A special meeting of the Board of Woods County Commissioners called by members of the Oklahoma Department of Health Emergency Systems seemed more about turf battles than health issues.
Discussion centered on whether or not the dispatchers of Woods County’s E-911 call center were dispatching the “closest” ambulance service or the one able to arrive at the scene in the “most expedient” manner.
Robert Irby, OSDH Emergency Systems Administrator, and Theresa Hope of the Oklahoma State Department of Health Emergency Systems told the newspaper by phone that they requested the meeting.
While attending a meeting with Woodward’s emergency services, the Woodward City Council and members of ambulance services that have overlapping territories – which Hope described as “a lot less hostile” – the state officials said they became aware of problems with the way Woodward’s ambulances were being dispatched.
Hope said three other ambulance services attended that meeting including Freedom’s ambulance director Pebbles Luddington who expressed dissatisfaction with dispatching.
“We initiated it (the Alva meeting),” Irby said, “and asked if we could help solve the problem.”
Woods County Clerk Pam Inman explained the county agreed to the meeting in hopes of mediating the problem between the Freedom service and the rest of the county.
“It’s not just Woods County, it’s the state of Oklahoma and the nation in relationship to emergency medical services,” Irby stated.
Commissioner Clint Strawn explained that the Alva E-911 Dispatch handles all calls for ambulance, fire and police from the central dispatch center located in the Woods County Courthouse.
“You’re a jump ahead of a lot of people,” Irby said.
Attending the Alva meeting in addition to the commissioners, Hope and Irby were Troy Brooks and Brooke Meyer of the Alva EMS, Jodell Durkee of the Waynoka EMS, Pebbles Luddington of the Freedom EMS, Brenda Starks, head dispatcher of the Woods County E-911 Dispatch and Jennifer Barnett of Woods County E-911.
Dispatching Districts
Lines drawn on maps by previous ambulance directors divide Woods County into three ESN Districts – one served by Alva’s full time EMS service which provides intermediate level care, and one each for Waynoka’s (also an intermediate level) and Freedom’s (basic level) volunteer services.
A separate Woods County map divides the county into six areas depicting fire department territories for Alva, Waynoka, Freedom, Greenleaf, Dacoma and Capron. Each of the fire and ambulance services signed mutual aid agreements which allow them to enter the other territories for emergencies or as requested.
Two maps were displayed at the meeting – the official one used in the dispatch center, and one provided by Brooks recently redrawn by the EMS personnel.
Currently, Woods County is in the process of providing dispatch services to Grant County and hopes to eventually provide dispatching services for a multi-county region. Irby said in that respect, Woods County was far ahead of most E-911 dispatch centers and that he would like to see regional centers instead of many smaller individual dispatch facilities.
Dispatching Protocol
Starks explained the normal dispatching routine. The call comes into the E-911 Center. That call is recorded and logged. The address is typed into the computer which immediately displays an overlay on the addressing map which tells the dispatcher which fire service to notify, which ambulance service to notify, and which law enforcement agency to notify.
Tonal pagers are sounded and radio calls made dispatching the appropriate services. This type of notification applies to both Waynoka and Alva who get the calls simultaneously. Durkee said they rarely had a problem with this method of dispatch.
Freedom ambulance requested their notification be sent to Luddington’s cell phone. She in turn summons the ambulance service members on duty.
According to E-911 Dispatch records, Freedom has four members of its ambulance service, at least three of whom work out of town.
“In half the country out here you don’t have cell phone reception,” Commission Chairman Clint Strawn said as an explanation for part of the problems.
Strawn said Freedom previously used the alpha numeric pagers which Luddington said didn’t work. The county requested Freedom use the same tonal and radio system used by the other services. That request was rejected by Luddington.
Two Sides of E-911
Strawn explained the two sides of Enhanced 911. The first half, which receives funding from cell phone tariffs, provides information – caller’s phone number and location – to the dispatching center. The other side, which in Woods County is funded in part by funds from Woods County General Fund, City of Alva funds and City of Waynoka funds, includes dispatching the proper personnel to the emergency.
