(This is a letter from Lincoln Parish Police Juror Logan Hunt and it does not necessarily represent the views and opinions of the Lincoln Parish Journal)
To the editor and the citizens of Lincoln Parish:
I write today in reference to the most pressing issue the Police Jury has faced in decades – providing Emergency Medical Services (EMS) and rescue services for those parts of Lincoln Parish outside the city limits of Ruston.
Presently, these services (both EMS and Rescue) are provided by the City of Ruston and have been for decades. The contract with the city will expire at the end of this year. That means the Police Jury must decide how we will provide these two essential services (EMS and Rescue) to half the population of Lincoln Parish. The Police Jury’s task is clear: (1) provide the highest level of EMS and Rescue service to our citizens; and (2) provide those in the most economical way to both the parish and the citizens.
The Police Jury and its ambulance service committee have discussed this issue for months. The committee has received two proposals, one from the City of Ruston and one from Pafford EMS & Lincoln Parish Fire District. Both of our Parish newspapers have covered this issue from the beginning, but there has been no official report from the Jury as a body or from individual jurors. There seems to have been more heat than light in the discussions so far.
That is why I am writing you. Lincoln Parish residents deserve to know how its Police Jurors see this issue and why. I want to bring more transparency and clarity to this matter, and here is my analysis of the two proposals.
EMS – Level of Service
The first step in comparing the proposals from the City and Pafford is to analyze the level of EMS proposed by each.
There are two main certifications for personnel staffing ambulances, Paramedic and EMT. Paramedics are the highest level of EMS certification. Paramedics have been trained to a much higher level and have more advanced, life-saving tools and skills than EMTs.
The City of Ruston proposal provides that its ambulances responding to EMS calls in the Parish will be Advanced Life Support-Paramedic staffed units (ALS). They will be staffed with 3 firefighters. At least 2 of these firefighters will be certified Paramedics, the third, at minimum, an EMT. En route to the hospital, the EMT drives the ambulance, while the two paramedics are in the back doing patient care. The City has more than enough certified Paramedics to provide this level of care. Of the 46 line personnel working for the Ruston Fire Department, 33 are Paramedics, and that number is growing.
Ruston Fire Department has 4 ALS ambulances that are at all times dedicated solely to 911 emergencies within Lincoln Parish.
Pafford’s proposal also provides for ALS units, but they will be staffed by only two people, 1 EMT and 1 Paramedic. The EMT will drive and the sole paramedic is responsible for all patient care once en route to the hospital.
Pafford currently has 2.5 ambulances in Lincoln Parish. Pafford is using these units to provide mostly non-emergency patient transport for trips that originate in Lincoln Parish, as well as some emergency calls in the nursing homes. The non-emergency transfers often involve trips to Monroe, Shreveport, and even further. These transport units are a mixture of BLS (Basic Life Support – EMT staffed) and ALS trucks.
Pafford’s proposal includes adding one ALS unit to Lincoln Parish, but it will continue to handle non-emergency patient transfers. Pafford’s proposal necessarily includes using units from other Parishes (Union, Bienville, and Webster) where it is currently providing EMS and non-emergency patient transfers.
My analysis of the level of EMS services offered by the City and Pafford:
The City offers us 4 ALS units dedicated to 911 calls, staffed by two Paramedics and one EMT, and the City has been successfully providing EMS services to Lincoln Parish for decades.
Pafford offers us 1 ALS unit dedicated to EMS calls staffed by only one Paramedic and one EMT, and proposes to cover additional 911 calls by utilizing ambulances currently providing non-emergency transfers and ambulances from other Parishes.
It is clear to me that the City’s proposal offers a higher level of service and more dedicated equipment, as well as a proven track record of providing EMS services in Lincoln Parish.
Cost of Services (to the Parish and small municipalities)
Ruston Fire Department (estimated assuming a 3% consumer price index increase)
Year 1- $645,604.00
Year 2- $664,972.12
Year 3- $684,921.28
Year 4- $705,468.92
Year 5- $726,632.99
Total $3,427,599.32
Pafford EMS / Lincoln Parish Fire Department (includes capital costs)
Year 1- $838,000.00
Year 2- $1,175,000.00
Year 3- $1,051,000.00
Year 4- $985,000.00
Year 5- $985,000.00
Total- $5,034,000.00
The Ruston Fire Department estimated cost is on average $320,000 less annually, equating to a monthly savings of approximately $26,000.
The Pafford EMS / Lincoln Parish Fire cost is nearly 47% more expensive ($1.6 million dollars) than the Ruston Fire Department option over 5 years. These numbers speak for themselves.
Cost of Services (to the patient)
There is a real potential for additional cost to Lincoln Parish residents in the Pafford/LPFD#1 proposal.
In its proposal, the City agrees not to bill Parish residents individually. The City will only bill the patient’s applicable Medicare / Medicaid and/or private insurers. The City’s proposal expressly states that it will not bill patients individually: “charges for ambulance services provided by the City to Lincoln Parish residents will be billed only to any applicable government and/or commercial insurers.”
However, Pafford would bill patients individually, whether they have Medicare/Medicaid or private insurance: “Pafford shall be solely responsible for billing, charging, and collecting all fees and charges for the provision of ambulance services and shall receive and retain all fees and charges as described herein.”
With the average ambulance trip costing $1250 – $1500, the importance of this difference cannot be overstated, especially for the citizens of our parish who have the least amount of money. There will be no billed, direct cost to the citizen for ambulance transport for the Ruston Fire Department option. If you have not met your deductible (or don’t have any health insurance) you could be looking at being responsible for the entire Pafford ambulance bill. The last thing we want is for someone to be in dire need of an ambulance and be hesitant to call because they are worried about whether or not they can afford it.
Rescue
The total number of EMS/Rescue calls in the parish in 2021 was 1,885, and is broken down as follows:
EMS – 1,675 (89%)
Rescue- 210 (11%)
While extremely important and necessary, rescue services cannot be the main focus of this conversation. The bulk of the manpower and resources are clearly being used for EMS.
While rescue services include more than just vehicle extrication, these “jaws of life” calls constitute most rescue calls. Other rescue calls include more low frequency/high risk incidents such as high angle and confined space rescue, trench rescue, swift water rescue, and structural collapse rescue, hazmat, and underwater rescue/recovery.
We must stay focused on our task at hand, providing the highest level of EMS and Rescue services to our citizens in the most economical way. The answer is very clear. The City’s proposal does just that, it provides the highest level of service in the most economical way.
My goal, and duty, is to inform the people of Lincoln Parish about this most important issue and encourage you to get involved in some way. We are elected to represent you. On that note, I would encourage you to reach out to your Police Juror and let them know your thoughts on this vital issue, or attend the Police Jury meeting October 11th @ 7:00 pm at the Lincoln Parish Library.
Honored to serve,
Logan J. Hunt
Lincoln Parish Police Juror, District 5
