What incentive do the people have to annex into the LMRFD?

What incentive do the people have to join the LMRFD? Nothing.

Be honest, would you voluntarily choose to increase your property tax by several hundred to several thousand dollars when you get the same services now at no cost? 

The LMRFD covers 144 square miles in the two communities of Dolan Springs and Meadview. It does not cover the 38 miles between the two communities, the hundreds of homes west of US93, in White Hills, or on US93 itself. 

We cannot continue to abandon the community paying for fire and EMS services to respond to areas that have been repeatedly told they have no service and have made no attempts to provide their own coverage.

I'm sorry but we need to reduce the area covered by the LMRFD Ambulance to the 144 square mile fire district. Currently the LMRFD CON, it's Certificate of Necessity covers 2200 square miles, that's 2056 miles outside of the 144 square mile fire district.  

Why should the LMRFD respond to your call leaving those who do support the fire district unprotected?   

We have no contractual liability to respond to fires outside the fire district. White Hills isn't in a fire district. We have no mutual aid agreement with White Hills because they have no mutual aid to offer. I'm not even aware of any volunteers from White Hills even though EMTs who work in Vegas live there. 

Residents in White Hills and West of US-93 must understand they are NOT in the Lake Mohave Ranchos Fire District or any fire district. They may believe they’re paying property tax to the district when they see “Fire District Assistance Tax” on their property tax bills. But this money typically just goes to reimburse departments that respond for rescue operations on state highways.

This is a map of the fire districts in our area. The big blue square is the area the LMRFD covers in Dolan Springs. The tiny blue dots above are scattered parcels and the larger blue area is the Meadview coverage area. 

Much of Meadview is not in the fire district pay no property tax yet we respond. Parcels just blocks away from the fire station are not in the fire district.

Meadview Area

Below is a map of the 2200 square mile area the LMRFD ambulance is required to cover. Why does it cover part of Coconino County? There are NO roads that even lead to that area without going through Kingman and Truxton many miles from Dolan Springs

 

Below the LMRFD 144 sm Fire District is in Blue and the 2200 sm LMFRD CON is in Red.  LMRFD's one ambulance covers an area larger than that covered by all other ambulances in the county combined. 

No other fire chief with such limited resources would send their ONLY ambulance 40 miles outside his fire district leaving taxpayers with nothing... 

The Taxpayers in the LMRFD Get NOTHING for their tax dollars. WHY do people outside the district get the same services?

In Arizona many fire districts operate on a subscription service charging $60 to $100+ a year. If you're not on the paid list, they don't respond.

So again be honest, would you voluntarily choose to increase your property tax by several hundred to several thousand dollars when you get the same services now at no cost? I didn't think so...

Yes an Emergency Medical Responders can Drive the LMRFD Ambulance Here's the LAW

The LMRFD could have a second ambulance using a paid or volunteer EMT and a volunteer EMR, Emergency Medical Responder. It costs $1500 to train an EMT and $250 to train an Emergency Medical Responder. 

The Emergency Medical Responder Law was passed by the Arizona Legislature because they understood without volunteers like Emergency Medical Responders on rural ambulances in medically underserved areas, people would die. 

Chief Bonnee has told me over and over that the LMRFD can't use EMRs. When I asked the medical director from KRMC, she said the LMRFD can use EMR's but there is some liability. 

I said, isn't it better if someone shows up? What's the liability if it takes two hours and someone dies, or nobody shows up at all? 

Rural Ambulance Transport

The law is pretty clear, EMR’s Emergency Medical Responders can drive the LMRFD ambulance and assist an EMT or paramedic as long as their primary responsibility is driving the ambulance.

I’m told over and over that we can’t use EMR’s on the ambulance that we have to have a paramedic and an EMT on the ambulance. Not True

 

Using volunteer EMR’s we could double our transport capability by reducing response times and improving patient care. 

 

ARS 36-2201 says "Ambulance Attendant" means any of the following:

A - An EMT, an advanced EMT, an EMT I-99 or a paramedic whose primary responsibility is the care of patients in an ambulance and who meets the standards and criteria adopted pursuant to section 36-2204.

 

B - An EMR emergency medical responder who is employed by an ambulance service operating under section 36-2202 and whose primary responsibility is the driving of an ambulance.

 

 

ARS 36-2202 - Duties of the director; qualifications of medical director

J. paragraph 5 of this section shall require that ambulance services serving a rural or wilderness certificate of necessity area with a population of less than ten thousand persons according to the most recent United States decennial census have at least one ambulance attendant as defined in section 36-2201, paragraph 6, subdivision A and one ambulance attendant as defined in section 36-2201, paragraph 6, subdivision B

 LAWS

36-2201 Definitions

In this chapter, unless the context otherwise requires:

5. "Ambulance" means any publicly or privately owned surface, water or air vehicle, including a helicopter, that contains a stretcher and necessary medical equipment and supplies pursuant to section 36-2202 and that is especially designed and constructed or modified and equipped to be used, maintained or operated primarily for the transportation of individuals who are sick, injured or wounded or who require medical monitoring or aid. Ambulance does not include a surface vehicle that is owned and operated by a private sole proprietor, partnership, private corporation or municipal corporation for the emergency transportation and in-transit care of its employees or a vehicle that is operated to accommodate an incapacitated person or person with a disability who does not require medical monitoring, care or treatment during transport and that is not advertised as having medical equipment and supplies or ambulance attendants.

