramedi

» c role on an ambulance. You will need to go from 39 to 47 employees, and it will require hiring seven full-time employees. I can tell you the reason why those numbers don't quite match up, guys, and it just dawned on me, and I do apologize. Remember when I was saying earlier that we have two folks deployed? We have been running heavy FTEs over the past about 10 months. So we actually have 39 bodies filling roles every day with two deployed. Does that make sense? So we've been running heavy FTEs the entire year because of COVID. The number of call-outs that we've had because of COVID or quarantines, we would have been shutting down stations left and right if we had not picked up those additional two FTEs.

» And we've done that with the existing monies that's in our salaries, and we're still going to have some at the end of the year left over. So that's probably why those numbers aren't 100% jiving with y'all, because we're actually running heavy FTEs. Which is full-time employees. Yes, sir. Yes, sir, it is. And we did that, again, being proactive early on in the pandemic. We knew it was coming. And that's what a lot of this comes back to, is just being proactive instead of reactive. So increasing the number of units assigned to each shift to six, with the sixth unit being comprised of the scheduled overtime crew. That sixth unit will address the call volume, the increased call volume, and the increased UHU that is so concerning. We'll reduce the number of QRVs on the road to one.

» We will only have one command and control, and he will be based here in the Camden area supervising. It reduces the number of hours worked to 2643. Again, you see an increase or a decrease in the number of hours worked because you have an 11-man shift that are going to rotate through on call. So you actually have your scheduled overtime day every 24 days as opposed to every 20. That makes sense. Adequately addresses increased call volume and unsafe UHU conditions. And for me, again, as the director, what's really important, the plan has been endorsed by our Workforce Improvement Committee. We have a group of clinicians, professionals, that meet monthly to address our concerns inside the department.

» and this is the plan that they feel very comfortable going with because it addresses the recruiting and retention and it addresses the high UHU and increased call volume. It will require re-examination in the near future to bring the second QRV back up. Those QRVs, even though it's only 4%, they do a lot of ALS backups. That's just something you have to remember. The cost on this would be around $500,000 salary and... Yes, sir. Let me ask a question. From your management standpoint, would it be more beneficial to you to be able to pay less people more money, or would it be more beneficial to just have more people on staff? Because it seems like you're, it looks like we're paying kind of the industry standard.

» If you were able to pay just a little bit above industry standard and provide the, I guess you work a 24-hour shift and then you're off for three days, is that, that's how that works? Off two days. Off two days. One day off to the 24-72 would be work one off. Yeah, that's okay. That's what I was asking. Yes, sir.

» So is it more beneficial to you as a manager to be able to pay these guys a little more to recruit the very best you can and maybe have a few less employees, or is it more important to you to have as many people in as many slots as possible and to just be meeting the bare minimum pay industry standard because you know I know the quality of the employee means a lot to me typically how do you feel about that I think that we're dealing with a unique workforce dynamic paramedics EMTs advanced EMTs are coming out of school today are more concerned about work-life balance than they are the paychecks sold that's why I'm seeing so many people leave to go somewhere else because they're getting that additional time off. They're not working those $29.60 a year. They're dropping down to $26.43.

» That's 300 hours that they get to spend with their family, friends, shooting pool, whatever. I think we continue to look at the dynamics of yesterday when it comes to the workforce of today. And this is something that we've spent a lot of time over the past five years addressing. First of all, and y'all have heard me say this before, EMS has this identity crisis. The identity crisis for EMS is, are we healthcare professionals, or are we first responders, public sector entities, like fire department? You would not ask a nurse to compromise her work-life balance for a few dollars versus a schedule.

» Does that make sense to you because they're trained professionals they're a niche you have to go out and you have to meet that niche so ideally you're going to compensate them well and you're going to give them a schedule that benefits more work-life balance i hope that answers it does to some degree but i think the question still was would you prefer a higher pay for for less people or would you rather have more positions to fill i'm going to go i'm going to go i don't have a crystal ball, but I am going to go out on a limb here and say that we could give an additional five or six percent raise, but if we don't change this schedule, we're going to have staffing problems in the near future. Take the schedule out of the equation.

» Say that we do change the schedule to the more attractive schedule. Then how would you answer that question? I believe if you take the equation, the schedule out of the equation, then you want to make sure that your employees are receiving a a good living wage um so you would have to once everyone is on our 24 72 then that that market is going to become competitive again and you're going to have to go back to trying to hit them for more pay russell not okay i was going to say russell basically i think what you're asking i may be wrong is do you want to take care of what you got now or do you want to continue to expand well i mean it and it looks like we need to expand to some degree but i don't know if there's but we have a full staff now they still have a full staff they have no openings t

» hey've had openings they've had to replace but there's no there's there's no opening right now right so it must not be that bad to work at kershaw county oh no absolutely not i think he he needs a few more staff members to to get to that more attractive schedule and and then my question would be you know do you because i'm sure there's going to be yet another need beyond that for more people but but do you recruit um the the top of the top with with maybe a an extra five percent pay or whatever or do you just hold it at the industry standard and try to get one or two more people to cover your shifts better i would be i i think as the director um i would be failing in my job to make sure that my folks are taken care of we're not going for that five percent sure i mean that's that's just my m

