By CASSANDRA SHOFAR

Staff Writer

There may come a day when voters decide whether Medina General Hospital’s Life Support Team still works as is or needs to change.

That day is not today.

Along with talks about possibly forming a fire district with Medina city and Medina and Montville townships come discussions about LST’s future, but it is just talk at this point, Medina Mayor Jane Leaver said Monday.

She said any changes to the fire department and/or LST would be up to voters.

LST history

Formed in 1976, LST has been dedicated to providing emergency medical services to residents in Medina and Medina and Montville townships, Gary Hallman, CEO and president of Medina General, said Friday.

“It was a collaboration of city council members, the mayor, Ed Hall (the hospital CEO at the time),” Hallman said.

Prior to LST, ambulance service was provided by Waite & Son Funeral Home, Leaver said.

It was decided the service was not adequate for the community it was serving, Hallman said, so LST was put together with eight members.

Since then, it has grown along with the population into a 29-member organization, Hallman said, with 20 full-time members, two directors, 1½ support staff and 5½ per diem (called when needed) members.

York Township has a separate contract with LST for daytime service from 6 a.m. to 6 p.m., Hallman said, adding the hospital’s EMS Outreach (which includes LST) helps educate countywide EMS groups.

In addition to LST’s station outside of the emergency department at the hospital, 1000 E. Washington St., Medina added an LST area at Fire Station 1 at 300 W. Reagan Parkway, Leaver said.

When LST was created, an advisory board also was formed, Hallman said, with one representative from each township and two from the city. Members are Medina Township Trustee Rita Holt, Montville Township Trustee Ron Bischof, and Leaver and At-large Councilwoman Linda Hoffmann from Medina.

For the hospital, Hallman is on the board, but does not have a vote, and directors of hospital departments including the vice president of finance and of nursing sit in on the meetings as well, he said.

The 20 full-time members of LST are hired by the hospital, and while they may have other jobs, they are full-time paramedics with hospital salaries and benefits, Hallman said.

Finances

The townships and city share rent costs for the buildings that house LST, Bischof said Monday.

Leaver said the advisory board approves the budget, but only has direct input on new hires and capital purchases.

“Otherwise, they’re hospital employees and the hospital sets their salary and benefits package,” she said, adding the billing for LST services fluctuates for each participant, and is based on the number of calls and insurance collections.

Every time the fire department goes out on a call, LST is also called, Leaver said.

For 2007, the city paid $888,219, Medina Township paid $262,256 and Montville Township paid $188,152 for LST services, according to figures from Robin Louis, director of public relations for the hospital.

The three participants have separate levies in place that fund their LST services, Leaver added.

The future

Currently, Montville contracts its fire service with the city.

The entities have been discussing the future of their fire services and what would be the most efficient option at the lowest cost.

Leaver said the main question is “at what point are we going to need to go to a full-time fire department?”

Last year, Leaver said the city paid more than $2 million for fire and LST services in the city.

“Can I provide full-time fire and EMS services for the city for $2 million? Probably not,” she said. “But for not much more, we could have full-time fire combined with EMS. I can tell you it will not be cheaper than we are structured today, but the benefit would be full-time fire protection and decreased response time.”

She added: “The system is not broke today, but with our increasing population, I do not see the system working in five to 10 years, so the time to start reviewing this arrangement is now. We may find this arrangement will work for years to come.”

There are 40 firefighters in the city’s fire department and 26 of them are already EMS trained, Fire Chief Bob Painter said Monday.

“I think fire-based EMS is the most cost effective,” he added.

Leaver said there are a number of ways fire services can be arranged, including a fire district, which would be a separate taxing entity that can be full time, or various layers of a part-time or full-time fire department, which would not be a separate taxing entity.

“I do not envision Medina’s fire department ever being 100 percent paid employees because we have one of the most dedicated group of volunteers I’ve ever seen in safety services,” Leaver said, adding whatever is decided, a project like this would require years of planning.

Hallman, however, believes the most “opportunistic” system is the one in existence today, where firefighters worry about fires and LST worries about medical emergencies.

“For 32 years, those districts have cooperated and collaborated to make sure those services were offered to their constituents,” he said. “We’re very cost-effective and considerably under budget.”

When asked in the grand scheme of things whether combined fire and EMS services would make a big difference safety-wise compared to separate fire and LST, Hallman said, “in a nutshell, no.”

However, he said it’s based on training, and while there may be some overlap, he gave the example that if a person had a specific condition, he or she would want the specialist to handle it, not the general practitioner.

“I think the rub comes when you have a department based upon staffing and you have multiple calls … a fire call, an emergency call, you’ve strengthened your forces (with LST),” he said. “They collaborate to work together. There’s a lot of efficiencies and effectiveness in how it’s run.”

Montville

While decreasing fire and EMS response times is a goal of everyone involved, it’s a pressing concern for Montville, which gets the short end of the stick in all this, Bischof said.

“The whole idea is let’s try and get response time reduced in Montville, which has the worst response time in the whole area,” he said. “Montville has paid its fair share down the line … but we’re not getting a fair share on the response time.”

Trustees have plans to construct a police station next to the current township hall at 6665 Wadsworth Road. It would have the capability to house three to four bays for fire vehicles along with LST vehicles and personnel.

“If the LST building were built right in the middle of Montville, it would serve us much better … because we could shoot north, south, east and west,” said Bischof, who has served on the LST advisory board since day one.

Bischof said no matter what Montville or Medina Township and the city decide with their fire services, that building would be useful for EMS.

“I also feel that if our fire department (is) going to go full time in any way or shape, they’re going to have to do it with the help of LST,” he said. “They (LST) have reduced their costs in the last two years a number of percentage points, but it still is a very expensive entity. But it’s a service that is second to none in this state. They’re extremely professional.”

He added: “I don’t believe if you encompass it with fire that you’re going to get the same professionalism. Somehow, they’d have to merge without losing the integrity of the LST. I don’t think you can combine them and have that same professionalism.”

The clinic

In October, the Cleveland Clinic announced it had entered into a memorandum of understanding with Medina General to explore the possibility of the hospital becoming part of the clinic’s health system.

While both parties are still in the due diligence stage, Hallman said they are “not alternating the (LST) operation based on any of their conversations (with the clinic).”

“Our goal at this point is to make sure the LST meets its goals with the contract we have,” he said. “We are providing excellent coverage right now … and will continue down that path.”

As for what is in the best interest of the city and townships long term, Hallman said those are conversations he hopes the hospital can be a part of, but it’s ultimately something those entities will have to wrestle with.

“We all have to look at efficiency and effectiveness and doing it better and cheaper,” he said, adding the cheaper element is always the most challenging.

Leaver emphasized that regardless of what is decided in the years to come, the final say will come from the public.

“No matter what is discussed publicly or privately, the ultimate decision will have to be made by the voters,” she said. “It’s a voter decision. It’ll be 100 percent their call.”

Shofar may be reached at 330-721-4044 or cshofar@ohio.net.