Just because I have retired doesn?t mean I?ve lost interest in, or don?t continue to follow what goes on in various communities around the country.   In fact I have more time to play mouse potato and mull with my old timer?s, set in stone mentality. The problem is I can?t make sense of the ongoing rationale and lack of support, be it financially or in policy for EMS in various areas around the country in recent events.

I have long held the belief that if a goal or objective is important to the community, someone it will get accomplished without excuse.  I question that belief now since more often then not, communities continue to elect or appoint representation that gives little interest and concern for EMS, except for those who still believe it?s a cash cow to supplement a budget, and not much more.

Most recently is Washington, D.C. Fire-EMS, 9NEWS NOW reporting,  ?Now that situations beyond their control have caused the department to go over its budget. One of the cuts they are forced to make is to abandon EMT re-certification until the new fiscal year in October. 9NEWS NOW ?has talked to a number of firefighters and EMTs who were scheduled to be in EMT re-certification classes in the coming weeks. All asked not to be identified, but complained that this shows a lack of commitment by the city government to provide top notch emergency care. Alan Etter assures the public that every fire truck and ambulance will have at least two qualified EMTs on board. Etter says the Department of Health could provide certifications extensions for as long as six months, if needed.?  

The Oklahoma Channel reported that ?Financial problems facing some emergency ambulance services are so severe that it may get to the point where rural 911 callers are given basic care instructions and told to take the patient to the closest hospital.

The past fiscal year, according to state records, Medicare was billed $94 million for ambulance runs to assist Oklahoma senior citizens on Medicare.

But ambulance companies only received $52 million from the federal government for those Medicare patients

Ten ambulance services -- in sizable towns such as Wynnewood and Vinita and the smaller hamlets of Kemp and Quapaw -- recently have closed. Other towns that have lost ambulance services are Picher, Commerce, Barnsdall, Kremlin, Garber and Wakita. Others are in jeopardy.?

That was later followed with the report, ?A sign can be found on the squad door on Whaley Street. It states that the service is now closed due to a lack of money and community support. It was formed by volunteers and has always maintained that they were a non-profit organization. Opp Mayor H.D. Edgar says he was disappointed to find out that the service is no longer in operation. Mayor Edgar hopes a private ambulance service operating in Opp will provide adequate service.

In Wabash, Indiana, The Journal and Courier reported,  ?at a Saturday meeting in which some outraged Wabash Township residents called for the dismissal of trustee Patty Mason, a new fire chief was appointed.

Mason opened the meeting, which about 70 residents and members of the volunteer fire department attended, by announcing that chief Jim Lewis had resigned.

Mason said she asked Lewis to resign because he does not share her ?vision for the department? and has disregarded a township policy designed to reduce the number of runs by sending only paid EMTs on non-life threatening calls.?

In Utah, the Toole Transcript reports in Grantsville, ?$150 million has been set aside by the city for construction of the new fire department. Grantsville City entered into an agreement with Mountain West Medical Center for a scholarship program to help local residents certify as EMTs. Those interested in the EMT course must initially pay their own fee, but will be reimbursed after passing state tests and volunteering with the city for one year.?

In Kodiak, Alaska, the Kodiak Mirror, ?The issue of ambulance funding is not new. There is no formal agreement between the two governments on who should pay for ambulances.?

The Detroit News reports, ?STERLING HEIGHTS -- A 30-year relationship and high ratings from city residents may not be enough to keep Universal-Macomb Ambulance in place as Sterling Heights' emergency transportation provider.

One of the "City Performance Objectives" included in the recently approved 2006-07 budget calls for officials to research whether the city's fire department should provide ambulance transport service instead of Universal. The proposal is drawing criticism from residents and at least one member of the City Council.

Sterling Heights and Universal have been at odds for more than a year over the city's attempts to receive a cut of the insurance reimbursements paid to the company. It's money that City Manager Mark Vanderpool said Sterling Heights is entitled to.?

So DC, which did have to re-direct Homeland Security funds for additional and overtime expenses for the Inauguration events, leaving EMS and other departments short changed.

Oklahoma, who is dependant on volunteers in a majority of communities looses another provider and the Mayor of Opp ?hopes? a private provider will be adequate (and assume the risks) after the volunteers shut their door.

Wabash, Indiana wants to reduce taxes by reducing responses. Where?s the medical control in that policy?

Grantsville, Utah, either the $150 million figure for the new fire station is a misprint or it?s a larger priority then EMS, because they are still asking for volunteers to train and certify as EMT?s on their own dime.  They will reimburse them after successful completion, certification and volunteering for a year.    

Kodiak, Alaska is still discussing who will pay for the ambulance.

Sterling Heights, in spite of a 30 year relationship with a provider now wants to be in the EMS business because it believes its ?entitled? to a cut in the insurance monies paid to the ambulance company. Since they can?t get their ?cut?, they now want it all.

Anybody see a trend here, or am I just paranoid?  

Those that represent us need to be educated to promote EMS or we will continue to be the foster child of emergency services. If those we elect continue to ignore EMS as a priority, elections are held on a regular basis and participation is required if you want your voice heard. In fact I believe that the loudest form of protest heard is done in the election booth.