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City discusses EMS before council meeting

It’s no secret by now that the county’s emergency medical services are in crisis.

But there have certainly been disagreement on what the solution — or solutions — is.

A Thursday night public hearing at the Struthers Library Theatre was called by Warren City Council to get feedback on one piece of the puzzle — expansion of a pilot agreement through the end of the year that places two City fire staff at the Pleasant Township station.

While officials have been thorough in explaining the problem Thursday’s session included some important background on how we got here.

The fundamental challenge the City of Warren faces is that — as the only paid 24/7 service in the county — they go when dispatched. And those calls are increasingly coming from outside the city limits. The city — in many instances — can’t recoup the cost of making that response, which increases the challenge the city faces in covering their costs.

Fire Chief Rodney Wren said on Thursday that — county-wide — one in five calls are dropped, or missed, by the agency responsible.

The decline in volunteer service can be framed this year: Less than 20 years ago, the city noticed it’s responses outside the city when that total hit six for the year. Through September 1, the city has responded 228 times outside the city limits.

And it’s not a one year spike. Wren said the city responded outside the limits 339 times in 2018 and 269 times in 2019.

Through September 1, 110 of the 228 responses out of the city have been to Pleasant Township, providing a clear impetus for the pilot agreement that is in place.

“Most of the time we are in Pleasant, we are at the (Warren) Manor,” Wren said.

Before the city received public comment on the issue, former Fire Chief Sam Pascuzzi provided an analysis of how the system has gotten to this point.

“The problem is the volunteer EMS agencies are dropping more and more calls because they can’t consistently staff,” he said, explaining that the city’s response outside the city is a problem that developed over the last 16 years and “accelerated” over the last five “becuse we haven’t done anything about it.”

Pascuzzi said the city entered the ambulance business in 1989 “to improve services for the residents” and establish a non-tax base revenue stream.

While the city noticed those six calls outside the city limits, that number rose to 20 in a couple years time and then accelerated up to 60.

“There was clearly a trend,” Pascuzzi said.

As a result, the Council of Governments established the COG Fire Services Committee to address these challenges.

Outgrowths of tht effort started with a resolution circulated to the townships that required them to acknowledge their responsibilities to provide the service and included a commitment to work with their providers.

“But it didn’t have much impact on the problem,” Pascuzzi explained. “For the next couple years, the committee focused on raising awareness that there was a problem” and implemented “traditional remedies” such a meetings, press releases, recruitment incentives, public safety fairs and a web presence and split the county into planning regions.

By 2008 or 2009, though, the number of responses the city made in the townships was around 150 per year.

A 2009 update to the EMS Act – which required that departments staff 24/7or participate in a county-wide collaborative plan – spurred discussions on that plan.

“By 2016, we thought we had a consensus plan that everyone was OK with,” Pascuzzi said. “Participation in that plan was voluntary” and went into effect Jan. 1, 2017.

What it called for was pretty simple: When a department knew they would not be able to staff, they were to call a neighboring department and ask for coverage and then notify the 911 center of the change. The plan aimed to ensure calls weren’t dropped but also would have decreased response time spent in the dispatch process.

“Unfortunately, nothing changed,” Pascuzzi explained. “The reason nothing changed, the agencies in the county that helped develop the plan… simply ignored the plan.”

Pascuzzi said by 2017 some agencies were dropping 50 to 60 percent of their calls.

“(We) had put a lot of hope and work into that plan,” he explained. “(We) thought people would want it to work.”

But it didn’t and he said he approached City Manager Nancy Freenock to recommend pivoting from the COG committee to partnering directly with the surrounding townships.

“If you try to maintain the status quo,” Pascuzzi said, “if we don’t do anything, those responses that the city makes outside of the city are going to increase” and there was “talk that some of the volunteer EMS agencies were going to fold,” which would bring all of those calls to the city anyway.

“At this point, the only way to stabilize services in the city is to help the volunteer agencies stabilize the services in the townships before they disappear and there is nothing to work with,” he continued.

“This agreement would help us stabilize and manage the resources of the city,” Wren said, emphasizing that the city cannot let Pleasant fail.

“We really have no manpower during the day,” Tim Johnson with the Pleasant VFD said.

Data presented at the meeting indicated that the city has utilized the Pleasant ambulance as a third ambulance in the city on six occasions since Sept. 1.

Wren emphasized that the data procured by the pilot through the end of the year would shape if – and how – this arrangement is extended on a more permanent basis.

Councilman John Wortman asked Pascuzzi his opinion on the importance of a six person crew for fire response. During the pilot, on the days when city staff are stationed at Pleasant, there are four firefighter/EMTs on station with two in Pleasant.

Pascuzzi said the reduction on station in the city is “not fair to city taxpayers and could result in a reduction of services, depending on the circumstance.

“My vision when I was chief, at some point, the city would be able to surge staffing during times we help our neighbors and pass those costs off to the township.”

“The last people in this room that want less than six,” city fire Operations and Training Officer Steve Hoffman said, “are the people putting their lives on the line every day for the residents of Warren…. Less than six endangers each and everyone of their lives… but we are taking upon ourself to work with our neighbors.”

There was discussion on the possibility of hiring two additional staff if the agreement were extended permanently into 2021, which would bring the city compliment on station back up to six.

There wasn’t much public comment offered during the session.

“To me, right now (it) seems like a no brainer,” Mike Lyon, a city resident, said, suggesting the plan is “self-supporting.”

Ron Hoffman of Pleasant Township asked who was going to pay for the agreement. The answer is Pleasant Township.

“What’s the problem, mayor?” he asked. “We’re paying for it.”

A.J. Foriska, a city resident, asked, if CARES Act funding is being used to cover the additional two days, and the result will be better service, “why not five?”

He said that if he were in an accident in Pleasant Township, he would want the same response he would get in the city.

The agreement amendment will be before Warren City Council on Monday, according to City Manager Nancy Freenock.

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