» y view like i said earlier you've got to take care of the people people first and what our industry sees is is nomadic type mentality where people travel 30 miles just to get an additional 500 to a thousand dollars worth of pay there they don't have that loyalty that that used to be generated or or uh that used to exist in the workforce thank you um let me see can i um understand like my my point of view what you're um what you're requesting i think going to the 24 72 frees them up and gives them more time off so that should generate a pool of people for call-ins too or will it not well um because now they off three days instead of two days yes sir and certainly ems folks are a lot of times their workhorses um our guys work 24 48s they work somewhere else to make sure that they're making en

» ds meet or whatever because again we we we're We're competitive, but you're not going to get rich in EMS. That's for like law enforcement. So folks have second jobs. We will always have the ability to pull people in on overtime. 2472, especially the modified 2472 here, brings on a sixth truck. So if you have a call out, you wouldn't have to go to the overtime well. You could simply move one of those crew members around, spin up two QRVs, and you're back to five ambulances and two QRVs. Okay. more maneuverability? Correct. So what this plan actually does is it brings that extra truck on duty for $400,000. You're getting an extra truck to address the call volume.

» If you have multiple call outs, because again, the pandemic or something of that nature, you're still going to end up with five trucks and two QRVs. Okay. And the reason I'm saying that, because I know just being in the reverse government or corporate or private sector, your biggest problem is when people have issues at the last minute don't come into work and it happens in every industry i don't care what industry you're in trying to cover those folks so i was just thinking if you had more people with more time off because a lot of times you've got a little crew that you can always depend on that would come in when on days off then you got some they're busy they're the one-legged man in the butt kicking contest they ain't coming in that's right um and you've got those folks but again this

» plan allows you to have some flex with staffing yes we'll be able to cover those so not spending more money in overtime so it addresses the overtime issue as well yes sir okay thank you yeah is there an option three there is okay let's you already want to go real quick go ahead well something hasn't been mentioned yet but based on my research and uh you've got you've got two staff members that have a really good ems podcast by the way and um yeah yeah it's really good so i encourage everybody listen to it kind of helps you get a perspective on the ems world but this is a mental health issue too right it is the the i hope you guys really i mean so you think about a trauma that a paramedic is going that possibly could experience not every shift but the possibility is there so it takes a day j

» ust to recoup your sleep and then a whole another day just to kind of mentally recoup from whatever trauma they just had and then that third day is actually to go and do family stuff and get things done right so kind of speak to that this is a mental health issue as well it certainly gives you more time to recover and and whether it be mentally or physically. A lot of times when people are saying they're going to work at another service for 24-72, I had a gentleman come in recently who turned in a resignation. He said, listen, I get off at nine o'clock. I've slept maybe an hour to two hours. I go home and I sleep until four in the afternoon. I've lost one day. I only have 24 hours off. This gives you that more recovery time mentally and physically.

» And mental health is becoming a much bigger issue. And 24-48 or 2472s are being looked at from a national scale on whether or not it's truly in the best interest of the individuals to run. Long duration shifts, again, because it's so expensive to do anything other than that, long duration shifts are challenging, but rural counties don't have a choice but to do them. Councilman, you said two employees have podcasts.

» Who are they? What is that I don't know I but I came I came across it recently it's really good it's just it's it they just talked about the industry and right but he brought it up so I just want some clarification on absolutely Matt seals and Wesley price have a podcast it's an educational show that talks about how to set up a rep or dopamine drip they just use some of their time use some of their co-workers WORKERS TO JUST PROMOTE EMS AS A WHOLE. ALSO, I HAVE HAD A COUPLE OF FOLKS ASK ME ABOUT FIRST AID COURSES. YES, SIR. IF VICK CAN GET THAT FROM YOU, I'D LIKE TO GET A LIST OR SCHEDULE WHEN YOU GOT SOME BECAUSE THERE'S SOME FOLKS THAT WOULD LIKE TO DO THAT. THANK YOU. SURE. OPTION THREE. HOW ABOUT THAT? ALL RIGHT. WE'LL LET YOU GET THROUGH YOUR BRIEFING EVENTUALLY.

» OPTION THREE CREATES THAT FOURTH SHIFT, 12 CREW MEMBERS. you're not losing your assistant supervisor so you're still keeping those two command and control units on the road you need to go from 39 employees to 51 it is the most expensive i recognize that it's probably cost prohibitive will require hiring an additional 12 full-time employees of various certifications and the other two options we've been able to to hire emts or advanced emts we don't have to have the most expensive paramedics because you're using your existing pool to subsidize those EMTs and advanced EMTs. Reduces the number of hours worked to 2643, the same as option two.

