EMS Subcommittee

Monday, January 30, 2023 - 9:00 am


Robin DeLoria - Chairman


Chairman DeLoria called this EMS Subcommittee to order at 9:18 am with the following in attendance: Robin DeLoria, Derek Doty, Shaun Gillilland, Roy Holzer, Noel Merrihew, Jim Monty, Matt Stanley, Ike Tyler, Meg Wood, Mark Wright, and Mike Mascarenas.


Also present: Dina Garvey, Rob Wick, Bryse Taylor and Matt Watts.


DELORIA: Good morning, Iíll turn it over to Rob


WICK: So, we do have a print of the end of year summary and there will probably a revision to this, because weíre trying to get some additional information from themselves. The conversation that we had last month was in regard to per diem volunteers, so some of the information that we want to cover on this is how that actually operates for a lot of the agencies, as weíre aware of it and some of the reasons why the volunteerism and per diem situation is the way it is and why in the past we had allocated a significant amount of the budget away from the per diem program that was a concept very early on. So, this will get revised with some of that information.

Okay, before we dive into that, weíll go over some current State stuff on the agenda. We donít have any resolution requests, right now. We do still have the medic car position thatís opened and an EMT in Moriah, that weíve identified, right, thatís in the hiring process. So, thatís been updated since this.


WATTS: So, Matt Rudow is moving from Willsboro to medic car and then we hired someone to replace him in Willsboro and we filled the Moriah one. So, weíre up to staff, except there is still one medic car position open,but we havenít been able to identity anybody for that, just by advertising.


MASCARENAS: But, Moriahís losing Bryse, in terms of a volunteer.


WATTS: And lost another one that was doing 40-50 hours a week, as well. So, theyíve lost a couple of people.


WICK: So, we were able to get all the contract renewals out. Weíre just waiting on some of those to get fully executed and get those back in.


WOOD: Are they late?


WICK: On getting some of the contracts in?


WOOD: Back to you?


WICK: So, they are due back, but they didnít get out until like within the last 2 weeks, they have gone out to all the agencies. So, instead like them getting snail mailed around or emailed them around, like, these guys have been taking them around to each agency and towns and stuff.


WATTS: Weíll let you know.


WOOD: Okay


WATTS: It should be getting to you, soon.


WICK: I was trying to avoid it getting lost in the paperwork, as it happens with all kinds of other stuff that goes across everybodyís desk. That includes those new contracts that we had with Keene, AuSable and Keeseville for just the materials, supplies that we worked with them on.

Matt brought up some of the changes there in Willsboro.

Didnít know if there had any other information that came across with Lake Placid EMS. Last month we were waiting for a formal request to work with them. Has there been any formal, further meetings and discussions in that regard?


DOTY: There hasnít. Iím still waiting for a report from Rick Preston, one of councilmen, thatís one of the volunteers on the force. Like I told you, we did augment their budget by $52,000.00 to help them make it through a combination of, letís say salaries and potential closure of the ER, up there. Internally, theyíre trying to determine, like the sharing aspect that Bryse kind of put in front of us, as a starting point. Iíll bring it up again this week and try to get some movement. Rick is asking for the ambulance service to give us a plan, so that it isnít just knocking at our door for more money each year. We need to develop something that will be, I think, mutual for both of us. At least thatís the direction Iím trying to make.


WICK: Understood.

A couple of the other items, still on the agenda here that we havenít gotten any formal requests from; Willsboro/Essex, Etown/Lewis and I think at point it was either Keene or Keene Valley, I hadthem both listed here,but they were talking about asking for an EMT.


TAYLOR: Keene Valley


WATTS: Keene Valley


WICK: Okay.

