By: Jeremy D. WellsCarter County Times
Despite concerns about falling staffing levels that means they may have to temporarily sideline one of their active trucks, the Carter County Emergency Ambulance service is considering the purchase of another truck.
The move isn’t as counterintuitive as it seems though. During the month of April, executive director Rick Loperfido told the board, they had four different vehicles in the shop for repairs or maintenance. One needed a transmission replaced, in addition to exhaust and manifold work. Another needed a radiator. A third required replacement of “a hydro-boost pump” and a power steering pump hose.
The fourth one, however, is experiencing issues the service has experienced with several other trucks as well, and one the new truck could eliminate.
That truck, like others, had previously experienced a problem with its DEF system. DEF, or diesel exhaust fluid, is an additive that helps eliminate the black smoke that some diesel vehicles can produce. It’s a solvent that can help burn off those carbon deposits before they’re released into the air. But the system can also go bad. When it does, it needs to be replaced or removed.
For most commercial vehicles, removing the system is an EPA violation, but Loperfido explained that emergency vehicles are exempt from that rule.
It causes less problems with the vehicle to remove the system, Loperfido explained. But because of the computer systems that run vehicles which come with DEF systems, removing them can sometimes cause a software conflict. Essentially the computer is looking for the DEF system, to interact with it, and it can’t find it. When it can’t find it, it shuts the vehicle down.
This is the problem truck number 15 is currently experiencing. The DEF was removed after it went bad, and now the vehicle is experiencing an engine issue as a result of the conflict in the PCM programming.
Loperfido said the only real option to overcome the issue is to have the PCM reflashed, with an updated custom program that doesn’t include instructions to look for and control the DEF system.
The cost for having that program flashed to their control system is $2,500 Loperfido said.
Loperfido said a fifth truck is now beginning to experience issues with it’s DEF system as well, which means if they need to remove that DEF system as well, they’ll also probably need to reflash their onboard system.
The vehicle Loperfido would like to consider purchasing wouldn’t have the problems with the software conflict, because it is a 2012 model, which means it was built before the DEF mandate.
Loperfido told the board he would be looking at the vehicle, a van front ambulance, later this week along with board president John Brooks and board member Sam Lowe.
Valerie Nolan, during her financial and billing report, noted that while income has been up and vehicle maintenance costs had been down, they were already increasing.
“If we don’t get new trucks, our maintenance costs are going to shoot back up,” Nolan said.
In other action Loperfido reported that calls for April were down by 49 compared to 2022, as were the year to date calls, which are down from 1,919 in 2022 to 1,855 in April 2023. However, he attributed part of that to a reduction in transport calls related to staffing issues.
Loperfido also discussed health insurance rates, noting that after dropping himself from the coverage they were able to lower the rate increase to 10.9 percent.
Loperfido also reported on his discussions with KDMC on the creation of a freestanding emergency room in Grayson. Loperfido said while the hospital system seemed reluctant, a number of the calls originating from KDMC’s Urgent Care and other healthcare facilities were for transport to a hospital ER. With a standalone ER in Grayson, he noted, they could cut those response times and handle more of those types of transport and other emergencies.
Loperfido estimated that around 10 percent of their 911 calls originated from a KDMC facility.
While engaging in the discussion a 911 call came in from Urgent Care for a patient presenting with “extreme fatigue.” That’s the type of call, Loperfido said, that a freestanding ER could resolve instead of taking an ambulance out of service for the time required to drive to and from Ashland.
The time constraints are especially an issue, he noted, because of the falling staff numbers.
They lost one full time paramedic to retirement last month. While they’re hoping to get one staff member back after an extended worker’s comp claim, they received the resignation of another full time employee within the last week.
If they can’t fill those positions, he said, they may have to sideline one of their trucks, but he’s talking to several people about helping fill those roles.
In addition, he said, he and Nolan are looking at various incentives for employee retention.
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