EMSA speaks now are you listening?

[Kiah]

I think you can speak on any item that's on the agenda for action, as long as you sign in at the meeting.  But, I don't think EMSA's on the agenda for action this week.  It's only on as a first reading, which is just reading the item and referring it to committee.  It'll be back on next week I guess for public comment and action.

[Steve]

quote:Originally posted by Kiah

I think you can speak on any item that's on the agenda for action, as long as you sign in at the meeting.  But, I don't think EMSA's on the agenda for action this week.  It's only on as a first reading, which is just reading the item and referring it to committee.  It'll be back on next week I guess for public comment and action.

The Tulsa World article today says "Councilors are expected to vote on the plan at their 6 p.m. March 29 meeting."

[inteller]

quote:Originally posted by Steve

quote:Originally posted by Kiah

I think you can speak on any item that's on the agenda for action, as long as you sign in at the meeting.  But, I don't think EMSA's on the agenda for action this week.  It's only on as a first reading, which is just reading the item and referring it to committee.  It'll be back on next week I guess for public comment and action.

The Tulsa World article today says "Councilors are expected to vote on the plan at their 6 p.m. March 29 meeting."

couldnt they vote on it at any time though?

[inteller]

oh and one other thing, the girl on the EMSA propagandacommercial looks like a bad Hillary Swank impersonator.

[Mike G]

Some food for though:

'07 Departmental Budget:
Tulsa Fire Department - $56 million
EMSA - $2.3 million
source

EMSA pays for itself for the most part by billing the patient and/or insurance, and partly by the taxpayers who the service is offered.  The fire department is payed in full by the tax payers.  So think about this: You pay a few dollars a month to support a service that when you need it, it will be there for you, and in return you or your insurance will receive a bill (EMSA).  For a lot more money, you pay taxes on a service that if you need it, it will be there, but you won't receive a bill (FD).

So now lets think about if the ambulance service is turned over to the fire department.  Now you're paying taxes to support a service that will be there if you need it.  If you use it, you or your insurance will also receive a bill in addition to the tax money you pay.

The general population isn't aware of EMSA's standings nationwide as far as an EMS system goes.  They are led to believe that all EMS services are on the same level, which is very far from the truth.  I've run calls where the patient had a family member or friend drive them from the next county over just so EMSA would respond on them and not the service that covers that area.  EMSA is one of the top five services in the nation for cardiac arrests saves, and is also one of the cheapest on the tax-payer.  There are a handful of other cities (comparable in size to Tulsa) that have cloned EMSA's way of operating and then tweaked it to fit their city/operations.  EMSA also has very tight quality improvement/quality assurance, which is generally not the case in a fire-based EMS system.  EMSA is required to respond to all medical emergencies, or potential medical emergencies (i.e. man down calls), where as not all fire-based EMS services are.  How would you feel if you were the man down and had to wait for PD to respond before anyone realized you needed medical help, and then had to start an ambulance?

quote:Originally posted by shadows


If one has the only ambulance contract in town it kind 'a floors the average citizen to see the adds in the only news paper and on the TV telling us how great a job they are doing. Sixty percent of the runs are transfers.

I'm not sure how you're figuring that 60%, but I know that on an average shift, we run eight calls with no more than one transfer.  So even if we had two (this is uncommon), that's still only 25%.

quote:Originally posted by Wilbur


I also found this little item interesting:  Those who decide not to participate would be required to sign a document... How on earth do you enforce that section? Turn off my water if I don't sign the document?

How many people actually need a total care program. Does not most health/automobile insurance cover the cost of an ambulance ride (I know mine does)?

Most insurance does cover part of the bill.  The TotalCare is designed so you don't have to pay any unpaid portion if that's the case.  However, a large number of our patients are covered by Medicare/Medicaid, which is where the problem lies now that there's been cutbacks.

The part of the article I find interesting is: Covering the subsidy from the city's operational budget would force cuts in nonessential services, city leaders have said.
source


Now replace EMSA with say the police or fire department.  Now how many people would agree that it would be acceptable to cut nonessential services?  What are these services and how much are they costing taxpayers?

quote:Originally posted by Double A

I think EMSA should start cutting the bloated executive compensation packages and golden parachutes of their top brass before they start asking for more tax dollars.

quote:Originally posted by Conan71

From the photo in the paper, it's not only the salaries which are bloated.

I'm curious as to why you think we have all of this "high-paid top brass."  Compared (per the '07 departmental budget highlights) to the fire departments 20 district chiefs, 147 fire captains, and over 15 other high positions.
Source

quote:Originally posted by Steve

EMSA doesn't seem to be hurting these days judging from how employees are compensated.