None of the other items had really moved forward, but I did have a note here on item 11 and thatís what I wanted to have more data detail in the program summary for the end of year that I will update and push back out to everybody. So, as some of these bullets are listed her, the program was first introduced way back as a concept in 2017 when this first came about, the per diem program, Iím referring to. We pushed that out year over year to all the towns, all the agencies about the intent of the per diem program, how we intended to fund it, how much money we had to fund it throughout the course of the entire term of the grant and how weíd like to do that. There were a number of folks, Mike went to some of the town hall meetings with Patty and Matt to talk about, like, okay, hereís this per diem program. We want to try and get more volunteers into the mix. We want to be able to subsidize that with the on-call, hourly rate that was lower, but then full-time, activated hourly rate, once theyíre, you know, actually going to be preforming some work. But, for 3 years, nobody really bit, nobody had any interest in it and the agencies continued to operate, as they were going to, unless they had the full-time EMS members from the County. That seemed to be the only desire they had, was just, to have full time people to fill in gaps and just let it ride with that or in the case of a couple of agencies, just material requests. So, thatís what itís been and when we shifted into the full scale phase of this grant we had to kind of commit how we were going to allot the rest of those funds for the duration and pretty much, everybody moved to the idea of sustaining all the costs that we knew that we were going to have to incur over the course of the next couple years to keep the program running, as opposed to having this budgetary figure out there for a program that nobody had interest in. So, I mean, obviously if the County wants to pay for a per diem program, if thatís something that everybody has an interest in, it definitely can be done. I donít think anyone would say no to that, but itís not really something that we can have grant funded at this point, because all those grant funds have been allocated to sustain the program to the end of year. So, what I would advocate for is if we, the County, proposed to have a per diem program, under EMS, that the agencies, themselves, like develop their pool of volunteers that actually are going to participate in the program and bring that as a part of their formal asks. So, that way we understand like how many people are even there to be part of the program to start generating the management aspect of that in terms of scheduling and part-time employees and that sort of thing.


MASCARENAS: So, at the time, Dan and I, Rob, when we were sitting down, looking at this program, what we quickly realized was that 24/7 operation, countywide is unsustainable and unaffordable, when you start putting what that looks like for the taxpayers. Itís simply something thatís unachievable. What was our original figure? 12 million, maybe, something like that?


TAYLOR: Over 5 year though.


MASCARENAS: It was a different format. It was basically following, thereís other ways to do it, but when we were looking at it, it was every agency operating, as they are today and whatís it going to take to do a 24/7 operation and that cost. So, what we said was, at the time, we need per diems and thatís a cheaper way and a way to kind of value the work that those folks are doing. So, we were willing to, at that time, pay anybody thatís showing up for a call. They just had to sign up and be part of that per diem program and what we have, Rob, maybe $300,000.00-$400,000.00 allocated that was part of the grant?


WATTS: I think it was $300,000.00.


WICK: We originally had $600,000.00.


MASCARENAS: $600,000.00?


HOLZER: How much did you use?


MASCARENAS: None, we sent letters to every volunteer in the County. Patty got us a list of every volunteer. We sent them letters explaining what this program was, we did the outreach, we went to towns and communities. I donít know if there was a real good understanding of what it was, but our goal was really to get those people that work every day in some other profession that may want to make a few extra bucks. If youíre on call that weekend, you would get paid. If you are activated that weekend, you would get paid the active rate. So, if the on-call rate was, say, $100.00 just for that weekend to be on-call and be available, thatís what youíd get, but once you got called into action, youíd get the hourly rate of whether you were an EMT, AEMT, paramedic, whatever your credentials were. For some reason that never took off. I do think long term thatís probably a mechanism that is going to have to be relooked at. But, as Rob said, now how do you fit it in and who pays it and how do you go forward with that? At the time, Dan and I were willing to pay it, because if we could keep full-time people off the list, it was cheaper for us to pay a per diem rate than it was to pay the benefits. So, our thought process was if weíre paying $25,000.00-$30,000.00, well, $25,000.00 just for health care, so our benefit is probably in the $30,000.00, it would be a significant savings and a way to keep those costs under control. But, currently there are no placeholders in the budget for any of those things.


TYLER: Itís just hard for me to believe why they wouldnít. Was it education of how they were going to get paid? They were going to do it anyways, why not get paid?


MASCARENAS: I agree, Ike. I think itís like anything else. I think misinformation, perception, kind of rules the rumor mill.