» It adequately addresses increased call volume just like option two, but the big deal is the fact that you're now looking at somewhere in the neighborhood of $750,000 in additional revenue. That's a big price tag for any county, I recognize that. It's scheduled overtime. S.O.T. is scheduled. Scheduled overtime. Yes, sir. You're killing me. I'm sorry, sir. Scheduled overtime. Why do you say it's cost prohibitive? You're making a judgment. Well, again, I mean, I've got a sticker shock. I admit it. But why do you come in and say this is not a viable option? Well, it's not that I'm not saying I just I know the other issues that we have and the other issues that we have is maintaining good equipment, maintaining stations.

» um maintaining competitive pay so there's a lot of things that made me made me say that i mean if you guys you guys are comfortable with 750 000 i'm certainly comfortable with it i've always i've always told you don't give me the money i'll spend it i've always i've always told you you guys tell me what you want and i will do everything i can to make it happen you know so but but again that is that is option three it is you have some stickers okay thank you all right okay so the modified 2472 again if approved the plan will be enacted somewhere in the second or third quarter the reason we want to do that uh mr brazel goes back to what you're talking about we want to be able to take our time measure twice cut once and make sure that we're getting the best quality folks in here.

» You like that wood analogy there? That was good, great fitting. I wish I could say that was on the fly. This would certainly is something that sort of offsets some of the cost. Like I said earlier, we've been running heavy a couple of FTEs this entire, well 10 months of this past year, and we're still going to have somewhere in the neighborhood of 125 000 left over in our salary line items that could go to help pay another thing this is going to reduce the use of part-time staff we have about 140 000 of that to offset some of the costs again trying to get the biggest bang for the buck for the guys in the field it will negatively impact the reserve funds won't have money left over at the end of the year to be able to continue purchasing our ambulance so changing the schedule is going to you

» know it's going to impact that reserve fund. Just keep that in mind. As I said earlier, doing nothing to assist recruiting and retention of staff, better schedule the services are doing. We want to be strategic. We've got to get out. Can I ask you a question on the, because I'm a little bit, yes sir.

» You're saying it's going to negatively impact your reserve fund because you're pulling some of those monies out like your part-time position line item and things of that nature that normally gives you that reserve at the end of the year correct yes okay yes sir then that money that that 125 that's left over this year right in its own special way okay if we have more ftes and we're using that money to pay those ftes we'll have less going into reserves yeah that's next year's ambulance you're looking at right there right would you say your last bullet point doing nothing to assist recruiting and retention of staff through better schedule is not a sustainable plan so what are you you're You're saying y'all won't be able to do your job? I'm saying that we will have a harder time making sure tha

» t we have staff. Quality staff. Quality staff. Adequate staffing. Let me go ahead. Just for a second, think about Orangeburg County MS. Love Orangeburg. Love the director. Good barbecue down there. Operations officer. But right now, they are setting with 20, at last check, 22 open vacancies at Orangeburg County. But we're not Orangeburg County. No, sir, we're not.

» that's what i said earlier we are so lucky to have in my opinion our supervision our family atmosphere we we are competitive pay but okay we are competitive pay we have a full staff you you do a great job and i just have problems with doing nothing to assist recruiting and retention staff through better schedule is not sustainable i mean that's a pretty strong statement uh i feel like to say to these five six seven people that are sitting up here so so you're telling us if we do nothing it's not sustainable so therefore definition of not sustainable if i may mr jones um i think that what mr gerald was trying to explain to us is that this problem is going to continue to build if we sit here and do nothing and what i don't want to do is become an orange bird um so uh sitting down doing nothin

» g makes everything that much harder year on year on we keep kicking the can down the road let me get to your point jimmy we don't kick the can down the road we've done some great funding for ems we've done some great funding for the sheriff we've done some and we're looking at doing some great funding for fire so i disagree with that you know that the taxpayers only have so much money there's only so much money to deal with and i'm sorry general go right ahead i i do understand that i'm gonna respond right quick and general can go um no i'm not a general anymore i do i do i do i do understand that but i think there's means where we can get some things done um we haven't done anything in recent uh past for ems we we've taken the bridge money and we've done that we should have been forever lo

» ng ahead and following this before uh we even got down to some of these scary moments with the sale of the the hospital and things of that nature but we that's the biggest scare we've got yeah we have very good ems right now guys they're running great uh looking set on a hand years ago look where they were so no question that the fee and loo to me is that is the big thing that we need to be concerned about because we certainly could lose that that's a million whatever dollars or 97 whatever anyway i'm just saying that i just have problems with the last bullet point i think to be fair to the I think he's doing his job. I mean, he's supposed to, he's supposed to come here and say, man, it's great. Y'all EMS is awesome. I don't need anything.

» You guys keep on doing what you, I think he's just making us aware that EMS is great and it's fantastic, but there is, there's possibly an iceberg out there and he's just kind of starting. And I've been a council three years and I've, I heard this three years ago and it was kind of like almost like the, the yellow light, just caution. This is what we're looking for. And so I think he's just continually to remind us, you guys have been great to us, but just want to keep you out in front of this is, as I look five years, 10 years down the road, this is what we're going to encounter. I understand. I don't take any exception to that. I take it as somebody who is looking down the road and doing his job. I just want sustainable. Give me, tell me what you mean by sustainable then.