I must be missing something or just getting the short end of the stick because I make an hourly wage (which is comparable to working at a call center) and currently can't even afford health insurance.  My car has 200k miles on it and I live pay-check to pay-check.  Where's the "employee compensation" I'm missing?

quote:Originally posted by sgrizzle


I thought the whole changes was do to a loss in medicare subsidies. If they're on medicare, they're probably not paying an emsa bill, whether it be $500 or $1000.

That's correct.

quote:Originally posted by Steve

I don't know what full page Tulsa World ads go for these days, but if EMSA has money to waste on propaganda such as this, they must not be hurting too badly.
-
Whatever EMSA's financial situation is, they seem to have a fully funded advertising budget.

Let's see... running a multi-million dollar EMS operation... a few hundred dollars for a page in the Tulsa World.  Not sure how you are comparing needing millions of dollars due to Medicare cutbacks to a few hundred dollars to educate people in what we do and why we need money to do it.

quote:Originally posted by inteller


if this passes people will call the ambulance for the dumbest of things, stumped toe, call an ambulance.....head stuck up your arse, call an ambulance. It is a vicious cycle that will keep costing more than the taxes bring in. EMSA bought off the fire department so they wouldnt push to take over the service...

People already do call for all of that.  EMSA didn't "buy off" the fire department.  The fire department's proposal was not accepted by the Mayor and City Council because it was lacking in detail and was proven the numbers were too low based on real-life expenditures, not to mention the fact that the fire department proposed 24-hour paramedic shifts.  I don't know about you, but I don't want to be a patient on that medic's 22nd hour, especially if he/she's working a high-volume station.

[waterboy]

Mike G. - I understand all of your arguments and pretty much agree. To be factual, however, you must look up the cost of newspaper advertising. A full page is 129 column inches in black and white. When I worked there 20 years ago the rate was nearly $50 per column inch or nearly $6450 NOT including the cost of production if done by an agency. Little or no discount for re-runs too.

I would guess the total cost of each ad today would be approaching $9000-10,000 for the space and $2000 for production. Not an insignificant cost. But apparently pretty effective reach.

[Mike G]

quote:Originally posted by waterboy

Mike G. - I understand all of your arguments and pretty much agree. To be factual, however, you must look up the cost of newspaper advertising. A full page is 129 column inches in black and white. When I worked there 20 years ago the rate was nearly $50 per column inch or nearly $6450 NOT including the cost of production if done by an agency. Little or no discount for re-runs too.

I would guess the total cost of each ad today would be approaching $9000-10,000 for the space and $2000 for production. Not an insignificant cost. But apparently pretty effective reach.

I do stand corrected on that, as you are correct.  I still think it is an effort, however, to educate the public on exactly what is being done to make sure we can maintain our quality of service.  Again, the general population doesn't even know what we really do unless they either know someone that works at EMSA or has been a patient or friend of a patient that has needed us.

On a side note, that's darned expensive to advertise in the paper!  I didn't realize it was that high now days.  Maybe I need to get into that business, heh.

[RecycleMichael]

I believe advertising is only expensive when it doesn't work. EMSA was very strategic with this campaign and it worked because I have heard lots of people talking about this issue and this thread is even more proof.

The best part of the conversations I hear is that EMSA is discussed on a elevated level of essential services and protection. We use to have a hierarchy of who is more important... police, fire or ambulance. Most people thought every city needed a paid policeman but could live with a volunteer fire department and most people felt that ambulance was something that hospitals did.

Now people treat all three as essential public safety components that our citizens demand.

[inteller]

quote:Originally posted by recyclemichael

I believe advertising is only expensive when it doesn't work. EMSA was very strategic with this campaign and it worked because I have heard lots of people talking about this issue and this thread is even more proof.

The best part of the conversations I hear is that EMSA is discussed on a elevated level of essential services and protection. We use to have a hierarchy of who is more important... police, fire or ambulance. Most people thought every city needed a paid policeman but could live with a volunteer fire department and most people felt that ambulance was something that hospitals did.

Now people treat all three as essential public safety components that our citizens demand.

they demand it because of sprawl.  I live on the edge of tulsa, so I live in sprawl.  however, i dont expect ambulance service to be available at all times because I chose to live here.  therefore I dont consider it to be a public utility and I sure as hell won't be paying for it as such.

EMSAs grand scheme is to get an ad valorem tax passed so that you won't have an "option" to not take TotalCare.  It is a grand plan to get them tenure with the city after their scare of almost losing to the fire department.