HOLZER: Letís be honest, I think what happened is, when it was first starting, is every department, ambulance department, fire district, theyíre very protective of their sandboxes. Youíre dealing with a ton of personalities. I know in my own town, I can see where, you know everyone was standoffish on the County program. Oh, theyíre going to come in and take control and itís evolving, but I think itís like anything else and itís taking some time for them to wrap their head around it. You know, Wilmington for example, we went from 40 members down to 15.


WATTS: I think they were afraid of losing control. Youíre starting to see that turn, now.


MASCARENAS: At the meetings I went and did, people were misinformed and Iím not sure they were certain they could believe the folks that were giving them the message.


TYLER: From what I am hearing from Roy, it might be more receptive now, to do.


TAYLOR: So, the reality of it is that EMS as a professional is evolving, just like nursing did many years ago and volunteerism in this profession is just not a realistic thing to look forward to, just like you donít see volunteer nurses anymore. Thereís a strong national push to be recognized as allied healthcare providers. Thereís strong national pushes by all of the governing bodies for accreditation, degree requirements. EMS is moving away from call mentality, moving towards clinicians and actual medical providers and if you try to implement a per diem rate, thereís not enough of us to go around. If Iím working in Moriah and they say, weíre not going to pay you for your shift, weíre going to pay you on-call and youíll get an hourly rate, I can go to 6 other agencies that are willing to pay me my hourly rate, the whole night, whether I run a call or not. So, we really are evolving away from the volunteerism that used to run this industry. Which is unfortunate in that thereís a significant cost to healthcare, especially which the way that healthcare in America, as a whole, is. But, it is better for the people that need us, because youíre getting trained, educated, motivated, compensated providers that come take care of you or your family members.


WOOD: Your key word is industry. Itís a profession, itís business then.


STANLEY: I think the other problem is, you start paying full-time staff, those volunteer people donít want to do the work, because somebody else is getting paid to do the same thing theyíre doing.


HOLZER: And itís evolving, too, because I know on like different, potential EMTs that weíve looked at hiring for Wilmington, all of sudden theyíre coming in and trying to set the tables of what their work scheduleís going to be like, for example, everyone seems to want 24-hour shifts, now, instead of a traditional 9-5 or a 10-hour shift, they want a 24-hour shifts. They want to make sure that the building has cable and internet and stuff like that and itís like, weíve done everything from checklists, if youíre working, youíre going to be working. You know, one wanted to make sure that there were beds and showers in our department, if they came onboard.


MONTY: In talking to some of the volunteers that have left the volunteer service in Elizabethtown/Lewis, theyíre upset the fact that theyíre stuck with the hours that nobody wants to work and stuff. Theyíre the ones that are covering the weekends or the ones that are covering nights and so the animosity there, for them, towards the paid staff is whatís keeping them from volunteering.


MASCARENAS: But, going back to Ikeís point. I get what everybody is saying, we were offering to pay those volunteers.


MONTY: Oh, I understand that.


MASCARENAS: Without an interview, without anything. So, I get what everybodyís saying in the room, but there still are volunteers, are there not?


TAYLOR: Very few, anymore, honestly.


DOTY: We only have three in Lake Placid.


WATTS: They dwindled, but there are some.


MASCARENAS: But, you would think they would want, go back to what Ike said, why wouldnít they want that? Why wouldnít those three people that are volunteering want that? I donít know. I donít know the answer to that.


DELORIA: So, is the suggestion to bring this back around for discussion to the various departments? Do you want to bring it back?


MASCARENAS: I think long term, Robin, unless thereís a total change in the way this service is provided that youíre not going to be able to afford it any other way. Unless you had, substations and all those things like other places that went to.


TAYLOR: And the crux of the matter is the staffing model that weíre using, currently, the logical conclusion of that is staff 11 to 13 agencies, 24/7, 365 by County staff. When an agency is on the verge of failing, theyíre coming here for help. Thatís not sustainable.


