Quad Ambulance District

The Annual Financial Reports are available for review. Requests can be made during normal business hours: Quad Ambulance District – 330-866-9847

Well, this is a simple and yet complicated answer. First of all, the apparatus are not both ambulances. One is a rescue truck used to extricate victims from vehicles, machinery, etc. The other is indeed an ambulance. Understanding why both are showing up requires a little knowledge about emergency medical service laws and rules in Ohio and a little history of Quad Ambulance.

The State of Ohio has for the most part, four levels of EMS providers:

EMR – Emergency Medical Responder

EMT – Emergency Medical Technician

EMT Advanced (Intermediate) – An EMT with more training, particularly in regards to trauma. The name for this certification has changed the most over the years, not that it really matters in this conversation

Paramedic – Highest level of EMS provider. There are some specialty certifications for flight paramedics and mobile intensive care units, but for everyday EMS response, this is the top.

Ohio requires that paid departments provide at least two personnel trained to the level of EMT when transporting patients, one of which can be the driver.

When Quad began operations personnel were not paid, they were volunteer. The station was not staffed. This model can be successful with a low call volume and a healthy roster of volunteers. Call volume increased, training hours and requirements increased, volunteer numbers diminished. In 2006 Quad began staffing the station twelve hours a day. This was an immediate success. A tax levy was passed, by the second quarter of 2007 Quad was staffing the station, not with just the minimum of two providers, but three, twenty-four hours a day, seven days a week. Even though most agencies the size of Quad only staff with two, Quad has always set the bar high, providing the best service while being financially responsible.

Quad is at another transition. As call volume has increased over the years more and more calls have gone unanswered. Why? When there are more calls for service, there are more chances that these calls occur simultaneously. Mutual aid departments have been requested in these situations, but always at the cost of a delayed response.

So… the question now is: How can Quad answer simultaneous calls more often rather than relying on mutual aid?

One solution would be to increase staffing. This does not fit into the current budget, so more tax levy money will need generated. This is a tall order considering that additional personnel are only needed a few hours a day while transports are being made. It doesn’t seem responsible to always put the burden on taxpayers either.

Another solution is to implement a recall system. Meaning that every time a transport takes place a request is made for off-duty personnel to come in and staff the station for a minimum number of hours. This fits in the budget and became policy a few years ago. However, it only had limited success and is dependent on the availability of off-duty staff.

Which brings us to another solution. Splitting the three person crew. Why? Over the years the expectations and use of EMS has changed. A larger percentage of calls for service are stable patients or, not even resulting in transport. Improvements in technology has streamlined the work being done, like heart monitors that continuously monitor the patient and communicate with hospitals, electronic patient care reports that can be completed once back at the station, power stretchers, etc. But with all this technology, the deployment model hasn’t changed. More than any other time in Quad’s history it is reasonable to expect two providers to be able to manage a stable patient while transporting to the hospital. However, responding with three personnel creates flexibility. The bulk of the work is done on scene which requires more providers and if a patient is unstable, the third person can transport.

What does the third person do if they don’t transport? They remain in the district, ready to respond to a simultaneous call for service. Provide immediate lifesaving interventions. Request appropriate resources. Or, if only one off-duty provider responds to the recall request, the minimum required number of providers have been met to transport a patient in the reserve ambulance.

How does the third person get to the scene if not in the ambulance? Quad doesn’t own a utility vehicle. Considerations have been made to purchase a used one, or a new one. Where to park it? Considerations have been made to build an addition. Is all that worth it for a solution that isn’t even proven to work? Likely not. What about that rescue truck?

Before considering using the rescue truck, why does Quad even have a rescue truck? Well… before the current make-up of fire and EMS departments and leaders were in place a set of hydraulic tools were purchased and placed on an old ambulance. These tools were used in the entire district. Auto extrication is an extremely technical and cost intensive part of public safety. Not that agencies don’t respond to many traffic accidents, but there are very few victims that actually need extricated. In fact, in 2021 that number was three. This number is important for a couple reasons. One, the current rescue layout Quad deploys cost in excess of $250,000. Is it reasonable to ask the districts taxpayers to provide multiple rescue trucks and tools for every fire department in the district? Not for three calls a year. This is why the departments (Quad, Magnolia, and Mohawk Valley) have continued to work together to provide this mission in the most financially responsible manner.