» I think what he said, if we don't do something better, he's going to keep losing staff tomorrow attractive he's got a full staff right now he does he but as he looks down the road i think he sees that the possibility does exist that he may be sourced out so i mean it is a strong statement but i'm just assuming he's doing his job and well here's what i'm saying we have 1920 departments we're dealing with we have sheriff's we have fire and they're all going to come in here and do the same thing it's our job well the sheriff hasn't done it sheriff has only three years he hadn't asked for any increase well i mean he didn't say he wants a a millage increase i think he's just telling us what we've what we're looking at that's our that is millage increases or you have to get the money from somewhe

» re so why isn't that a millage increase councilman i mean to him i mean he's just saying this is what i need but you just said it was not a millage increase but it is if we were to fund that where is it going to come from it's got to come from somewhere but then i mean i understand but but i'm just trying to bring a point up that was made and that's the second issue that i've had about maybe not being able to be ran properly or not being able to rent call volume exactly if we're comfortable with that call volume i'm not comfortable with anything you said the best we can do and if you tell me that something's not sustainable then you're telling me it's not going to last if i may if you may um it it won't last in the long run is it what's the long run then with that projection this is worthy

» it is worthy of discussion i mean you know obviously we can't ask who on council would say it's not worth it if If I may, if I may. No one said that. That's what I said. Well, Mr. Chair, I appreciate that. Because if anybody up here said it was not worthy of discussion, let's talk about it right now. Because we're talking about spending the taxpayer's dollar. Yeah. Can I ask you this? I would not be quiet if somebody even said that anyway. Thank you. Well, that's fine. The last bullet is worrisome to more than just me. I think Jimmy has expressed concern. Thank you so much. Here you see nothing, doing nothing.

» let's take that word out and say if i change the sentence to read increasing pay now this is the balance okay do we increase pay or do we improve the schedule i mean is there a a trade-off here between those two i believe that again to be competitive in the ems healthcare market you're going to have to be competitive in schedule and in pay we've we've lost more folks in the last 18 months than we had prior the two years to three years prior to this um that 18-month period we're losing more folks on a more regular basis and that's what leads me to believe looking down the road that we've been incredibly lucky where when someone resigns we have that slot filled within uh two to four weeks generally about two weeks and we we have the slot filled that's only going to be our reputation that we h

» ave now is only going to allow that to continue happening for so long especially the more services that go to 24 72. yeah well put another way previously you answered that question i made to you thank you for these um now you answered the question by saying schedule was more important than pay yes sir okay thank you mr mr chairman sure i just have to make this statement because it's burning in my belly um we asked our staff to come up here and give us honest opinions on what they think and and i think if something offends us as a council member or as a council as whole let's state our peace and then let's move on because what you don't want to do is have staff intimidated to come up to give the truth or state what they believed to be in best interest for their department and and i've been s

» itting here a long time just like you councilman jones i don't always agree with what they asked for or approve what they asked for but i always want them to be truthful and honest to what they see the department needs and what um what they have to have to operate an efficient and effective uh department within this government that we so call ourselves uh leading and you don't think i do and i didn't SAY THAT BECAUSE I ASKED QUESTIONS I HAVE A CONCERN YOU PICKED YOU PICKED YOU PICKED THE THINGS OUT OF WHAT I'M JUST SAYING OR NEGATIVE WHAT I'M SAYING IS STATE YOUR PEACE BUT I DON'T THINK THAT WE OUGHT TO BE CHANGING WHAT THEY PUT UP HERE AND PRESENT TO US I ASKED FOR AN EXPLANATION COUNCILMAN YES CHAIRMAN I DIDN'T ASK FOR HIM TO CHANGE IT I ASKED FOR AN EXPLANATION WHEN YOU'RE TELLING ME THA

» T DOING NOTHING ASSISTS TO ASSIST RECRUITING AND RETENTION OF STAFF THROUGH BETTER SCHEDULING IS NOT SUSTAINABLE BUT HE GAVE YOU AN EXPLANATION YOU DIDN'T LIKE THE EXPLANATION BUT HE GAVE YOU ONE NO I DIDN'T SAY I DIDN'T LIKE HIS EXPLANATION I JUST DIDN'T THINK IT WAS A CLEAR EXPLANATION OKAY WHY ARE WE STILL TALKING ABOUT IT BECAUSE YOU ARE MAKING A COMMENT ABOUT MY COMMENT OKAY SO YOU GOT TO HAVE THE LAST WORD NOTHING HAD BEEN OVER NO IF YOU HAD TO SAY ANYTHING WE COULD HAVE MOVED ON ALL RIGHT I'M DONE BUT YOU AND COUNCIL SNAGGRASS TOOK ISSUE WITH WHAT I SAID SO Y'ALL CAME TO HIS DEFENSE AND YOU NEED TO COME TO HIS FIST I'M NOT AGAINST GERALD I'M JUST ASKING QUESTIONS BUT BUT SEE YOU STAYED ON CLARIFICATION SOMEBODY OBVIOUSLY MENTIONS TO THE CHAIR THAT THIS IS NOT WORTHY OF CONVERSATION Y

