The Harford County Board of Estimates has approved two contracts that are necessary to implement the planned takeover of the emergency medical response system in the county.
At its meeting Tuesday, the board approved the purchase of two backup/surge ambulances and the hiring of a system medical director.
The approvals were unanimous, both for a $540,294 contract with Atlantic Emergency Solutions Inc., of Yorktown, Va., for the two 2017 Ford ambulances and for a one-year, $30,000 contract with Dr. Timothy Chizmar to serve as the county's medical director.
Both actions follow County Executive Barry Glassman's game plan for the county government's Department of Emergency Services to begin running an emergency medical services system that historically has been under control of the county's 12 private volunteer fire and EMS organizations.
Estimates board members had few questions about either contract. Member Timothy Hopkins, the county executive's appointee, noted later that board members had received information about the contracts before the meeting, as they do with other contracts on the agenda, and the contract presentations during the meeting were clear.
"I didn't have any issues with it," Hopkins said Thursday. "I think what the county is doing is headed in the right direction."
The two surge ambulances, the medical director, as well as the appointment of an EMS standards board, are the first steps of Glassman's planned transition to a county-run EMS operation. He announced the plan during his State of the County Address in January.
Glassman had Director of Emergency Services Edward Hopkins take on a supervisory role for the local EMS system earlier this year, before he released his proposed fiscal 2018 budget in April.
"The county executive hopes to work with partners and appoint the EMS standards board this summer, so they can begin work on the future transition," Cindy Mumby, the county executive's spokesperson, said Thursday.
The county expects to have the first surge ambulance in service by the start of 2018, according to Mumby. Glassman allocated $271,028 in his budget for eight EMS personnel who would staff the ambulance 24/7. The personnel would be county employees.
The funding for those eight positions is scheduled to kick in during the second half of the fiscal year, or the start of the 2018 calendar year, according to Mumby.
Glassman allocated $501,308 total for EMS in the Emergency Services budget for next year for ambulance crew salaries and benefits, plus funds for radios, EMS billing, medical and office supplies, office equipment, uniforms, travel for training, fuel and vehicle maintenance, according to the budget.
Chizmar, the county's first medical director, is an emergency room physician at University of Maryland Upper Chesapeake Medical Center in Bel Air, and he has been the volunteer medical director for the Harford County Volunteer Fire & EMS Association, the umbrella organization for the county's fire and EMS companies.
Chizmar has been working for the county since April 1, and the contract approved Tuesday is a one-year contract extension, according to Mumby. He will work for up to 500 hours and be paid up to $30,000.
The EMS standards board would work out the details of the transition, such as where the surge ambulances would be based and the areas of the county where they would be deployed.
An evaluation would be conducted of how busy those units are, Mumby said.
The surge units are meant to augment the service provided by the fire and EMS companies.
"The county executive is methodically working through this process and wants to take the time to do it right," Mumby said.
The changes to the system are based on a study conducted by the University of Maryland Center for Health & Homeland Security, or CHHS, in 2016 at the county's request.
The report found that the county government "can provide EMS in a more cost-effective manner by playing a more direct role in funding and supervising the EMS system."
The report cited concerns that have been expressed in the past by fire company leaders, as well, such as a declining volunteer base while EMS call volume increases, especially in the highly-populated parts of the county.
A mix of volunteers and paid medics employed by the various fire and EMS companies provide the service now. Funding for the paid EMS workers comes from the companies themselves and from the Harford County Volunteer Fire & EMS Foundation, an arm of the volunteer association.
The county provides annual funding for the foundation, $3.05 in the FY18 budget that takes effect July 1, according to the budget. The foundation also collects funds for ambulance from patients' insurance companies, according to its annual financial reports.
The Fire and EMS Association is independent of the county government, although it also receives an annual allocation from the county, which will be $6.77 million in the new budget. Those funds are in turned divided among the member fire and EMS companies by the association's leadership.
The Fire & EMS Association took issue with the CHHS report findings earlier this year, noting in a statement issued in March the "numerous errors and misstatements" in the study.
Association spokesperson Rich Gardiner said Thursday that the current EMS system is "manageable," and association representatives still want to have a voice in implementing the changes desired by the county.
"You always want to make something better than it is, and it's all for the citizens' benefit," Gardiner said.
He said the parties involved "need to look at the bigger picture and decide how we do this in agreeable format."
The association has been preparing "data points" regarding the use of the surge ambulances, and officials hope those making the decisions take them into account.
Gardiner stressed local EMS providers are the "subject matter experts" regarding ambulance deployment, based on their experience.
"We still would like to have a say, and a seat at the table, when the decisions are made to deploy these surge units," he said.
Mumby noted the Fire & EMS Association will have representation on the EMS standards board.
"We are seeking to provide the best possible service in the interest of public safety," she said.