Ambulance District still seeking MOU resolution

Wednesday, February 20, 2013

For months, the Barry-Lawrence Ambulance District has been asking area fire departments to sign new memorandums of understanding (MOU).

The Monett City Council approved the MOU for the city fire department, which makes the most responses in support of Barry-Lawrence Ambulance crews. The Butterfield Fire Department, whose territory overlaps the ambulance district, has also signed on.

The chief of the Freistatt Fire Association has signed, but authorization is still pending from the board. The Monett Rural Fire Association has given verbal agreement. The Pierce City city and rural departments asked to delay a vote until after the April 2 election bid to create a tax-supported fire district.

The Purdy Fire District has remained at odds with the MOU for a number of reasons. Mike Bennett, the chairman of the Purdy Fire District, also serves on the Ambulance District board but has remained out of the discussion. The ambulance district's attorney views Bennett's position as a conflict of interest. Bennett subsequently abstained on the vote to adopt the MOU.

According to Marty Newman, ambulance board chairman, the service operated on verbal agreements for too long and needs to formalize procedures in writing for liability protection. The MOU asks first responders to follow the ambulance district's protocols, which have been developed by the district's medical director.

Policy #61 details how the Barry-Lawrence Ambulance District will replace a specific list of supplies used in basic life support actions taken by first responders during calls answered by district ambulances.

Some confusion has been created when first responders find themselves at a scene when another ambulance service pulls up, answering in mutual aid because Barry-Lawrence is not available. Some departments believe Barry-Lawrence should still replace the used materials.

Not so, said Daryl Fenski, long-time chairman of the ambulance district board who currently serves as vice-chairman,

"The other ambulance service is doing the billing," Fenski said. "They should provide the replacements."

Jeaneittia Pierce, the ambulance district's office manager, said a responding service only has to submit a signed receipt for supplies used. Supplies will not be replaced at the scene to avoid delaying patient transport.

The Purdy Fire District organized into an Emergency Medical Response Agency (EMRA) shortly after its formation, the only one of its kind in the Monett area. Fitting a state definition, an EMRA can provide advanced life support with its own paramedic and protocols developed by its medical director.

According to Purdy Fire Chief Mike Redshaw, Purdy had an MOU with Barry-Lawrence signed by its then operations director, Jim Liaromatis. Under the agreement, the ambulance district replaced supplies used by Purdy responders, including electrodes for Purdy's defibrillator, a different brand than what the ambulance district uses.

Redshaw believes that MOU, which was approved by the Missouri Bureau of Emergency Medical Services, is still valid.

Newman said the Barry-Lawrence Board knew nothing of the MOU and did not discover it until a year after Liaromatis had left the district. Fenski added that an MOU is only valid for one year anyway.

To create a working relationship with an EMRA, Newman said six to eight months of work went into developing a separate MOU, one that included replacing specific advanced life support supplies.

According to Newman, Barry-Lawrence cannot practice due diligence with its tax dollars by purchasing supplies that only one service will use, especially supplies with a limited shelf life.

"For us to accept their MOU, they have to accept the protocols written by our doctor and approved by our board," Fenski said. "Optimum care is what we're here for. How they run their fire district is of no concern to us. The only thing we're interested in is patient care. What we do will be under our medical director's care."

Newman and Fenski encouraged the Purdy board to send a letter on the Barry-Lawrence MOU that detailed concerns to start a dialogue. No communication about the MOU has been exchanged since the ambulance district's September board meeting, which Redshaw attended.

Newman, Pierce and Fenski said they are each available personally to discuss issues.

The lack of having supplies replaced has forced the Purdy Fire District to budget for materials at its expense. Pierce said she has received two requests for replacing supplies from Purdy. The ambulance board instructed her not to act until the MOU was signed.

Discussion of MOUs have been on every board meeting agenda but one since September. Newman said anyone could come to talk to the board about concerns by asking to be on the agenda. The board next meets at 6 p.m. on Tuesday, Feb. 12.

"What we think is workable is what we offered," Newman added.

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