EMSA wont be the cheapest after this passes, because they are raising the rate to 1100 dollars to foist more money out of insurance companies who pay on a percentage basis.  I suspect insurance carriers will start dropping their ambulance coverages like a rock here in Tulsa.  An enterprising individual should get a health ins quote now and after this thing passes because I guarantee ins companies will start raising their rates nd changing their coverage if you live in Tulsa city limits.

[shadows]

In  reading these post one might have the impression that EMSA is a backup for the fire department as it seems to be the first responders.

Seems that there would be some way to audit EMSA operational expense and submit it to the general public, if it is on the borderline of being a TRUST before adding more burden on the aging retirees.

It seems that the rolling stock is paid for by the city?

Is the supplies paid for by the city?

EMSA also servers other local communities.

Do the other communities use Tulsa's rolling stock ?

How much do they contribute to maintenance?

Who and when was the $1,100 dollar per run authorized?

If 60% are transfers' what % are Medicare or Medicate paid?

Isn't water a necessity of life?

Are those who are struggling to live on $400 SS monthly able to find the money to increase their 'whipping boy" water bill?

There is the provision to op out.   (In the sales tax rebate it was discontinued because only those on the south side ask for it.)  Is there a simple way to op out?

Could we double the fee on all meters South of 21 street and leave them off the meters North ot 21.

This blind increase on the water bill or increase on property taxes are not the answer but one would find it if they had representatives in the governing functions of the city.   There are so many that are more concerned about how they are underpaid for their ability to rule.

[Mike G]

quote:Originally posted by inteller

I live on the edge of tulsa...
however, i dont expect ambulance service to be available at all times because I chose to live here.  therefore I dont consider it to be a public utility and I sure as hell won't be paying for it as such.

EMSAs grand scheme is to get an ad valorem tax passed so that you won't have an "option" to not take TotalCare.  It is a grand plan to get them tenure with the city after their scare of almost losing to the fire department.

Curious, where exactly do you live?  If it's in EMSA's coverage area, then you are guaranteed an ambulance if you call.  If you aren't in EMSA's coverage area, then there's no issue.  And I don't understand your logic of not expecting an ambulance all the time.  All area's of Oklahoma are covered by some sort of ambulance.  Does this mean if you or a loved one or friend has an emergency, you are going to take care of it yourself and take them to a hospital on your own?  CPR is very difficult in the back of a car.

There will be an option to 'opt out' of the TotalCare, you simply have to sign a waiver.  I pay $3/month on my water bill in Jenks to support EMSA and some city Storm deal (not 100% sure what it is).  The city of Jenks is already doing what is proposed to the City of Tulsa on the water bill.

I don't know if you know how the renewal contract works with EMSA.  Every five years, the city has the option to find another provider for ambulance.  This was built in to the contract with the city around 30 years ago.  In that 30 years, the city has always chosen EMSA.  This past time, the only difference was that the city didn't auto-renew the contract as they had done the past two times (or ten years) to make sure there wasn't a better option.  This is the same for Oklahoma City as well.  Oklahoma City Fire Department has been trying for a long time now to take over ambulance service and has been making a strong push for it lately.  They are easily five to ten years ahead of Tulsa Fire as of the last contract to try to take over ambulance services and so far Oklahoma City has chosen EMSA.  What makes you think that EMSA almost lost to Tulsa Fire?  TFD's proposal was full of loop-holes and non-realistic numbers.  Not sure how that constitutes almost losing.



Originally posted by shadows

In reading these post one might have the impression that EMSA is a backup for the fire department as it seems to be the first responders.

I think a better picture is the fire department is a backup to EMSA since they don't run on all calls and usually are cleared before they arrive or within minutes of arriving.

It seems that the rolling stock is paid for by the city?

The city has paid for all non-disposable equipment, with the exception of a few ambulances and support vehicles and some equipment funded by other means.

Is the supplies paid for by the city?

All disposable equipment and personnel are paid for by Paramedics Plus.

EMSA also servers other local communities.

EMSA serves Tulsa, Jenks, Bixby, Sand Springs, Leonard, Turley, Oakhurst, Berryhill, and some other areas.

Do the other communities use Tulsa's rolling stock ?

Yes, but they pay in to the subsidy.  Example:  I pay a couple of dollars a month on my water bill here in Jenks to support EMSA.

How much do they contribute to maintenance?

Who?  The other area's served?  I believe it's an equal amount per person served.

Who and when was the $1,100 dollar per run authorized?

Not sure, I believe this is part of the TotalCare/water bill charge.  If you opt out, you agree to pay that amount (probably set by EMSA) since you aren't paying in.

If 60% are transfers' what % are Medicare or Medicate paid?

