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Home » News » Schuyler County reflects on changing EMS model: What makes service so challenging in rural communities?

Schuyler County reflects on changing EMS model: What makes service so challenging in rural communities?

  • / Updated:
  • Rebecca Swift 

Schuyler County is coming up on the one-year anniversary of working with Schuyler Hospital on a new EMS model. Eleven months ago, several organizations, including the county and hospital, developed a plan, called the Schuyler Emergency Management System.

“The model is a collaboration between the county and a health system, in which both invest time and dollars into a contract,” said Fonda Chronis, CFO at Schuyler County. “We hold that contract accountable as far as metrics of success are concerned. The county has invested dollars in this. The ultimate goal is for the hospital and the Cayuga Health System to take it over 100%, including having a certificate of need, and running it as a stand-alone operation.”

“We saw that the best way to do this was to do this was to utilize the best of what both of us brought to the table,” said Rebecca Gould, President and CFO of Schuyler Hospital. “Fonda and his team had a lot of the operational knowledge necessary to actually get it off the ground. And we had a lot of the business operations available that we could offer almost a turn-key product if we could work together. So this collaboration has been really good.”

The conversation to make this happen started because there are a number of challenges facing rural emergency services.    

“The biggest challenge is that these are all volunteer organizations,” Chronis said. “Volunteerism just isn’t what it used to be. The world is different now than it was 20-30-40 years ago. These organizations have morphed into more of paid organizations. The problem is, high levels of training necessary, not enough people. And the business model, now that you have to pay folks to do what used to be done for free, just doesn’t work anymore.”

They said the reimbursement process through insurances makes things difficult for emergency management.

“Let’s say that you have to run a 24-hour rig,” Gould said. “That’s two people at whatever the rate is that they get paid. But because you live in a rural community, you only see four calls during one day. The reimbursement that you’re going to get from Medicare or Medicaid doesn’t actually cover the cost of the people that you have to employ.”

They feel this is successful because of the people behind it.

“There’s a bunch of people that put this together that, I think we said the other day it was 11 months timeframe from when this conversation started till it actually going live,” Gould said. “It’s the team that put the service together. It’s also the EMT’s and the paramedics that are doing the job. And they know what their goal times are.”

They said this model is one that other rural counties should be looking at and considering.