» OU YOU MISS YOU MISS YOU MISUNDERSTOOD THIS THING THAT COUNCIL SNUGGERS YOU'RE ON THAT END OF THE TABLE WELL FIRST OF ALL HE WASN'T EVEN TALKING TO YOU HE WAS TALKING TO RUSSELL IF YOU WANT TO KNOW THE COMPANY I'M JUST ASKING BUT HE DID NOT SAY IT'S NOT WORTHY HE SAID IT'S WORTHY IS WHAT WHAT WE'RE SAYING BECAUSE I WAS SITTING RIGHT HERE LISTENING WE DID SAY IT WAS WORTHY, WHY DON'T YOU LET ME ASK MY QUESTIONS. BECAUSE YOU KEEP TALKING OVER ME, YOU JUST KEEP GOING ON AND ON, I'M TREATING YOU JUST LIKE YOU TREAT ME. I UNDERSTAND. OKAY. WE'RE ON SLIDE 17 OF 25 SLIDES, RIGHT. WE'RE TALKING ABOUT A LOT OF MONEY, A LOT OF MONEY. I LOVE YOU. I RECOMMEND WE GO TO THE NEXT SLIDE. ALL RIGHT, STAYING WITH THE TOPIC OF PERSONNEL RECRUITING AND RETENTION, WE'RE MOVING AWAY FROM THE 2472.

» THIS IS SOMETHING THAT SOME OTHER COUNTIES IN THE STATE HAVE BEEN DOING FOR A WHILE. RICHLAND COUNTY IS ONE AND MS. BROWN HAS CERTAINLY HELPED WITH SOME OF THIS DISCUSSION BUT IT'S RETENTION AND LONGEVITY BONUSES. ESTABLISH AND IMPLEMENT A LONGEVITY BONUS PLAN TO REWARD TEAM MEMBERS IN CONTINUOUS STABLE WORK ENVIRONMENT FOR CLINICIANS. BE REWARDED IN FIVE-YEAR INCREMENTS, 1%, 2%, 3%, 4%, FIVE YEARS, BE REWARDED AS A BONUS ON THE ANNIVERSARY DATE OR ADDED TO SALARY. I BELIEVE RICHLAND COUNTY DID A ONE-TIME CHECK, YES, SIR, YES, MA'AM. THE INITIAL IMPLEMENTATION WOULD BE THE LARGEST AMOUNT OF MONEY. THERE ARE 12 OF US, RATHER, THAT WOULD BE LOOKING AT THAT BONUS OF 1% FOR THE FIVE YEARS. All right, that's us doing some training and work with the sheriff's office there and Asher.

» I thought it was a cool picture. I really love that picture. All right, operational readiness, constructions of new EMS Station 2. Replaced station vacated due to mold located at Lockhart and 521. Since closing the station, service to the Shepard, Westville, Barondecab, and Liberty Hill areas have seen an increase in response times, suitable for housing two crews that meet DHEC's expectation OF CLIMATE-CONTROLLED BAYS. WE WERE TALKING ABOUT A MOBILE HOME EARLIER. THAT IS CERTAINLY AN OPTION. I'M NOT SAYING IT'S NOT. BUT THE STATIONS THAT WE HAVE NOW PUT LESS WORK ON THE SHORELINE AC UNITS BECAUSE THEY'RE IN A CONTROLLED ENVIRONMENT. DHEC EXPECTS THE EQUIPMENT AND THE MEDICATIONS IN THOSE UNITS TO BE CONTROLLED. SO OUR STATIONS THAT WE ARE CURRENTLY BUILDING optimally handles that.

» It's a significant cost increase. We recognize that. Projected cost for a new station is going to be around $800,000, and that number came from Pete Furlong, our projects manager. The one thing about having the station at the government center has been positive is it has reduced the UHU for station one to 22 percent. So station two 22 to 24 percent. Station two coming to the government center because the volume at one is so high it has balanced that out. Construction for new EMS station one as I said earlier this was supposed to be a three or five year plan being in that station. It's a damp old concrete building prone to flooding. We talked about that earlier. We have had significant vector issues in that building over the past year.

» We've had to have it closed several times for extended period of time due to roaches, rodents, bed bugs. We have even taken on the responsibility of treating the AA site at this point through our budget to try to control the vector, but it's an old building. It's just got issues. Difficult to heat in the winter and cool in the summer, resulting in high utility bills. I believe our utility bill average for this station is around $700 to $800 a month for utilities. All right, continuing on operational readiness. Again, going back to these new, oh, I'm sorry, go ahead. Can I, we ran through the personnel recruiting and retention pretty quick. You're back to that last bullet point.