Freedom, due to its limited city population and small tax base, pays nothing for the dispatching services, but did sign an interlocal agreement with the county for dispatching services as did Alva and Waynoka. The Local Problem
During the meeting in Alva Monday, Luddington’s main complaint relating specifically to ambulance dispatch involved an incident on January 10 when a call came into the Alva call center from the Lifeline pager service.
Alva E-911 Head Dispatcher Brenda Starks said a new dispatcher was on duty at the time. The Lifeline dispatcher gave the dispatcher the address saying it was an Alva address. The dispatcher immediately dispatched Alva EMS, Alva Fire and Rescue to the scene.
Twenty-six minutes later it was determined the Lifeline customer actually lived in territory north of Freedom covered by Freedom EMS despite having an Alva postal address. At that time, Luddington was called.
Luddington said the Alva crews were nearly to the site before she could drive three miles from her house.
Luddington insinuated that Alva’s fire and ambulance crews are routinely sent to before she’s notified, although she didn’t provide any other documentation.
New Software
In an effort to keep the addressing current, a new software system is being installed by Woods County at a cost of more than $45,000. This will provide more local control over address changes when new addresses are added. It will in no way affect the current addresses established for E-911.
A representative of the software company installing the equipment during the meeting said once the software is installed and the dispatchers are trained, they will be able to change the ENS lines in-house, if necessary.
Alva EMS Director Troy Brooks met with the dispatchers and Strawn following the meeting and drew concentric circles on the map from Alva, Waynoka and Freedom to determine the exact point where territories would intersect. The circles did not take into consideration any closed roads or inaccessible areas.
According to those circles, Freedom would lose an area of about 18 square miles to Waynoka. They would gain approximately 20-25 square miles in northern Woods County from Alva. In the area Freedom would gain, there are approximately 20 addresses with phone service, some of which are merely barns with a phone, E-911 Mapping Director Jennifer Barnett said. Very few residences are in that additional area.
No Resolution
Despite his seeming agreement during the meeting that the county was working on the problem, in a phone call the next day, Irby said he was not at all pleased with the meeting’s results.
“There was no movement toward a resolution,” Irby said, despite the fact Strawn said the lines could be redrawn after the new software installation and training are completed.
Hope kept reiterating the statement that the regulations say the “closest” ambulance to a situation must be dispatched, then added “but that’s not as the crow flies.” “Lawyers will be able to argue quickest, most expedient,” Irby said. “The question is, which is going to get you the best care for that patient as soon as possible.”
Strawn pointed out that the Alva EMS is full time, always on duty ready to go as soon as the call comes in, whereas sometimes it takes longer to assemble a volunteer crew.” Hope said, “I would highly suggest that the three or four of you and Pebbles and the rest of the EMS agencies get together and look at these two maps and be sure that you have exactly what you want, and that they’re perfectly right, and relatively soon.”
She requested that subject be placed on the next county commissioners’ agenda. The commissioners explained to her that that would be impossible since the new software was not yet installed nor the dispatchers trained to use it. “I think really the biggest problem is communication, not dispatch,” Irby said. “You need to get either a memorandum of understanding or a contractual agreement that Pebbles has with this dispatch center that says “this is what they’re going to do for us, and what you’re going to do for them.”
County Clerk Pam Inman said, “We have an interlocal agreement with the cities and the ambulances.”
“I’ve never seen one,” Luddington stated immediately.
“The town clerk has one,” Inman said.
Durkee said she was sure Waynoka had one although she had not seen it.
“I’m not the one to be in the know,” Durkee said. Hope said, “We recommended that all of these requirements be written down by all parties – dispatch, EMS and Fire.
That they write down all their requirements, their needs and wishes and everybody signs off on it so that it’s in black and white what needs to be done. Then if there’s an issue, they can go back and talk it out.”
Following the meeting, Luddington informed Inman she would never sign another interlocal agreement with Woods County Dispatch.
Hope said she would be compiling a data base of statistical evidence to see just how much of a problem actually existed in Woods County.
Each ambulance service sends in a report to the Oklahoma Department of Health on the number of calls they make per month telling the time, date and the patient.
“I can go into my system and look up the time for these areas for 2009 or at least the last six months,” Hope said. “If it happened three times in six months, there really isn’t a problem. If it’s happening once or twice a week, then it’s a problem.”
01/29/10
By Helen Barrett
Alva Review/Couier
