Bensalem EMS 2009 BRINGS FINANCIAL CHALLENGES. New Heart Monitors Save Squad Money. Annual Report. 2009 in Review. Inside this issue: March 2010

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March 010 Annual Report Bensalem EMS 009 BRINGS FINANCIAL CHALLENGES 009 in Review Insurance revenue decreases as more and more Americans find themselves out of work. Deputy Chief Evan Resnikoff resigns. Bensalem s Public Safety Training Center opens. The rescue squad s involvement with Bensalem EMA continues. Bensalem Rescue Squad becomes the busiest in Bucks County. Inside this issue: Bensalem EMS had a truly ground breaking year in 008. The squad became the busiest ambulance service in Bucks County. We moved into our new headquarters and were the only ambulance service to be approved to use the drug Etomidate. In 009, the squad s operations continued to grow. Our call volume continued to increase at an unprecedented rate. We expanded our efforts n the community working with Bensalem Township s EMA department providing safety inspections in schools and participating in lock down drills. As the year wore on, the squad was effected by a perfect storm of financial problems that jeopardized our future. Bensalem EMS has been experiencing a financial slow down for the past few years. To over come these obstacles our organization has found grant income and used investment returns to support much of its operations. The shrinking labor pool of paramedics has driven up labor costs. Billing income has been reduced by Medicare reform. The financial crisis has caused nearly all of the grants that Bensalem EMS received to be cut or eliminated all together. Investment income not only disappeared but the Squad s investments that have been set aside for future major equipment purchases have also decreased in their value. 009 brought many serious challenges to our department. Airway Simulation Lab Public Safety Training Center Industrial Contract Continues Fleet Upgrades Delayed 3 Community EMA 3 Deputy Chief Resigns 3 Financial Crunch 4 BEMS Busiest in Bucks 4 Our Future 5 New Heart Monitors Save Squad Money Bensalem EMS uses state of the art Philips cardiac monitors. These units were 5 years old. In order to keep these monitors current with new guidelines issued by the American Heart Association, upgrades needed to be purchased. Bensalem EMS worked with their vendor to provide all new heart monitors with 5 year service agreements and new warranties. Financing the new equipment provided the squad a savings of nearly $15,000 compared to upgrading and servicing our old equipment. The new units enable our staff to perform 1 lead EKG s, external pacing, and monitor different levels of oxygen and carbon dioxide. The new upgrades also allow our staff to monitor temperature, transmit EKG s to hospitals, and electronically transmit patient cardiograms directly into patient reports. This equipment can also allow crews to monitor CPR for effectiveness in the future.

Bensalem EMS Airway Simulation Lab Goes In Service Our crews perfect their life saving skills using the Laerdal 3G Sim-man. Bensalem EMS was awarded a large grant in 007 to purchase equipment and build a traveling simulation lab. This project was completed in 009. Our lab features a Laredal 3G Sim-man. The 3G is a wireless, computer controlled mannequin that is able to provide paramedics with a wide range of medical emergencies. Paramedics are filmed during training exercises as they perform life saving techniques. The films are then reviewed with trainers to improve paramedic skills. This technology is so new that Bensalem EMS received the first 3G Sim man in Pennsylvania and this is the only mobile lab in the Commonwealth. The 3G is capable of being treated just like a human being. Paramedics can perform intubation, IV, defibrillation, cardiac pacing, and other highly skilled procedures on it. The mannequin is also capable of knowing which medications are being used and is programmed is act appropriately to incorrect dosages, or the use of inappropriate medications. This truly amazing technology will hone our skills for many years to come. You can view this equipment at: http://www.laerdal.com/us/ doc/85/simman-3g Prop Built at Public Safety Training Center These type of technical rescues are very complicated low frequency / high risk events. Bensalem paramedics and EMT s worked to construct a training prop on the grounds of Bensalem s Public Safety Training Center. This prop was built on a stone lot. It offers places to simulate technical rescue scenarios such as confined space and building collapse exercises. The prop has an above ground area where various building materials can be set up for breeching and tunneling. These skills would be used in situations such as the collapse of a building. Crews can work through light construction problems to heavy concrete and rebar applications to simulate every type of construction found in our community. The prop also features man holes up to twelve feet deep. There are also pipes spanning hundreds of feet underground to simulated confined space rescue scenarios such as a worker trapped in a man hole or a large above ground tank. These types of technical rescues are very complicated low frequency / high risk events. It is imperative responders keep skills current to ensure their safety and good outcomes for victims. Industrial Contract Continues Page Bensalem EMS continued to p r o v i d e s u p p l e me n t a l emergency services to a local industrial plant throughout 009. Because of our ability to demonstrate competencies over a wide range of emergencies, a company approached our organization for assistance. In the fall of 008, Bensalem Rescue Squad signed a contract to supplement the company s paid fire staff when needed. Although these services only generate a small amount of extra income, the training opportunities for our staff are very important to our work in the community. Our staff has also received hands-on experiences in the handling of industrial and chemical incidents. The squad hopes to continue this relationship well into the future.

