April 01, 2023
by Krystal Steward
Grand Lake Fire and Grand County EMS Move Forward with Phase 3 of the EMS Partnership Plan
In 2019, the citizens of Grand Lake passed Ballot Issue 6, which asked for funding for “creation of an emergency medical response program." Grand County EMS and Grand Lake Fire Protection District have been working together to develop a plan that benefits Grand Lake area residents and visitors efficiently using all of the emergency medical service resources available within each agency.
Below are answers to some of the burning questions we’ve received about this partnership.
Partnership Plan Timeline
Phase 1: Partnership plans were outlined in November 2020, and enacted January 1, 2021
Grand Lake Fire introduces the Quick Response Vehicle (QRV).
Agencies begin work to stock the same brands of medical equipment and types of medications.
This phase ensures the responders from both agencies have working knowledge of the resources available to them, regardless of where the resources are coming from. This is critical to the success of the partnership.
Phase 2: Implemented in May 2021
Both agencies began using the same medical director (Dr. Darcy Selenke), and have the same EMS protocols.
Grand County EMS remained the only agency billing for services through all phases.
GCEMS agreed to reimburse GLFPD for emergency medical equipment used on EMS calls.
Phase 3: Executed in November 2022.
Grand County EMS supplied Grand Lake Fire with an ambulance approved to transport under GCEMS's license, and staffed by Grand Lake Fire personnel.
Gives Grand Lake Fire the capacity to transport critical patients to Middle Park Health in Granby if GCEMS is unavailable.
Grand County EMS maintains financial responsibility for the ambulance, including insurance, maintenance, and all equipment used or expired that needs to be replaced.
Partnership Details
Why did Grand Lake Fire pursue this partnership instead of its own ambulance service?
A cost-benefit analysis of the project showed that the overall financial burden, time spent out-of-district, staffing needs, and loss of cohesive county-wide EMS services made a stand-alone ambulance service impractical.
The overall financial burden to GLFPD to operate an independent ambulance service was cost prohibitive. The annual cost would have been greater than the mill levy increase approved by voters in the 2019 ballot initiative.
A single medical transport to Granby takes a minimum of two staff and their ambulance out-of-service/ out-of-district for more than an hour. Each transport to a Front Range hospital takes that crew out of county for a minimum of 4 hours.
Because of the out-of-district time required by each transport, this strategy would have required GLFPD to double its staffing. Even with double staffing, Grand Lake Fire would still only have the capacity to handle one ALS transport at a time.
Only one agency can hold final authority for Emergency Medical Services in a service area. If GLFPD absorbed the legal boundaries of EMS services in our district, GCEMS would need to revoke its authority, and revoke the mills received from this geographic area. As a whole, this would weaken the emergency services in the County, and in the GLFPD area. Grand County needs to have cohesive EMS services with proper funding from all service receivers.
The strategy of being a separate ambulance transport service puts an unnecessary risk both on the department, and our residents. It is better for all to have increased resources available via a strong partnership with our county-wide emergency service providers.
What did Grand Lake Fire do with the 2019 increased funding from the ballot initiative?
The ballot question asked for funding for equipment and personnel necessary to improve EMS and wildland fire prevention. GLFPD's website provides more information on the changes made to the Wildland Division.
The first change Grand Lake Fire made was to increase its Advanced Life Support (ALS) capabilities by adding three experienced firefighter paramedics to the full-time staff. This change effectively moved Grand Lake Fire from Basic Life Support (BLS) care to ALS care.
Firefighters who are certified as Emergency Medical Technicians (EMTs) are providers of Basic Life Support emergency service. These responders can provide basic life safety care such as CPR, emergency airway support, and start IVs. EMTs are trauma and airway specialists. A BLS provider does not have the legal scope of care that an ALS provider does.
Firefighters who are certified as Paramedics ("medics" for short) are providers of Advanced Life Support emergency services. An ALS provider has the legal authority and knowledge to administer narcotics and cardiac medication. They have advanced skillset allowing for proactive interventions during a cardiac event, place advanced airways, and administer medications that can increase the likelihood of a better patient outcome.
Grand Lake Fire’s strategic mission in EMS is to provide the fastest and most comprehensive care to the patient. This mission is not supported by being an independent ambulance service, but by increasing our ALS care abilities and training to all staff members.
After hiring ALS staff, Grand Lake Fire purchased two ambulances and the tools to equip them to full ALS capabilities.
Scenario: Grand County 9-1-1 receives a call reporting a patient with a heart attack in GLFPD's service area. What happens?
Response Option 1:
Grand County EMS ambulance and staff respond to the incident alongside Grand Lake Fire’s Quick Response Vehicle staffed by a Grand Lake Fire paramedic.
This puts 2 paramedics on the incident. It is worth noting that this is the only area in Grand County with this level of service. This response also leaves 2 Grand Lake Fire staff available to respond quickly to the next fire, EMS, or vehicle accident call.
Response Option 2:
Grand County EMS staff is enroute from a different part of the County. The Grand County EMS ambulance stationed at the GLFPD station as part of Phase 3 responds, staffed with 2 Grand Lake Fire personnel. The paramedic and supporting EMT will stabilize and package the patient in preparation for Grand County EMS’s arrival. If the patient is critical (which means they are in need of immediate definitive care at a hospital) GLFPD has the authority and ability to transport this patient directly to MPH without waiting for an additional ambulance to arrive.
Do you have more questions? Contact Us