As much as anything, last week’s county commission and EMS advisory board summit laid bare the folly of trying to make do with less.
For an ambulance system subject to dreadfully complex regulations, knocked off balance by the firing of its director, beset by internal squabbles, and short-staffed, commissioners turned not to a seasoned EMS professional, but to a relatively inexperienced EMT who lacked many of the minimum requirements spelled out in the job description.
An advisory board was assembled for support. Commissioner Dan Holub urged EMS crew members to give the new arrangement a chance, a harbinger of troubles ahead.
Brandy McCarty took on the director’s job with enthusiasm and good intentions, likely unaware of the challenges ahead of her.
Medical director Paige Dodson stepped down shortly after McCarty took over, to be replaced by Don Hodson. Commissioners forced the resignation of the Tampa crew chief because, they said, he refused to comply with McCarty’s directives. In June, the state EMS board deliberated over a complaint about McCarty filed by a Peabody paramedic. The EMS office manager resigned in July. Three months later, commissioners fired the aforementioned Peabody paramedic.
McCarty displayed a great deal of personal and professional integrity by resigning, indicating at the summit she lacked the preparation and expertise needed to lead EMS. It’s an unfortunate end to an ill-advised experiment that had trouble written all over it from the start.
Now commissioners must regroup. To their credit, they’re going about it the right way by engaging the advisory board immediately; to be fair, there wasn’t a board to consult last time.
Commissioners were receptive to the board’s recommendation to seek a seasoned paramedic with EMS administrative experience to lead the department. They also appeared ready this time around to shell out the money it will take to get one, even though doing so likely would make a new director one of the county’s highest-paid department heads.
Perhaps the best thing coming from the meeting was the willingness of commissioners to hire a consultant to evaluate EMS. They’re used to depending on the expertise of external professionals for road and bridge projects; for a department dedicated to saving lives, they should be even more so.
Getting a qualified director and hiring a consultant is as far as commissioners should go for now. If changes are coming to EMS, as surely they must, a new director needs to be involved in charting a new course. All should be informed by a thorough evaluation before making isolated changes that could be uninformed and ill-advised.
Commissioners should, for now, leave alone a suggestion McCarty made to create another administrative position, one which she said she would be willing to fill.
If an evaluation of the system indicates a highly qualified director needs an assistant to get the job done, that director should take the lead on who that person should be. Fair or not, McCarty’s tenure included actions many responders found to be divisive; it should be up to a new director whether to take on what could be an awkward situation of supervising a former director with political baggage. It wouldn’t be surprising if they preferred to start with a clean slate.
Commissioners also should hold off on the possibility of handing over advanced-life-support transports to an out-of-county service until the financial ramifications of such a move are carefully considered. It would ease the load on county crews and increased the availability of ambulances to respond to in-county situations, to be sure, but what are the financial implications of giving up thousands of dollars while simultaneously increasing expenses by thousands? What would giving up those runs mean for the administrative workload in the EMS office?
Commissioners should move with due diligence, but not undue haste, to bring on a consultant and hire a new director. They should use those objective opinions in collaboration with input from EMS personnel to determine what changes will lead to a viable EMS system that will serve citizen’s emergency transportation needs for many years to come.
— david colburn