EMS: Doors 1, 2, 3 & 4

You may have seen Jim Bellis’s article in the Robertson County Times (RCT) this past week related to the Robertson County Emergency Management Services (RCEMS) – “County Ambulances Could Go Private.”

This article has to do with the viable options that the RCC EMS Committee will be considering at their April 11, 2011 meeting.

I do not want to go through each of the four options that Jim Bellis discusses. What I would like to suggest is what I would like to see happen for RC EMS, but more importantly, for the citizens of Robertson County.

In RC, NorthCrest Medical Center (NMC) and RC EMS interact daily, if not hourly serving some of the most rudimentary and crucial services for this County. These two entities are separate, for sure, but there exists a de facto state of dependency on one another. RC EMS more dependent than the hospital since it serves such a specialized purpose.

Now, with all of that said, here is the point of which I want to focus on Jim Bellis’s article:

A second alternative presented for consideration would involve a partnership with NorthCrest Medical Center in a fashion to be determined through joint negotiations. In this scenario, it was suggested that NorthCrest would provide, operational “management,” in the form of one of their staff, who would oversee staffing , training, policies and procedures, and “medical directorship,” through their emergency medical staff.

Now, just think about this for a moment. What were some of the more disturbing and disappointing facets unfolding from our own EMS a few short months ago? (See here and here)

A consistent mantra I maintained was that we have some very good personnel - our “boots on the ground” were/are second to none. What we needed was leadership through administrative reform.

By now, you probably see where I am going with this….the above proposal would be exactly what NMC could offer the RC EMS. By letting the folks concentrate on what they already do best, this solution would free them up that much more. NMC could and would offer their expertise in items related to administration and leadership.

Moreover, there would be a relationship forged by agreement that would ensure that communications and cooperation could and would exist between two entities that by default work together already.

But, I am just one commissioner.

MY Minutes: 2011.3.21 - RCC Regular Meeting

Several folks have e-mailed me inquiring what the results were with some of the resolutions from Monday (from the Regular Meeting March 21^st).

As always, here are results of the votes (in bold font), and my editorial comment (in italics).

Appointment / Library Board –

Ms. Linda Thompson was nominated, and appointed to the Library Board.

I will look forward to serving with her.

Budget Amendments –

The Highway Commission and Robertson County Schools had proposed Budget Amendments. Both of these resolutions passed without discussion.

Generating the most discussion of the night, the backpay for former EMS employees was taken up by the RCC.

You will recall, and you have probably heard talk of this throughout the County. It was not an easy vote, and quite candidly it was a very difficult decision for the body. Recall that this proposal has been discussion, re-discussed and discussed again.

This issue stems from some of the original turmoil coming from EMS as noted here.

In my humble opinion, what made this such a difficult issue was the allegations and rumors surrounding EMS. But, at the end of the day, the pervasiveness of these problems dictated the outcome that the RCC had to come to terms with – that the lack of oversight and adherence to polices & procedures created a low standard of accountability that the RCC was bound to in making this decision.

At the end of the day, the RCC could night change the” rules of the game” when it came to these employment matters. I underscore employment matters because notwithstanding the issues and concerns with EMS, the employment matters will be handled separately.

The RCC could not consider both.

That is what made this decision tremendously difficult.

At the end of the day, I did not like it, but I think the RCC took the right approach. It brings the County closure on this issue, and allows the EMS Committee to focus on much needed reform in EMS.

This reform is forthcoming.

10 Commandments Resolution –

The resolution I mentioned in the couple of weeks leading up to this meeting PASSED.

It passed overwhelmingly.

I do not mind sharing with you that I voted against this resolution. I did, for several reasons. Most notably, I see no reason for the RCC to take such a position on such an issue spontaneously. It is spontaneous for this is but a special interest matter of a handful of folks. We do not have an existing monument or placard here in the County that is currently under attack by some outside group.

Now, we have drawn a line in the sand.

I just hope that no one was watching when we did.

Law Enforcement / Sheriff’s Department –

There were several proposals brought to the floor by way of the Robertson County Sheriff’s Department.

-          28-Day workweek: This proposal will give way to allow the RCSD to change the way that they schedule their shifts. The Sheriff hopes that it will allow them more flexibility in the way they schedule a work-week, by moving to 12-hour shifts. Further, over time, the objective will be a cost saving measure since it will likely decrease the amount of overtime.

-          Inmate Booking Fee: Relatively self-explanatory as it assesses a fee for the booking process in the Robertson County Detention Facility.

-          Inmate Medical Payment Plan: Relatively self-explanatory as it assesses a fee for medical payments incurred while an inmate is incarcerated.

Worth the Looking At

I wanted to pass along a note to go along with Jim Bellis’s reporting in his “County Commission to Examine Employee Policies”  

We will certainly being doing just that in the coming months. As this particular issue unraveled (w/EMS), more and more aspects of the Employee Handbook appear to be out-of-date and/or not a good fit for Robertson County.

The current Employee Handbook was last substantively updated back in the mid-1990s.

At the last RCC Personnel Committee Meeting,  the Committee asked that each department head submit issues they note for the Committee to consider. Further, the Committee has already begun the process of requesting and receiving Employee Handbooks from other counties to begin a process of comparing and contrasting handbooks.

RC EMS: The Latest Example....

And, another example (w/video from Channel 4 News) of items that continue to trickle out of EMS.

This one is inexcusable. It is inexcusable in the sense that I do not care who “authorized” these folks to do this, this is blatantly dishonest from the top to the bottom.

I think it illustrative of the culture that has been allowed to take shape at EMS.

EMS

Not wholly unexpected. Unfortunately, I did see these events transpiring.

With the resignation of Robertson County EMS Director Jackie Wilkerson, County Mayor Howard Bradley moved quickly to maintain continuity by appointing an interim director.

I have intentionally refrained from taking time to write on this issue since I did not want to contribute to the proliferation of the rumors and innuendo that many of you have inquired with me on in the past several weeks. Channel 4 covered this story this week (there is a video). I will say, with what has been discussed and what continues to come forward in the fallout. Here is their coverage of the issue:

Last spring, Robertson County's EMS Director Jackie Wilkerson signed an agreement with Saint Thomas Hospital to send Robertson County ambulances to Davidson County High School football games. However, the mayor said that Wilkerson didn't get permission.

"It shouldn't have happened. First of all, he was not authorized to sign a contract," said Bradley.

"I thought that's why I was the director. I could make those decisions," said Wilkerson.

County leaders call what occurred a breach of safety because if there was a major emergency in Robertson County, some ambulances would have been farther away.

"He knew I was sending trucks to cover events," said Wilkerson.

"The mayor knew?" asked reporter Jonathan Martin.

"Yes sir," said Wilkerson.

Wilkerson and the assistant EMS director are resigning over this controversy. After 23 years on the job, Wilkerson said he's hurt that he's leaving over a decision that ultimately brought in money for the county.

"The fact that my ability was questioned after all these years. Yep, that hurts," said Wilkerson.

"It should have been made universally aware to not just the committee, but to the full commission. There was a lapse there that shouldn't have happened," said Bradley.

Wilkerson's final day on the job was Wednesday. An interim director is already in place.

Because of what happened, the county mayor says he's meeting with all department heads about getting approval before making certain decisions.

This week's CC Personnel & EMS committee meetings will be that much more important as we move forward.

What we will have to look at is what direction this vital service is headed.

What can we do to re-structure, to re-organize…to ensure that this vital service runs as fluidly as possible? That will be my concern in looking ahead.

Now is the opportunity to evaluate where we are with this service. A fresh look, and a fresh start in moving forward.