By Oliver Tatom
I am a part-time paramedic with Jefferson County Emergency Medical Services District (JCEMSD), which since 1986 has provided emergency, nonemergency, and interfacility ambulance transfer service to the communities of our district without the support of taxpayers, relying instead upon user fees.
In recent years, Chief Elizabeth Heckathorn and Assistant Chief Michael Lepin have identified opportunities for cost savings, improved fee collections, and secured grants to pay for fleet improvements that make our services more advanced.
However, despite determined efforts to do more with less, changing circumstances make a continued fee-for-service model unrealistic and impractical. Call volumes have increased significantly, including for unreimbursed community services like lift assistance and mutual aid responses. Patient transfers from St. Charles Madras to other hospitals have doubled in the past two years. Pension costs imposed by the state on local governments, including special health care districts, have dramatically increased, as have fees imposed by our regional dispatch service. Meanwhile, insurance reimbursement rates have fallen or remained flat.
The district has long relied on volunteers, but the increased time and money required for initial licensure and continuing education has led to a precipitous decline in volunteers at rural EMS and fire agencies across the nation, compelling districts like ours to rely more on paid staff.
I love being a part-time employee — my wife is a nurse practitioner with St. Charles, so I have the privilege to be home with our two young children during the week — but I have seen too many talented paramedics and EMTs move on to agencies in other communities because we cannot afford a competitive wage or the security of full-time employment.
Opponents of the proposed levy point to a 2003 task force report favoring a merger between JCEMSD and Jefferson County Fire District No. 1. This report was rejected at the time for its failure to demonstrate cost savings or improved care. In fact, merging districts would prove costly to taxpayers. The EMS district covers a larger geographic area than the fire district, so both districts would need to be dissolved and a new district created.
Most employees of both districts would require additional training to be licensed as both firefighters and EMS professionals, and state-required pension costs would increase. Additionally, no savings could be achieved through streamlining of staff, as adequate coverage would need to be maintained to cover medical emergencies during a fire as well as to cover fires while ambulances are pulled out of district for interfacility transfers and mutual-aid responses.
I received my paramedic training at Yale-New Haven Hospital in Connecticut and began my career at American Medical Response, the nation's largest ambulance service. I have also been an EMS instructor since 2012. In the course of my education and career, I have been exposed to a variety of EMS systems, examples of which you can find throughout Oregon. There are hospital-based systems, like those in John Day and Tillamook. There are fire-based systems like Bend, Redmond, Prineville and Sisters. Multnomah and Clackamas Counties have contracts with AMR. And then there are the "third-service" systems like our own Jefferson County EMS District.
Each of these systems have both positive and negative attributes, but for my money — and I mean that literally, as a Jefferson County taxpayer — the best is a third-service EMS system.
This is not to slight the absolutely extraordinary employees, students, and volunteers of the fire district. Indeed, I (and all of JCEMSD) have enormous respect for them. They are literally willing to lay their own lives on the line to protect the lives and property of our communities. But you must know that I have worked with colleagues at other departments who only became paramedics to get hired by a fire department. Most firefighters I know want to extricate trapped victims and suppress fires, not treat sick people and transport them to the hospital. Likewise, I would rather be running down a medical diagnosis than running toward a burning building.
This is why I believe our district is best served by maintaining an EMS agency dedicated to the unique mission of providing emergency medical services and ambulance transport. JCEMSD provides support to the fire district on all fires, sending an ambulance crew to care for the fantastic employees and volunteers of the fire district if there is a medical emergency; they in turn provide integral support on critical EMS calls like cardiac arrests and car wrecks.
With this model, there is no duplication of services and the community receives the right resource for the right emergency at the right time with professionals who specialize in the type of emergency response needed.
All of the paramedics and EMTs of Jefferson County EMS District are proud of the service we have provided our friends, families, and neighbors for the past three decades. With a small amount of financial support — approximately $7.00 a month on a $200,000 property — the district will be able to maintain our current equipment, continue to train our staff, and better retain talented employees. Vote yes for EMS.
Oliver Tatom grew up in Bend, graduated with a Bachelor of Arts from University of Southern California, and went back to school to become a paramedic, while his wife was in nursing school. Now, he raises his kids, works part time, teaches part time, and tries to mountain bike as often as possible.He and his family live in Bend but he also owns a home in Madras.