Seems like a no brainer, use the rescue truck. Not quite. Occasionally, the vehicle used to get the third person to the scene needs left on scene if that provider is needed for transport. This is where the three actual extrications comes into play again. Based on the call volume of Quad and making reasonable predictions based on years of data, there is about a 1 in 200 chance that the rescue truck will be left on scene, making it unavailable, and a traffic accident occurring that requires extrication. Mutual aid requests will be made to mitigate the incident if needed. However, off-duty personnel retrieve the rescue from the scene as much as possible returning it to an in-service state. This decreases those odds even further. 

Back to the original question:

Why are two ambulances showing up when I call for assistance?

To do more. To be flexible. To provide the right staffing, at the right time, for the right patient, rather than a one size fits all approach.

If you call for service and one person shows up, don’t be offended, don’t be upset, your emergency just happened to occur the same time as someone else. Rest assured this one provider has called for the appropriate resources and can make the difference between a positive or negative outcome in an emergency. Prior to these policy changes, no one was showing up unless another agency was available resulting in delayed response at best.

Is it working?

The first four months of 2022 has been arguably the busiest first four months in Quad’s history. Call volume has increased by 20% since this time last year. Despite these numbers, a Quad provider has been available to respond to every single call. Not one patient has been transported by another agency. The rescue truck has been available to respond to every traffic accident.

Yes. It is working. It is effective, cost efficient, and responsible. Services have not diminished, in fact care to the district as a whole has increased. Quad’s providers and administrative staff are working harder than ever to accomplish the mission:

To provide efficient and professional pre-hospital emergency medical care, 24 hours a day – 7 days a week, with an emphasis on sensitivity, compassion, and professionalism, to the residents and visitors of the communities comprising the Quad Ambulance District.

Over the past several levy renewal cycles the Quad Ambulance District Board of Directors have considered requesting an increase due to rising expenses and little to no increases in revenues. In the past the board has opted to look for additional revenues from other sources. Quad has looked at merging with neighboring departments, much like some fire departments in the area have done. These mergers have fallen short of expectations and not materialized as hoped. Grants have been and will continue to be a great source, but are not guaranteed and often times fall short of making any real impact on increased revenues from a year-to-year projection.

Quad has not asked their residents for additional funding since a 5-mil levy was passed in 2006 for full-time staffing. Essentially, it has been nearly 15 years since Quad has asked for a raise. Since 2006 the cost to operate a full-service advanced life support department has increased substantially. A new ambulance in 2006 cost roughly $130,000. Today a similar ambulance costs over $200,000. Cost for equipment required by the State of Ohio has increased as well. A heart monitor/defibrillator costs $30,000. An ambulance cot is nearly $40,000.

The time has come to ask for a raise, which is a little complicated given Quad’s current tax levy structure. Presently two tax levies exist to fund Quad, a 5-mil staffing levy and a 2-mil operations levy. These two levies combined generate about 5.3-mils due to neither of them being replaced, only renewed over a long period of time. Replacing both of them to their original mils is likely too much of an increase given the recent property reevaluation. Adding a third levy only seemed to make Quad’s funding more complicated. 

Quad is requesting a replacement of the current 5-mil levy with a 6-mil levy this November. If this levy passes, Quad will petition the Stark County Budget Commission to drop the 2-mil levy once Quad begins receiving the increased revenues. If the budget commission does not approve, the 2-mil levy will not be renewed when it expires.

In the short term, Quad will use the increase for capital expenditures. This includes replacing apparatus and expensive medical equipment as needed. In the long term, Quad will use the increase to offset rising personnel costs. This includes policies beyond the control of the department, like minimum wage increases, insurance, workers compensation, etc.