» Initial implementation would be the largest cost, $8,000 for 12 team members um what is that is that like a hiring bonus or what is that i misunderstood that they've they've stayed on board with us for five years we're going to give them one percent of their yearly salary and one check just retention bonus okay to say thank you okay in the initial implementation there's there's there's 12 team members uh not including myself that would be eligible for this for this bonus all right sorry i i just needed to clarify that thank you i appreciate the questions go back to that picture i love that picture all right construction of one we went through that okay new dodge 5500 type 1 ambulance um continue to replace or remove the high fleet g3500s out of our inventory out of our fleet uh this truck f

» or that price tag which again there is some sticker shock there i'm sure it has the striker power load that is about a thirty thousand dollar system that physio cardiac monitor with rack that's about a thirty five thousand dollar system power load oxygen system that prevents back injuries it lifts the oxygen tank into the truck so you're not looking at worker comp claims our new trucks are going to have to have radio systems in them as as you guys probably heard from fire the 800 systems that we are currently running in our trucks are soon to be uh obsolete yes sir so we're going to be ordering trucks with the radio systems again that adds to that total up there uh identical it's very important when you're develop some muscle memory uh when you're in the back of an ambulance you know where

» everything's at so we're staying with identical compartments set up and ease of you know from premierization we don't want to move away from the dodge fit 500 if we can help it we can move to a different company may save i think we've gotten quotes from other companies that we're saving like five to ten thousand dollars but it's they're all in that range that 290 range and and just so you know generally new trucks are purchased out of our existing reserves so we are we're always capable of making our truck purchase schedule will have an impact on that as i mentioned earlier we're also looking at trying to get our first remount i don't know if you're familiar with uh ambulance remounts a typical box can be remounted on a new high mileage chassis um industry standard is once can push twice bu

» t then you start worrying about the integrity of the box but we are looking at trying to remount one ambulance uh ems 14 is uh is a 2015 high mileage dodge the picture that i showed you earlier we could in the third or fourth quarter of next year get this truck remounted for around 160 000 fully refurbished patient compartment they'll go in and make sure everything cracks busted cabinets everything's repaired electrical components are replaced again we will have to go with a new motorola system we will be replacing trucks that don't have the power load again reduction of back injuries is a primary reason and the purchase made from ems reserves in the third quarter like i said we would want to make sure that get that first unit ordered and we're still sitting good with our reserves before we

» go down that road on the remount um what's the mileage on that truck you know it's going to be by the time we would be looking at so what i'm hearing is everything that all of the trucks that are being bought are being bought with cash out of reserves we're not financing we're not cash flow financing they're just we've saved enough money to write a check again you know i'll compliment the staff really do try to pay as much attention as possible for any waste um so yes savings have purchased the units thank you miss brown what about radios uh the sheriff the sheriff and you guys both hit the constant theme of radios you mentioned radios but is that a part of the reserve by purchase as well the radios are going to be when we purchase an ambulance uh it's it's um turnkey ready so it will have

» the new radio system in it so we don't have to worry about replacing it until the answers the radios are included radios are included thank you yes sir if this is get our first one works the way i hope it will anytime you're taking and we would need to go through the same manufacturer we would want to go through aeb because you're talking about electrical wiring you don't want to take a different manufacturer and try to hook those wires in if this goes the way we wanted to the significant cost savings towards our you know our reserve fund wouldn't be needed as heavily you can get two for one almost yes sir all right remember i just mentioned that thirty thousand dollar monitor that's an lp that's an lp15 there that that recently um we ended up having to take out of service as you can tell t

» hat the handle got busted um we were we were looking to replace that monitor anyway uh because it is a it has a lifespan of about seven to eight eight thousand dollars every seven to eight years i believe it was uh mr jones realities of that and i know mr connell has mentioned before about why we constantly talk about end of life this is medical equipment right you go out and that monitor doesn't work right the only thing that's going to be determined by the lawyers is how many zeros i appreciate your time i said anything yeah you didn't um all right we still have a quorum uh ben said he may be able to come back mr gardner of course has got work issues i think mr jones has departed so we're still at four uh let's continue to talk uh gentlemen what do you think a lot well first can i if i ca

» n gerald thank you thank you for your presentation and your honesty and um uh giving us what we need to hear um it's kind of hard to make good decisions with incorrect or inadequate information so i just want to thank you and your staff for that and i want to say thanks to miss brown too who does a lovely job in our finance department there on keeping up and making sure that all our departments are within their budget means and trying to save so um kudos to all of you thanks all right now echo that as well you did a great job presenting like any good uh manager you you're looking out for your employees and wanting the best for them and you know that's what you should be doing it's up to us to balance um amen you know the finances and see what's what's first and how to help help you prioriti

» ze how we move forward yeah i just i think you all would join with me and say and we have a certain amount of scientific objectivity that's been attached to a very subjective topic uh that's absolutely vital to the county and we saw the same professionalism in the presentation of on fire and uh i don't mind taking blame if if this body makes a mistake and we do it all the time that's what we get paid to do the further up the flagpole you go and being on this council is not very far up a flagpole but it's high enough but the higher you go up the flagpole the more your backside shows and if you be if we make a bad decision we own it so it's not the staff it's us who are the policy makers so that's what we do so you're signed up for uh criticism whether you make the right or wrong decision so