60% of our calls aren't transfers.  I would shoot more towards 30-40%.  And a large amount are Medicare/Medicaid from what I've seen.  But I'm not 100% sure how many have private insurance.

Isn't water a necessity of life?

Yes.

Are those who are struggling to live on $400 SS monthly able to find the money to increase their 'whipping boy" water bill?

Most of those people either have TotalCare now or can afford a few extra dollars.  Now I can't speak for them since I don't live off of SSI, but I don't see how it's much different than rising gas/electric/natural gas prices.  Plus they can always opt out.

There is the provision to op out. (In the sales tax rebate it was discontinued because only those on the south side ask for it.) Is there a simple way to op out?

Yes, you just have to sign a waiver saying you don't want to pay the extra money on the water bill and you will be billed if you call an ambulance.

Could we double the fee on all meters South of 21 street and leave them off the meters North ot 21.

I doubt that would fly.

[inteller]

um I didn't post that last stuff you respionded to.  please get your posters straight.

you didn't even understand my post anyways.  but bottom line is I dont consider it a necessity and I dont expect to pay for it as such.

[Mike G]

quote:Originally posted by inteller

um I didn't post that last stuff you respionded to.  please get your posters straight.

you didn't even understand my post anyways.  but bottom line is I dont consider it a necessity and I dont expect to pay for it as such.

Whoops, sorry about that.  Made the needed correction.

Again, where do you live and is it covered by EMSA?  If you don't expect to pay for it, then you can opt-out.  But do you not consider police and/or fire dept. a necessity?  What is the logic in not needing an EMS system?  I'm not saying your thinking is wrong, just trying to understand why anyone would think that.

Here's some more food for thought:
(Disclaimer: Approximate numbers used.  Numbers are assumed to rise respectively over time.)

Opt-out ambulance bill = $1,100
TotalCare on water bill = $3/month
$1,100 divided by $3/mo. = 366.6 months

This means you could pay the $3/month for over 30 years before it would equal one opt-out ambulance bill.  I know I'm under 30 and I've already used an ambulance once.

[shadows]

The 60% transfers was the percentage that was published during the EMSA-Fire Department discussions.

According to your post EMSA has a hand in the pocket of all the Metro citizens and can raise the rates to any figure they choose.  The threat of a $1,100 ambulance "if you op out" needs to be looked into by the city.

In your evasive answer to the use of Tulsa bought rolling stock in out of town areas along with who contributes to their purchase is unanswered.  

The prorated share of cost in the surrounding communities by population, as explained by you, needs further data.

There  is a need for the citizens to understand where and how the millions of dollars are spent.

If a fee is placed on the water billing that is no more that an open check to be fill out by EMSA as the amount can be increased at their desecration.   There are many households in the city that do not have the extra dollars to squander on a uncontrollable service.

Citizens can reduce their gas and electric bill by setting in hot or cold houses, turning lights off  but there is no way that they can reduce a fee on the water bill or property taxes that is placed on there with no accountability.  

Will the op out petition be included in the citizen water bill so unlike the sales tax rebate that many could not have access to nor understood it?

Any situation as this one being forced down the throats of the citizens they should be able to see what they are having to swallow.   They surely have an audit of all their transactions.   Where can the citizens see a copy?  

Or is this the preverbal "PIG IN THE POKE" we are buying?

[inteller]

quote:Originally posted by Mike G

quote:Originally posted by inteller

um I didn't post that last stuff you respionded to.  please get your posters straight.

you didn't even understand my post anyways.  but bottom line is I dont consider it a necessity and I dont expect to pay for it as such.

Whoops, sorry about that.  Made the needed correction.

Again, where do you live and is it covered by EMSA?  If you don't expect to pay for it, then you can opt-out.  But do you not consider police and/or fire dept. a necessity?  What is the logic in not needing an EMS system?  I'm not saying your thinking is wrong, just trying to understand why anyone would think that.

Here's some more food for thought:
(Disclaimer: Approximate numbers used.  Numbers are assumed to rise respectively over time.)

Opt-out ambulance bill = $1,100
TotalCare on water bill = $3/month
$1,100 divided by $3/mo. = 366.6 months

This means you could pay the $3/month for over 30 years before it would equal one opt-out ambulance bill.  I know I'm under 30 and I've already used an ambulance once.

I grew up all my life in the country.  phones water and electricity were necessities.  Not having an ambulance within 30 minutes just makes you think before you do stupid **** and maintain a healthy lifestyle.

As it is now I live 3 high speed minutes from an emergency room.  If we need medical assistance I'm not waiting for the ambulance to show up as I'll be at the hospital by the time it would have arrived.