County exec moves to take control of Harford's emergency medical system

Even before he released his new budget Monday, Harford County Executive Barry Glassman began taking control of the county's emergency medical services system, placing his emergency services director in changed and naming a medical director.

Glassman said the county's director of emergency services, Edward Hopkins, has been placed in charge of the system which heretofore has been operated independent of county government control by the local volunteer fire and EMS system.

The budget for the 2017-18 fiscal year that the county executive submitted to the County Council on Monday also contains funding for the purchase of two so-called surge ambulances that will eventually be operated directly by the county and the positions to crew them, although Glassman said the intent is to have just one operational by the winter of 2018, with the other unit used initially as a backup.

He also announced that the county is in the process of contracting directly with Dr. Timothy Chizmar to be the medical director of the county EMS system and will eventually convene an EMS standards board that will look into all aspects of the system, including training, service terrorities and billing for ambulance services.

Volunteer group bypassed

Some of the changes, including hiring a medical director and deploying the surge ambulances, were previously announced by Glassman and are based on a study of the local EMS system performed at his request last year by the University of Maryland Center for Health & Homeland Security, or CHHS.

Placing Hopkins in a supervisory role over the system, while contemplated more than a year ago by Glassman, is something leaders of the volunteer organizations have steadfastly resisted.

While acknowledging such past resistance during a budget briefing with representatives of The Aegis on Monday morning, Glassman said he had full authority to act through the Maryland Institute for Emergency Medical Services Systems, or MIEMSS, which he noted has statutory authority over all emergency medical services in the state.

"In the past we had delegated this authority" to the Harford Volunteer Fire & EMS Association, Glassman said. "This changes the delegation of authority...we did not have to go through the association."

Glassman has said previously that the current EMS system in the county is structurally non-functional and needs to be changed before a major disaster hits the county.

Among his concerns, several which were reiterated Monday, is having enough trained personnel to staff ambulances in an era when volunteer EMS members have become almost extinct because of the training and time commitments required.

He's also said that as the county grows, there remains a concern of having enough coverage to respond promptly to EMS situations.

Leadership profiles

Hopkins, who has a nearly life-long relationship with the volunteer service, is a former chief of the Bel Air Volunteer Fire Company. He also had a lengthy career in law enforcement, most recently as chief deputy in the Harford County Sheriff's Office before becoming head of the county Department of Emergency Services. He also previously worked as a top administrator in the Maryland Emergency Management Agency, or MEMA.

Glassman said Chizmar will continue to work at University of Maryland Upper Chesapeake Medical Center in Bel Air, where he is a board-certified emergency physician, and will have a contractual relationship with the county. His rate of pay from the county is still being negotiated, according to Director of Administration Billy Boniface.

According to Chizmar's Linkedin profile, he has served as a medical director for local EMS companies and is a regional EMS director for MIEMSS. With the county taking administrative control of the EMS system, Chizmar's relationship with individual local companies or the Harford EMS Foundation will no longer be necessary, Glassman said.

None of the changes Glassman talked about Monday will affect the county volunteer fire service, which will still operate independently of the government, except that it will continue to receive some operational and capital funding from the county, as well as a firemen's pension system that is likewise county funded.

The new budget calls for about $6.1 million to be distributed among the 12 fire and EMS companies for the general operations plus another $160,000 for training. Glassman also placed $500,000 in the new capital budget, $400,000 for firehouse repairs and upgrades and $250,000 for equipment replacement such as individual breathing units.

Hopkins, the emergency services director, will have no direct control over the county fire service, Glassman emphasized, which he added "is in good shape."

Nor will there be an immediate change in the county's relationship with the non-profit EMS Foundation which currently provides a number of paid EMS personnel throughout the county, as well as providing back-up in some situations where volunteer crews are no immediately available.

The county also provides operational funding annually to the foundation, proposed at $3.01 million in the new budget, an increase of $171,000 to address wage parity for the EMS personnel employed by the foundation, higher benefits costs and drug replacement costs, according to budget documents.

Gradual changes

Over time, however, Glassman said he expects the county's contribution to the foundation will decline and be replaced with more insurance reimbursement money.

Eventually, he said, all paid EMS personnel will become county employees and some form of cost sharing or reimbursement will be worked out with the private fire and EMS companies and the foundation, he said.

Glassman stressed, however, that this could be a five to 10 year transition, possibly longer, whose final form – he conceded it will be mostly likely be some sort of "hybrid" – will be developed out of the deliberations of the planned EMS standards board, whose membership will include both people from within the industry and the general public.

"Over the first couple of years this will take a lot of cooperation" from everyone involved, he said.

The surge units will need eight trained EMS crew members each to provide 24/7 service, according to Boniface. When the first unit becomes operational next year, it will be based at the Department of Emergency Services headquarters in Hickory, a couple of miles north of downtown Bel Air.

In all, $501,000 is in the new budget to pay the crew members and the medical director and to equip and operate the surge ambulances, according to budget documents.

Rich Gardiner, who is spokesman for the Harford Volunteer Fire and EMS Association, said via email Monday that the organization is aware of the changes regarding EMS administration.

Gardiner said the future of how the foundation, which is an arm of the association, is operated, as well as billing for services by the fire and EMS companies, "are for discussion down the road" once the EMS standards board is "assembled and given their directions."

"The Association continues to ask that they be included in the planning processes," he said.

Gardiner also confirmed that the association will hold a meeting Thursday "for all chiefs, presidents and trustees to attend to discuss EMS operations and the county."

This updated version contains a correction. Fire and EMS Association spokesperson Richard Gardiner was referring to the planned standards board in his comments about the future of the EMS foundation and other aspects of the emergency medical system.

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