» let's just move on with the best decisions we can make that god can can inform so what do you need from us uh vic well mr chairman um again to kind of restate some some things first of all gerald was and all staff are are told to come up and tell you the unvarnished understanding of where they are and what they see coming yeah well next time put some syrup on it or something so so um you know this is hard mr blanchard has shared with you what he sees coming uh it may not be tomorrow it may not be next year but it's coming and it's opinion um and we are asked to give advice so we will give recommendations you know and that's what we do we recommend but council makes the final decision especially on the biggest issues that are policy related and obviously no one questions anybody's commitment

» to health and safety and in life but y'all have to make big decisions here for us the going forward we'll be presenting a budget to the council what will be helpful to us is in the next week two weeks three weeks that if you have additional questions or concerns about anything you heard, reach out to us so we can better formulate for you the proposal to you. You know, it's, again, Gerald's job is to run an ambulance service with the resources he's given and do the best job he can. I think evidence shows, you know, and to your point, Mr. Chairman, about the competence of the professionalism, I will remind you, or if you didn't know, I will inform you that that Gerald is the incoming president of the state association of EMS directors.

» So his peers have certainly recognized his ability to run an EMS station. And I would take what he thinks is important as gospel because clearly he's been doing this for a lifetime. So we will prepare a budget, but if we receive no further input, then we'll receive a budget based on our best ability to provide to you.

» it'll probably have um you know where we sit now we might have have two components one is status quo we normally present you a status quo budget which is with no additional resources here's what we do or a recommendation that might require in most cases we we rarely would require additional resources but given some of the circumstances he's facing um there would probably be one that would be provided to you that would show additional resources and what that would would look like based on on our recommendation recommendation is just a starting point council will then take those recommendations and change it as you best see fit and go in direction that that you see fit and that's our job is to give you that best information so the long answer to your question sir is is if you have additional

» thoughts questions or concerns please let us know so we can give you the best information we can let me tease out some questions here um starting with philo uh they've raised the warning signal so my feeling is we got to be ready for that and uh and act 388 i think applies except for the solution i think that mr tucker came in so as a matter of concern for me we've got to be ready to address the philo issue okay it's just got to happen um and i think that's complex and uh we'll have to chat about that the second one is fleet i think there's no demands on us for resources other than to approve the use of reserves this year i think that's what you said on facilities i didn't think i got a real clear signal from any of these gentlemen or from me on whether we go in a trailer or we live in blac

» k mold for the rest of our lives or we live in the current tank so i didn't i don't think we gave you a good signal on facilities i'm just saying not our fault it's just i don't think we did on pay versus schedule i'm leaning towards fix the schedule now you've been coming at us for three and a half years on this schedule and i'm leaning towards your solution um i liked option seven though that wasn't on there yeah there was no option seven keep talking about it so i'm in favor of schedule over pay having been deployed most of my life i know what you mean okay the money didn't matter after a while it was scheduled i'm tired of going to this place and that place all over the world but it's the same it could be said here for the uniformed personnel in this county so i think we got a gap and g

» uidance on facilities i think we're okay on fleet i think we got to address this philo problem that's going to hit us one day if not sooner and i'm in favor of the schedule issue um guys any further comments is i think you all have a free shot at any of these people today and any other time going forward we'll go ahead and address it now i'll speak to your facilities i mean something needs to be done i mean the only thing that concerns me is you know big tax hikes if we can do it if you can if you can issue a bond that's tax revenue neutral and something that makes sense you just got to tell us i mean a couple of us have talked about combining a fire department with ems that's done in other counties um i think that's a way to use our resources better and i don't know about how everybody fee

» ls about that but i personally have friends i've got a good friend in south florida she retired and she was ems and she worked in fire stations they utilize the same facility um you know we last last week we talked about fire this week we're talking about ems so it's up to us to help formulate something that makes sense for the taxpayers um you know whatever we need to do we need to do it we don't need to i mean that that little single wide trailer has been sitting there as long as i can remember is an ems station um either either we we build something there that's this revel that's revenue neutral from a tax perspective we can figure that out together but we need to move forward some way some way some way shape or form in the other building i'm not as familiar with but it looked like it ne

» eded some attention as well so um as mr jones said earlier give us a plan on on what you want to do or give us a plan vic as to how we could combine fire and ems and save money and at the same time still provide um good solid solutions for everybody in a good healthy environment something that's not you know infested with mold and cockroaches and everything else comments others gerald i just would say because this is just such in the scheme of things minuscule of money that you probably need to get with um finance and mr carpenter and you work out your retentions because that's there you go that means so much to the employees at little cost to the to the taxpayers and and i'm really surprised it took us this long to even do this because this has been in your field not ems but in the medical

» field nurses have been getting retention and sign-on bonuses and things of that nature that's just where we move that in all industry so you guys brainstorm figure out what's going to be best practice and um i appreciate you sharing this with us but this is something you guys can do internally uh to save the ones and encourage the ones to stay and and get this money so um they can feel that that they're more valuable to kershaw county others yeah sir i'll just echo what russell said about the facility i i read about that station the other day and it just kind of hit me i'm like man that thing looks terrible you know and and then there's our fronts parked a 1995 chevy blazer probably who knows when the last time that thing was driven um it cranked up just last week okay i'm just kidding i me

