There are some needs most of us would prefer not to think about.
When we turn on the faucet, we expect clean water to pour out. If there's a fire, we expect firefighters to arrive quickly.
We want prompt, reliable ambulance service in an emergency.
News in recent weeks from Three Rivers Ambulance Authority – the public-private agency that oversees emergency medical services in Fort Wayne – has raised questions about whether residents can rely on a seemingly outdated and increasingly embattled system.
The ambulance authority moved from low-profile but essential agency to subject of concern and uncertainty in July, when City Councilman Russ Jehl, R-2nd, made public what had been internal concerns about staffing and operations. TRAA had been hemorrhaging employees for months, and EMS crews were not meeting targeted response times, he said.
Both problems were later acknowledged by authority Executive Director Gary Booher, who worked to help restructure ambulance runs. Life-threatening emergencies get better-trained medics; less serious cases draw help from crews trained to handle more basic needs, for example.
Facing tough criticism from Jehl and other City Council members, Booher – who had planned to retire at the end of the year – moved his retirement date to Oct. 1 and said he'll be on vacation the rest of this month, essentially quitting on the agency he had led since 1989.
That left the ambulance authority's board scrambling to find new leadership, agreeing Friday to form a three-person executive committee made up of board members to oversee the nonprofit. Fort Wayne Fire Chief Eric Lahey, attorney Rachel Guin and Brett Steffen, manager of Parkview Health's Samaritan Helicopter system, will lead TRAA until a new director is chosen, possibly as early as next month.
The board hired Missouri-based emergency services consulting firm Fitch & Associates to lead the search for a new executive director, and four finalists have been identified. The names of the finalists have not been released.
Three Rivers Ambulance Authority operates under a public utility model in which it purchases services from a Texas company that provides ambulances and staff. EMS public utility models trace their history back to the early 1970s, when University of Oklahoma researchers were studying new ways municipalities could offer low-cost ambulance service.
The model was put in place here in 1983, and ambulance runs since have been paid with user fees rather than taxes. That saves the city money, but leaves little room for financial creativity when EMTs are leaving for more lucrative jobs and response times are lagging.
Public utility models are rare. Fitch & Associates founder Joseph “Jay” Fitch, in an article published last year by industry news site EMS1, wrote that the models “reflect the smallest market segment of accountable systems.”
The article says several things are necessary for a successful and efficient ambulance system. Among them: mechanisms for external oversight, plans for retaining talent within the system and “the ability to safely terminate the relationship if the provider fails to perform.”
As plans move forward to install new local ambulance authority leadership, TRAA officials should also consider whether the current model is the best fit for Fort Wayne.