GILLILLAND: inaudible


TAYLOR: Maintaining these individualized squads is not sustainable. Itís not sustainable logistically. Thereís not enough healthcare providers to go around. Itís not sustainable financially, because of the burden that would place on the taxpayers.


GILLILLAND: Let me ask you a question; what is sustainable? What is your model?


TAYLOR: A consolidated, transporting ambulance service, staffed by County employees, 24/7 with distributing ambulances.


GILLILLAND: For the entire county?


TAYLOR: For the county.


GILLILLAND: Whatís the price tag?


TAYLOR: Before revenue recovery, $3.4 million a year.


GILLILLAND: No, youíre way low. You are way, way low. Weíve done this again and again. That was the fight that we had with this Board of trying to get this whole thing established, was the $14 million in initial.


TAYLOR: So, thereís a misconception, if you read the CGR report, thatís $14 million over 5 years. thatís not $14 million a year in the original CGR report that was the foundation of this. If you staff, even if I staffed every agency and Iíve run the numbers, I can provide the numbers, if you staff every agency with one EMT and one paramedic, 24/7, 365, itís ^6.8 million a year in salary and then the fringes are an additional 60%.


GILLILLAND: And who is picking up the infrastructure?




GILLILLAND: Who is picking up the infrastructure?


TAYLOR: You eliminate the infrastructure.


GILLILLAND: You canít eliminate the infrastructure.


TAYLOR; You eliminate the infrastructure and take it over.


GILLILLAND: Take it over, but you donít eliminate it.


TAYLOR: instead of having 13 stations, you have one central station, people come and work a shift on an ambulance, and that ambulance goes out and covers the County and that ambulance could end up in Lake Placid. That ambulance could end up in Ticonderoga. It doesnít matter. The ambulance is a county asset and you can do this with 7 ambulances and 4 to 6 fly cars during the day and drop it down to 4 to 5 ambulances at night and that brings your costs down, youíre not maintaining every building, youíre not maintaining two or three ambulances in every agencies, half of which never get used. Youíre not paying for the power. Youíre not paying for the heat. Youíre not paying for a ton of it.


HOLZER: Geographical, how you would handle one ambulance? I mean letís say thereís a call up inÖ


DELORIA: Newcomb, Minerva, North Hudson, Schroon


TAYLOR: So, Newcomb is an outlier, because you would have to leave a truck there, thatís just an inefficiency in the system.


DELORIA: But, Minerva is with Warren County, now.


TAYLOR: So, you can stack three ambulances in Crown Point to cover Ti and Moriah and hereís the thing, this isnít static. We donít just, youíre in Crown Point, today. You move ambulances around, itís a concept called, system status management and it works in geographically equivalent counties of the same size as ours. This is an established workable system in the Country. So, you stack three ambulances in Crown Point, they can go up to Westport, they can go out to Moriah, they can go down to Ticonderoga, they can go to Crown Point. If they start getting calls, you pull one of your two ambulances thatís at like Exit 31, because they can go north, south, east, west from there and hit anywhere at the same, your time on-scene would be equivalent to what youíre getting now, because you have an ambulance thatís immediately moving, as soon as somebodyís calling 911. Right now, youíre waiting for a driver to come to the building, get the ambulance out, respond, and get the scene. By eliminating three of those four factors, you donít lose any time getting an ambulance to a patient.


DELORIA: But the response time would be critical to certain 911 calls.




DELORIA: What is that span? Do we have any idea what that span would be? How many minutes before they actually responded on-scene?


TAYLOR: So, your time on-scene would be roughly, when you move the resources around, youíre maintaining that time to dispatch to on-scene. Thatís why you move your resources around. †††


DELORIA: You know what Iím saying, brain dead after 4 minutes, I learned that 25 years ago, so thatís 4 minutes, not 15, not 20.


TAYLOR: So, without a significant expenditure that is not sustainable you wonít ever have four-minute response times everywhere in the County. Itís just not feasible, because of the geography.


DELORIA: Countywide, no. I think Newcomb runs pretty tight with their numbers, as far as getting out there, because we staff the building.