» an so i'm i'm all for uh getting a proposal and trying to figure that out and i i'm i've you know mobile homes definitely certainly an option but i'm kind of a i'm a long-term person and i realize there's some things that you do that 10 years from now you maybe face the same same situation so if you're going to do something you do it when it's time to do it and along the lines with brussels i've since i've been elected i've always and i'm you know i'm naive to the industry i get that but i've always said that there seems to be a natural dovetail with what with what with fire and ems and that it as a county we should be looking more towards uh seeing how you guys work together uh in tandem whether that's sharing facilities or being on the same property or whatever it seems to be uh very effe

» ctive just from a cost from a cost standpoint and because i know other departments do that so and uh so thank you for what you do people don't realize that as a paramedic you guys are you guys are these guys are pushing drugs they're making i know not diagnosis but you're making field observations and when you compare that to someone like an rn and we're not trying to say who's better but i mean these are individuals who are trained um to to be able to maybe do more advanced with with less you know because of being out in the field instead of being in a controlled environment of a hospital you know i think about you guys get on lockhart road or out in the country and just like four or five of you and you're trying to you're trying to do for a person that they really probably need a team of

» 20 people to do you know and and they do get that once they get in the er so as far as the retention um i'm all i'm all ears on how we can make sure that we have we have the best because at the end of the day we're all elected to be good stewards of the county and be good stewards for our citizens and when when our citizens dial nominal 9-1-1 um i will fail in my responsibility as elected official if they don't receive the best employee the the best paramedic the best truck and the best emt to their to their door uh when they dial 9-1-1 so keep up the good work thanks for thanks for keeping us on our toes and making sure we know what's what's coming ahead of us okay uh you got enough guidance um yeah and and in closing let me just say that that um you know we always present council a budget

» based on our advice and recommendations that's going to happen and for things like a building um you know or any capital things if there are different ways of paying for something we'll present you those options as well but we'll give you you know the options so the budget we'll present will include how we propose dealing with all these and how we propose to pay it because that's what we always do so i don't want anyone thinking that we're sitting here wanting y'all to tell us how to spend the money now we will prevent you a budget present a budget that is our advice on what to do and y'all will will accept it or not as you as you always have done so but we just want to in presenting alternatives i don't want to have a another recurrence of presenting a an alternative and someone saying wel

» l what made you think that that was something that we wanted so i just want to make sure that we understand where your thoughts are as we build your budget so we don't waste time we get into the process but we have plenty of information you got some good guys working here okay i think to that point uh our we will see the budget on first reading and the first reading and first tuesday second tuesday in may right and uh that will be the next time we talk about the budget or will there be other other times um we'll we will have a budget workshop starting um next week next week what time 10 o'clock 10 o'clock tuesday the 27th right here and now those workshops televised in case the public wishes to see it all televised just like this okay you guys good i will speak that i had a constituent actu

» ally uh text me this week and say hey i went back and watched the fire budget or the fire workshop and it was very helpful so uh well you know if i could if i could address that too because you know it was said at some time in the past um why are we just hearing this that's another thing that i've stressed to staff make sure council understands your issues so that they're aware of it some of these general we've been talking about for three years so we're trying to do our best to make sure council understands our issues so it's not a surprise when when or if we get to a point where we need to deal with them vic i want to make sure i had some numbers correct here and maybe gerald can help me out as well um the 21 22 budget uh without adding anything to it for ems is about four million um yeah

» the current budget is 4.2 million 4.2 yes sir all right and then anything additional that we want that we were showing today we need to add to that 4.2 to some degree yes i mean if we can save money in other aspects then that would shrink some increase others but yes okay i think i see where you're headed with that question and the point about 12 mils moved around as to not raise taxes is that your intent or i i am exploring that and i'm and i'm open ears to um and i don't don't hang on to 12 mils because i'm sitting here doing math now and i'm seeing that it's going to be a little different um but that is an area that i'm exploring and i'm open to hear others yeah you know but i want to i want to GET MY NUMBER STRAIGHT THROUGH VIC AND THROUGH GERALD AND THEN I'LL BE ABLE TO DO A BETTER PRE

» SENTATION UH TO MY COLLEAGUES OKAY OKAY ONCE ONCE YOU HAVE THAT WE CAN WE CAN LOOK AT UH A PROPOSED TAX BILL TO WE CAN PICK A HOUSE IN THE COUNTY AND JUST SEE HOW IT'S REVENUE NEUTRAL BUT WHAT WE NORMALLY DO IS YOU KNOW LIKE TRY TO DO IT LIKE A HUNDRED THOUSAND DOLLAR HOUSE SO THAT WAY YOU CAN DO IT IN YOU KNOW MULTIPLES RIGHT LIKE 150 200 AND THEN YOU'LL KNOW WHAT TO COST because remember most of our seniors just got a fifty thousand dollar what you call homestead exemption so right yeah okay that was excellent thank you gentlemen thank you sandra mike mary and vick of course well done thank you thank you sir thank you all