EMERGENCY MEDICAL SERVICES
Our Role in County Government:
By a voter referendum, Leavenworth County EMS was established in 1976. That referendum granted the county the rights to own operate and collect taxes, from county residence, to provide an emergency medical service. Originally EMS was a basic life support service. In 1981 the voters again went to the poll and passed another referendum, which would allow the Board of County Commissioners to tax a maximum of three (3) mils to support an advanced life support service.
Leavenworth County Emergency Medical Service upgraded to an advanced life support ambulance service in 1982 and continues to operate that level of service today. The Board of County Commissioners oversees the fiscal management of the service and appoints the Director to oversee daily operations and staff management. EMS is a department within county government and provides services to the entire county. We hold an exclusive providership, which means all calls for an ambulance, which originate within the geographic boundaries of Leavenworth, require our permission to respond.
The State of Kansas Board of Emergency Medical Service is the regulatory agency, which oversees the statues and regulations pertaining to EMS providers. Our service permit is for a Type I provider (advanced life support A.K.A. - ALS). Employees who care for patients must hold a valid certificate from the Kansas Board of EMS. Kansas State Board of EMS does not have an age requirement for initial training to gain certification as a technician. On the other hand, due to vehicle insurance, there are services that restrict application to candidates who are at least 21 years of age.
Our Service:
As an ALS service, we are required to staff the ambulances with the appropriate equipment and personnel to meet Kansas BEMS regulations. The minimum staff requirement is a paramedic and an EMT (emergency medical technician). We employ Kansas board certified mobile intensive care technicians (MICT), better known to the public as paramedics and emergency medical technicians.
When fully staffed, we have thirty (31) line technicians. Our administrative office includes a Director, Assistant Director, Operations Officer, Business Manager, Data Entry/Billing Clerk and a Receptionist. The Director, Assistant Director and Operations Officer are also certified paramedics.
The MICT has an initial course of instruction, which averages 1200 hours, as well as an associate's degree. Upon successful completion, they are allowed to challenge a written and practical certification exam. The State of Kansas requires thirty (30) hours of approved continuing education each year to maintain their certification.
The EMT has an initial course of 120 hours. As an EMT they are trained in basic first aid and are basic life support providers. If they wish they can take an addition forty (40) hour course, to certify as an EMT-Intermediate. As an EMT-I they can draw blood and initiate an IV line per established protocol. They are required to have twelve (12) hours of approved continuing education per year.
It is the MICT (paramedic), who provides the advanced life support care to the citizens we serve. In the pre-hospital setting they are able to monitor the patient’s vital signs, interpret the electrocardiogram (EKG), draw blood samples, initiate an intravenous (IV) line, provide appropriate drug therapy, place an endotracheal tube (breathing tube to the lungs), assist and/or breath for a patient, do chest decompression (release air that is collapsing a lung) and other interventions that may be necessary.
The MICT is responsible for field diagnosis, intervening with appropriate medical care, contacting the receiving hospital, and documenting the call thru run report and other required documents. As the MICT they function directly under the license of the Medical Director and must follow approved protocol standards.
The EMT is responsible for assisting the MICT. They are capable of ascertaining a patient’s pulse, blood pressure, respiration and other basic life signs. They assist in setting up advance life support equipment used by the paramedic. On the scene of a call, it is the EMT’s responsibility to remove the patient to the ambulance. They drive the ambulances, which requires them to adhere to appropriate emergency vehicle driving standards.
Leavenworth County EMS provides both emergency (911) and non-emergency services to our community. We provide coverage to all of Leavenworth County, Fort Leavenworth and the three prisons. We operate under system status management, which place requests by priority. Emergency calls receive the highest priority. We respond to an average of fifteen calls per day, which could result in an excess of five thousands calls each year.
Three advanced life support ambulances, staffed twenty-four hours a day, is the minimum. The service, two in Leavenworth and one in Tonganoxie maintain three stations, which helps decreases the response time for emergency calls. At times, due to paramedic shortage, we will staff a basic life support ambulance, which has two EMT crew members.
Leavenworth County sheriffs department receives the 911 calls for an ambulance and dispatches the units to emergency calls. Non-emergency requests (transfers) are arranged thru the shift supervisor on duty, at the main station. It is the EMS supervisor responsibility to see that the system needs are met on a day-to-day basis. There are three supervisors and twenty-seven technicians that provide pre-hospital care. The Operations Officer directly oversees this part of the daily service, we provide.
Besides responding to calls, the crews are required to check and clean all equipment and supplies, on an ambulance each morning and maintain its condition throughout the twenty-four hour shift. They clean and maintain each station and the buisness office. Daily training is conducted and once a week the quality assurance committee meets with the technicians for call reviews and medical care discussions. Throughout the week, the shift supervisor meets with the crews to do one-on-one reviews of calls. Verification exams are conducted on an as needed basis, with a minimum of a yearly protocol exam requirement.
The tax mil levy and user’s fees fund our service. Billing office personnel are required to be proficient in data entry, insurance billing, private pay billing and follow up billing. They maintain all legal records, patient records and any documents required by Medicare, Medicaid and other insurance providers, as well as the State Board of EMS, DEA and the Kansas State Board of Pharmacy. They also oversee administrative and budgetary files.
EMS has to be business minded and provide accountability, as we must independently collect the majority of our operating budget. EMS collects in user fees approximately 78% of our operating budget. Only 22% of EMS's operating budget will be collected from tax subsides. EMS receives just over one mil from the taxpayer. By law, we are allowed to collect up to three mils for funding an Emergency Medical Service.
Do to liability, EMS does not allow volunteers to serve in our department. Our records are part of a person’s medical records and thus confidentiality must be maintained. Due to the nature of our buisness, a volunteer’s safety can not be guaranteed.
Our most difficult task is finding qualified individuals to work as line technicians. The average career life of a paramedic is five years, due to job stress. Many people enter this field, but few are actually qualified to handle the day to day situations they are presented with. We make decisions that impact lives. It takes dedicated, caring, and well rounded individuals to meet these demands