6. "Ambulance attendant" means any of the following:

(a) An emergency medical technician, an advanced emergency medical technician, an emergency medical technician I-99 or a paramedic whose primary responsibility is the care of patients in an ambulance and who meets the standards and criteria adopted pursuant to section 36-2204.

(b) An emergency medical responder who is employed by an ambulance service operating under section 36-2202 and whose primary responsibility is the driving of an ambulance.

8. "Basic life support" means the level of assessment and care identified in the scope of practice approved by the director for the emergency medical responder and emergency medical technician.

13. "Department" means the department of health services.

14. "Director" means the director of the department of health services.

15. "Emergency medical care technician" means an individual who has been certified by the department as an emergency medical technician, an advanced emergency medical technician, an emergency medical technician I-99 or a paramedic.

16. "Emergency medical responder" as an ambulance attendant means a person who has been trained in an emergency medical responder program certified by the director or in an equivalent training program and who is certified by the director to render services pursuant to section 36-2205.

36-2201

17. "Emergency medical responder" as an ambulance attendant means a person who has been trained in an emergency medical responder  program certified by the director or in an equivalent training program and who is certified by the director to render services pursuant to section 36-2205.

18. "Emergency medical services provider" means any governmental entity, quasi-governmental entity or corporation whether public or private that renders emergency medical services in this state.

23. "National certification organization" means a national organization that tests and certifies the ability of an emergency medical care technician and whose tests are based on national education standards.

Other Fire Districts use Emergency Medical Responders Why Can't the LMRFD?

 I don't understand the reluctance of Chief Bonnee to train and use EMR's Emergency Medical Responders in the LMRFD. Other fire districts like Yucca and the Heber-Overgaard Fire District in rural areas use EMR's, so why don't we?

I contacted Chief McCluskey of the Heber-Overgaard Fire District and asked how he uses EMR's in his fire district. 

When I told Chief McCluskey we had one ambulance and response times can be hours rather than minutes.

Chief McCluskey said "Our volunteer EMRs enable us to keep the higher trained firefighters and EMTs in the District for the 2nd call which happens pretty frequently" Just like here in Dolan Springs and Meadview

 

Thu, Oct 10, 3:11 PM
Chief McCluskey
Heber-Overgaard Fire District
chief@hofdaz.com

Jay,

Don’t let their short sidedness stop your pursuit. No an EMR is NOT and EMT. However when you want to keep, medically trained EMT’s in the district (when transporting patients to the hospital), EMR’s become VERY valuable.  If we respond with EMR’s, they are a 3^rd person. Currently our EMR’s either respond to the scene in an additional ambulance or wait at the station for the transporting crew to stop and change out drivers. This way the scene gets the higher level of care, but the transport driver meets the state requirements. 

Let the other districts know they can call us anytime to get information on what we do. 

Thanks.
Chief D. McCluskey
Office (928) 535-4346 Ext 106
Cell (928) 240-4149
Fire Chief / Paramedic
Heber-Overgaard Fire District

Jay Fleming <leapspeaker@gmail.com>	Thu, Oct 10, 11:00 PM (8 hours ago)
to chief

Sorry I'm old and forget things..... 2 Question 

Since the law allows for EMR's to assist and drive the ambulance in rural communities, and the state doesn't "certify" EMR's, do you know if the medical director can stop EMR's from driving?  

Your EMR's respond to the scene in an additional ambulance, then the EMT or paramedic takes the 2nd in ambulance and the EMR and the EMT or paramedic transport? 

Thanks again

Jay

 

William McCluskey	7:17 AM (6 minutes ago)
to me

1. I’d have to look up the statue regarding medical control/director, but he/she can only require what level of service is required for the care of the patient under their direction. The driver provides no care during the transport therefore doesn’t fall under the medical directors control. 

2. Our EMR’s volunteer for time periods during the week. When a call comes out the “Car #” comes up on the air and responds to the station. By the time they get to the station, the responding crew has arrived and the Captain directs the EMR to bring the second amb or wait at the station.  

a. If the EMR is directed to the scene, they always drive without lights and siren. Upon arrival the EMR then prepares for transport in either amb at the wishes of the captain. Then drives the medic to the hospital. We are 45-50 minutes from Summit, so it’s a 3 hour event from dispatch to back in the area. 

b. If the EMR is told to stay at the station, the call has likely occurred west of the station and the crew will simply stop by the station on their way to the hospital and switch out drivers. 

Correct. Our volunteer EMRs enable us to keep the higher trained firefighters and EMTs in the District for the 2nd call which happens pretty frequently. Of course we encourage and pay for the EMRs to become EMTs but some just don’t want to or have the time to go. 

It seems if you have the people interested in helping the community and district this way, it’s a Win-Win for the district and community.

My 2 cents 

Chief Dee McCluskey
Fire Chief/ Paramedic 
Heber-Overgaard Fire District
(928) 240-4149