The negative side of not procuring an increase in revenues is difficult to see and only comes at specific moments. For example, as equipment ages it needs maintained more and has an increased chance of failure. It is this failure and down time to repair the equipment that creates the moment of negativity for the department and ultimately for the residents. There comes a point when replacing aging equipment is the ethical and moral thing to do rather than risk failure when it is needed most. The same is true with personnel costs. If the department does not meet the demands of the workforce within a given geographical area, the workforce will move to a different department. Turnover and staffing shortages create these moments where the best coverage is not available when it may be needed most.

Quad Ambulance thanks the voters for their continued support.

March 17^th, 2020

Quad Ambulance District Response to COVID-19

The Quad Ambulance District is following all recommendations from the Stark County Medical Control Board, county and state health officials, and the Center for Disease Control and Prevention (CDC). Quad is committed to keeping providers safe so they are able to keep the public safe.

Regardless of these changes, if an emergency occurs due to illness, injury, or otherwise, call 911. However, here are some changes that have been made at Quad:

• Quad’s providers are being screened when they report to work and every 12-hours during their shift. Any provider with a temperature of greater than 100.4 is being sent home. This is consistent with recommendations from the CDC and falls in line with other health care facilities. That vacancy will be filled with off-duty personnel. 

• Quad’s administrative offices located at 6930 Minerva Rd SE are closed. Administrative staff are working from home to the extent possible. Please call the administrative number at 330-866-9847 and leave a message for routine business inquiries.

• Quad’s station is closed to visitors. Routine blood pressure checks will not be performed. Employees are prohibited from being on the property if not on-duty or reporting for an emergency.

• Residents that do activate the 911 system may see some changes:
  1. The 911 dispatcher may ask additional questions
  2. Providers may be wearing additional Personal Protective Equipment (PPE) like face masks, eye protection, gowns, gloves, etc.
  3. The patient and family members may be asked to wear a surgical type mask
  4. Family or friends will not be allowed to ride in the ambulance to the hospital, unless circumstances exist that would be beneficial to patient care, like the patient is a minor and/or the minor must be transported with their parent or guardian
  5. Depending on the nature of the incident, patients may be approached by one provider initially. The driver may not ever leave the ambulance unless necessary.

• When EMS encounters a patient with known or suspected COVID-19 and are otherwise stable, transport to a hospital may not be indicated. Quad’s providers will be in contact with ER doctors and other health professionals to provide the best information and next course of action for those patients.

• These measures are being taken so Quad Ambulance District can continue to provide quality patient care. Any questions or concerns can be addressed to the chief.

May 2018

April 2018

March 2018

February 2018

January 2018

December 2017

November 2017

 

 

 

Shoveling snow during the winter months is a common cause of heart attacks.

Please keep the following ideas in mind when shoveling snow this winter.

TAKE IT EASY:
Work at a slow pace and take frequent breaks.

KEEP HYDRATED:
Drink plenty of water while working. You can become rapidly dehydrated due to extreme sweating under heavy winter clothing.

COVER YOUR HEAD:
The head is the best place for heat to escape from your body. A stocking hat will greatly reduce the amount of heat you lose while working outside.

LISTEN TO YOUR BODY:
If you feel tired or any type of pain, IMMEDIATELY stop working and rest. Your body is trying to tell you are working too hard. Ignoring these warning indicators could lead to serious heart problems.

KEEP A PHONE WITH YOU:
Keep a cell or portable phone with you while working. If you should happen to fall and be unable to get into your home, you can dial for help from outside. If you don’t remember the number for help, dial 911.  The appropriate help will assist you.

SWALLOW YOUR PRIDE:
Hire a neighborhood youngster to assist you or to do the shoveling for you. It will prevent you from risking your health and the youngster could use a little spending money as well.

Remember, cold weather and labor intensive tasks don’t mix well. Many heart attacks could be prevented if people remember to exercise caution when shoveling snow in the winter.

Check back next month for a new and informative health tip. The community’s health is our greatest concern.