Ford Motor Problems Delay Fleet Upgrades Bensalem s fleet of six Advanced Life Support (ALS) Ambulances have been placed on Ford Econoline chassis since the early 1980 s. Ford is the industry standard for ambulance chassis comprising nearly 80% of the Nation s ambulances. Due to EPA restrictions Ford chose to abandon its 7.3L diesel motor in the middle of 003. Ford went to a 6.0L motor. Bensalem EMS currently operates three 003 ambulances with 7.3 liter diesel motors and three 006 ambulances with the 6.0 liter diesel. Bensalem EMS has had an enormous amount of problems with the new motors and has delayed replacing ambulances until Ford could address the issues. At the end of 009, Bensalem EMS was informed that Ford would not be continuing the Econoline series with diesel motors. At this time Bensalem intends to continue maintaining our current fleet until Ford Motor Company develops a solution for the E- Series diesel or the fleet vehicle need to be replaced. Gasoline engines are not an option for various reasons. Changing chassis limits our ability to remount the ambulance box onto a new chassis. If Ford does not develop a solution Bensalem EMS will have to go back to the drawing board a redesign our current ambulance package. Squad Broadens Its Role With Community EMA Bensalem EMS worked with members of the Bensalem Fire Marshal s Office and Bensalem Police Department in 009 to evaluate school safety and response plans. Under the direction of Public Safety Director, Frederick Harran, members from the various services came together to form a team of people who inspect our schools and offer safety suggestions to the school district. The group also helps to train school district personnel on emergency plans and intruder drills. Under this initiative Bensalem EMA members have conducted and/or witnessed fire drills and lock-down drills in every public school in Bensalem. The group plans to expand this service to Bensalem s private schools and day care centers in 010. This is just one area that Bensalem EMS works with other public service agencies in Bensalem to make our community a safe place to live and work. Bensalem EMS is proud to serve our community as part of its public safety team. Bensalem EMA members have conducted and/or witnessed fire drills and lock-down drills in every public school in Bensalem. Deputy Chief Evan Resnikoff Resigns In October 009, Deputy Chief Evan Resnikoff informed the squad that he would be moving on. Evan has been with the squad since 000. He worked his way though the ranks from paramedic to nd in charge of our organization. Evan represented the squad at the Bucks County EMS Chief s Association, where he became president. Evan was very involved as the squad s liaison with many outside agencies. American Military University and was instrumental in coordinating many of the Squad s day to day functions. Evan has moved to Temple Hospital System to head up their emergency preparedness department where he will be responsible for many of their hospitals emergency plans and disaster preparation. GOOD LUCK EVAN! Evan obtained his Master of Science Degree from Page 3

Bensalem EMS Financial Crunch Felt in 009 The squad has begun to feel the effects of our Nation s economic crisis. The squad began to feel the effects of our Nation s economic crisis by the end of 008. Our investment income disappeared as no type of investment vehicle was safe. As federal and state budgets felt the crunch, many cuts were made to the grant programs that have supported Bensalem EMS for many years. Billing income slowed due to the many people who suddenly found themselves out of work with no medical insurance. Although our income increased by $14,000 in 009, nearly $50,000 of our income consisted of grants and corporate donations. Much of this funding may be cut in 010. The squad must continue to find alternate means of funding. Demand for service in our community continues to grow. The Squad faces serious challenges ahead. In order to conserve funds there are no major purchases budgeted in 010, although our fleet is growing older and will need replacing, currently a new ambulance costs $140,000. Bucks County intends on changing its entire radio system in 01/13. This must be done to meet new federal requirements. At this time the estimated cost to Bensalem EMS is $11,000 and there is no plan to help local fire, police, and ambulance services fund this mandate. In order to save money the squad has been replacing full-time paramedics with EMT s and part -time paramedics. The Squad also intends to not fill the Deputy Chief s position that was vacated this year. However, there is a minimal staffing level that we must meet. Minimal staffing levels also limit the squad s ability to perform certain medical procedures. 010 looks to be very a very trying year for funding. Bensalem EMS will continue to look for ways to finance our operations and provide the community the best service. Demand for Service Continues to Grow Bensalem EMS Now Busiest in Bucks Our fleet of ambulances ready for the next call. Bensalem EMS reached a new milestone in 009. Our organization responded to 6,679 calls for service. That is nearly 18 calls per day. The squad continues to have unprecedented increases in call volume due to the development of our community. Bensalem Township continues to have the highest demand for EMS service in all of Bucks County with 6,484 calls. Bensalem EMS handled 6,50 of these calls with our three staffed units. The other calls were handled through mutual aid from other communities when all of our trucks were busy. Bensalem EMS also provided mutual aid 381 times out side of our community. When you call 9-1-1, the dispatcher enters information into the computer aided dispatch (CAD) system. The CAD recommends the closest available ambulance. There were times in 009 where as many as 5 ambulances were needed in Bensalem at the same time. Our average response time from dispatch to on scene was 8.58 minutes which was slight better than in 008. This is still far below Pennsylvania Department of Health standards. Year: Total: 003 5306 004 5163 005 554 006 5356 007 5873 008 6147 009 6679 Page 4

Our Future Our future is unclear as 009 comes to a close. Unforeseen economic turmoil has shocked our entire Nation. As the Federal government looks to stabilize our economy, it shall cut funding to individual states and programs. There are trickle down effects that will effect our organization through continued cutting of grant programs and funding sources at the local level. Talk of healthcare reform will have unknown effects on our ability to bill for services rendered. Medicare is already predicting a 5 to 7 percent cut for EMS services. This comes as more Americans find themselves unemployed and without medical insurance. payers approximately $60,000 per year. In 010, Bensalem EMS intends to continue our hard work providing quality service in the community, pressing for direct pay insurance legislation, and seeking new ways to fund our organization. We also plan to do this with less staff. Bensalem EMS has been proudly serving our community for 8 years and will continue to be a leader in our EMS region. We thank our community and supporters for all they have helped us to accomplish. Bensalem EMS only collects 5% of what we bill as it stands now. Unlike many other medical professions, Bensalem EMS must provide services to those in need regardless of their ability to pay. Bensalem also must provide services to people who keep their insurance checks fraudulently. Bensalem EMS has been calling for statewide legislation requiring insurance companies to pay us directly for services rendered. This has been met by stiff resistance from the insurance lobbyists in Harrisburg. These fraudulent acts cost the rescue squad and our community s tax Page 5