TAYLOR: Your average time, for most agencies to get an ambulance out of their station, regardless of travel time to the call is between 8 Ĺ and 11 minutes.


DELORIA: Okay, I think weíre under that though. Only because of the way, we were setup. I wish all of our towns were the size of Newcomb, where you can throw $400,000.00 a year at it and forget about it and that includes fire protection, but thatís Newcomb.


TAYLOR: So, countywide the average is between 8 Ĺ and 11 minutes for an ambulance out the door and I know that even, like in the agencies, and thatís one of the problems with our staffing model, is that even the agencies that we have a full time person at, we donít have the 0 minute response time, because weíre still waiting for the agency driver to get there and the agency canít afford to pay somebody to be there 24/7.


MASCARENAS: So, at the end of the day what Bryse is referring to is maybe a concept that happens years from now. Right now, weíre not ready to do any of that. So, I donít want to misinform the public.


GILLILLAND: And that has been the model that weíve been looking at, is what heís talking about, down the road is what we will evolve to, eventually.


MASCARENAS: But, right now thereís still enormity issues.


GILLILLAND: But, I disagree with him about substations and things like that, because Iíve lived in some pretty remote counties around the Country and they all have, you know, State Police have substations, but the best and Dan Palmerís thing when we put this together was we got to keep the volunteers as long as we possibly can with the understanding that weíre going to attrite them until theyíre not there anymore.


MASCARENAS: Well and you have district issues.


WOOD: The towns like Schroon that are on the edge of another county, are we working in tandem with other counties towards this goal?


GILLILLAND: Youíre next to Warren County, right?


TAYLOR: Warren County had the process that we did and instead of forming anything, the agencies have refused to consolidate in anyway.


WOOD: I remember Johnsburgh, 10-15 years ago.


DELORIA: Letís bring this topic back up and put some time and thought into it, but can we introduce Mike, here? Because I donít know if anybody knows.


WATTS: I was going to do it in there.


DELORIA: You can do it out there, as well.


WATTS: So, this is Mike LaVallie, heís my Deputy Director, 911 Coordinator. Do you want to go around the room and introduce yourselves?


At this time, introductions were made around the room.


LAVALLIE: Nice to meet you all thank you.


DELORIA: So, the per diem thing has to come back. I think we need to focus on that. If thereís people out there, letís find them, however that takes. You said something about, maybe the individual towns to put something together and pool, a pool of people and then something about adding it to the contract, how would that work?


WICK: So the agencies themselves are going to have a much better sense of the, well, letís just say their overall membership, whether they be active or inactive. I think the first step would be for each of the agencies to clean up their membership rolls and actual identify those members that are like willing and able to not just be volunteers, but if they also want some kind of per diem program subsidize. That would give us something to go off of. You know, like Mike said, we did the one on ones, way back when and if there is willingness to do this again, I think it has to start with the entities, it has to start with the agencies to push it up to us. That way we understand like what weíre working with in terms of the people that are available, not just from guesses and that was kind of one of the things that we had lacking from being able to have a more complete end of year report here was we have our own roasters, but there are a lot of unknowns in terms of the actual active roasters at the agencies. So, for us to kind of put together some information to bring before the committee here to have a more in-depth conversation about the per diem program and the volunteers and stuff, we have to understand like we they actually have, right now, on their rolls, thatís active.


WATTS: We did put a request out and have gotten any back, yet.


TAYLOR: Three have.


WICK: Three agencies have responded, but thatís really all we have. I didnít want to put that in here, it would be two pages of a lot of missing data. So, thatís why I say, this will be updated and pushed back out once we have a little bit more clean information and that will be a huge part of that per diem program conversation.


DELORIA: So, you did send out a request for these lists and three out of how many got back to you? Three out of nine?


WATTS: 15 agencies?


TAYLOR: I think if we count the agencies that are staffed and dispatched with other counties, yeah.


DELORIA: Snail mail or hard mail, how was it put out?


WATTS: Email


TAYLOR: Directly to the agency leadership.


DOTY: Rob or Bryse, how many independents like Lake Placid are there? And are their volunteers qualified for per diem?


TAYLOR: Everywhere other than Keene Valley and Westport is independent and Newcomb. Newcomb, Keene Valley and Westport are fire districts or fire protection districts.


DOTY: Okay, so all volunteers will qualify?




MASCARENAS: Yeah, under the old system, I think we need to reevaluate and see, like Rob is saying; we need to start with the numbers. Itís hard to make a decision without understanding the impact; right? Whatís that financial impact going to be? Whatís it look like? So, I think if we started with that partnership with the agencies and getting an idea of what their numbers look like and who is interested, we could move forward with a decision.


WATTS: We have an EMS association meeting on Wednesday night, itís virtual, do you want to be part of that?


WICK: Sure


WATTS: At least get some dialogue started.

Do you want to be part of it, Mike?


MASCARENAS: Yeah, send it to me.


WATTS: Even if you canít make it, at least youíll have it.


MCNALLY: The on call-pay for, weíre with Johnsburgh. The on-call has been very successful. Theyíre taking 12-hour shifts for $75.00. Our ambulance is only ran 18 times last year, but at least weíre getting first responders signed up for that.


WATTS: And thatís volunteers that youíre paying that to; correct?


MCNALLY: Yup, and they get $75.00 a shift. So, I was talking to Simon Gardner whoís a paramedic for Luzerne, but he lives in Minerva and he takes every Friday night in Minerva, a 12-hour shift and he has all year and heís made just one call in Friday night. So, he gets the $75.00 for being in town and being available. So, the on-call is and you can on-call an EMT. It gives us our local ambulance and first responder to get to the scene and if we do have a call, a lot of times they will take it and they get paid additional for that, but just having the on-call and having people scheduled and that little bit of money makes all the difference in the world.


DELORIA: How many do you have, Steve?


MCNALLY: On that system? I have about six people that take shifts.




MCNALLY: But, some of them take four shifts a week. You know itís $300.00 a week and you might not go on a run. Last year I think we had 80 calls. Thatís not many.


DELORIA: And theyíre certified volunteers. You said first responders?


MCNALLY: Theyíre all EMTs


DELORIA: Theyíre all EMTs, at the minimum staffing level, EMT?


MCNALLY: Yeah, I have three paramedics.


MASCARENAS: Some people can roll ambulances, because they ainít got a driver.


MCNALLY: Thatís our biggest problem. Now weíre going to start paying on-call for drivers.


DELORIA: Okay, you donít currently do that?


MCNALLY: No, but weíre going to have to and thatís probably going to a little, probably $50.00 a shift, but that seems to be a big problem, drivers.


DELORIA: And of course, once you get this certified list of volunteers and get them in the system, they have to be recertified, so we monitor that on a County level to make sure that thereís classes?


WATTS: The only ones that we currently monitor are the staff that we currently have.


DELORIA: So, if we move into this per diem program, we will monitor those people to make sure that they continue to be certified.


WATTS: I mean weíll make sure that theyíre certified, but itís their responsibility to make sure.


DELORIA: Well, the agency would have to.


MASCARENAS: Weíre really a staffing.


WATTS: Yeah, weíre not there to babysit to make sure, oh, your card expired. You need to take responsibility yourself.


DELORIA: I understand, the agencies, the towns and the villages are going to have this program and certify these volunteers and pay them, theyíre on the payroll; okay. So, they qualify for it today. How do you make sure that they qualify for when their certification is expired? Somebody has to track that if theyíre going on somebodyís payroll and itís really that simple. I donít know if we do it on the county level or the towns have to submit an annual report or whatever, monthly report.


WATTS: We can very easily run a reportÖ


DELORIA: I thought that perhaps that wouldÖ.


WATTS: To make sure theyíre certified.


DELORIA: Exactly, because you have access to that data.


MCNALLY: What has changed a lot and I was an EMT for 12 years, of the five or six people that respond in Minerva, theyíre all professional EMTs now. They work in other locations, thatís what they do for a career, that take those shifts. When I was an EMT, we used to just like, three or four of us, every couple of years, would take the class. So, we had all these EMTs, some of them would show up at one call, every year. But, thatís gone now, I mean now these are all career EMTs that are taking these shifts. They work for other agencies and then theyíll take a shift.


MASCARENAS: Yeah, thatís what a lot of our folks do.


DELORIA: How many hours is the EMT course, coming out the box for a newbie?








DELORIA: Use to be 120, right?


WATTS: You donít want to know what it was when I took it. So, we just had 14 graduate from the class that just finished up in Crown Point. About half of them have taken their test already and passed. So, that will help a little bit. It helped with Westport; Westport had a ton of people in it.


DELORIA: Of course, that brings me back to the virtual attendance of these programs and having it setup, so that can be done virtual. Iíll probably say that every meeting for the next six years of me being here.


MCNALLY: Those people that took that class, theyíre not going to use this as a career. That $75.00 signup time makes a big different to keep their attention. You may turn them into more than that.


WATTS: I just had one thing from last meeting that Ike wanted me to check into and you guys, with regards to Essex County and the hospital. I have a meeting on Thursday with them; finally, it took me almost a whole month to get things together.


TYLER: With Matt?


WATTS: No, with the Director of Nursing from each place.


TYLER: Wouldnít you think Matt should be involved with that?


WATTS: I figured that was at least a place to start and it seemed to be moreÖ.


TYLER: Would you like me to come to it, too?


WATTS: If you want to.


TYLER: If I can, I will.


WATTS: It seems to be more on the Essex Center side of things that the issue was.


TYLER: Youíre meeting with their people, too?


WATTS: Yes, theyíre both coming that day. 9:00 at the hospital board room. Noel, if you want to come, too, youíre welcome.


MERRIHEW: Is that about the access?




MERRIHEW: They use that for dialysis.


WATTS: Yes, thereís no reason they canít use it for some of the other stuff.


DELORIA: Sure, thatís a good point, so youíre going to go to that meeting?




DELORIA: Okay, this there anything else thatís super relevant to this particular meeting?


TAYLOR: I have a letter that I would like to read.


DELORIA: Yup, go ahead, Bryse.


TAYLOR: So, this is my goodbye letter.

To the Board of Supervisors,

Is it with sincere regret that I have resigned my position. May last day was Friday. I have nothing but appreciation for the job I have held and the impacts I have made. My leaving is in no way a reflection of the office environment or leadership of Office of Emergency Services.

I have spent the last year as a subject matter expert for EMS and I hope Iíve earned your trust and I feel it is irresponsible of me to not use my parting words to continue the mission I have carried for the last decade in this county, taking care of the people who call 911.

EMS is in a dire situation. Not just in our county but in the country as a whole. The EMS system that has implemented and overseen by OES is the only reason that the system, as whole has survived. I cannot overstate the importance of the continued support and growth of the County System moving forward.

EMS is a service and it has a cost. That cost will be paid, either by money, or the wellbeing for your constituents. It is an unfortunate, but hard reality that volunteerism is not going to be the solution to the problems in the EMS system. Relying on volunteers has led us to this point and unfortunately cannot be relied upon to get us out of it.

There is a viable solution in consolidation, but it must be embraced from the top down. Gone are the days were each town can or even should pay for its own ambulance service. Pooling resources and sharing ambulances can and will work here, as it does in other counties.

I have dedicated my entire life to EMS, and the last decade to EMS in this county. Know the only motivation that I have in offering this publicly is for the well-being and care of the people who call this county home.

I cannot overstate how much of an honor holding this position and helping serve the people of this county has been, and I will remain available to assist OES going forward, as needed. Thank you for the amazing opportunity I was given.


DELORIA: Thank you, Bryse.


STANLEY: Thank you


WOOD: Thank you.


DELORIA: Okay, is there anything else that canít wait for our next meeting? We stand adjourned.








Respectively Submitted,



Dina Garvey, Deputy Clerk

Board of Supervisors