Times Observer photo by Josh Cotton DCED EMS Peer Consultant Ken Hellendall presents his findings on the county’s EMS system during a meeting held Tuesday at the Youngsville Fire Hall.

Outside perspectives can still be valuable even if they tell you what you already know.

Such is largely the case with a state Department of Community and Economic Development analysis of emergency medical services in Warren County.

The plan was presented to municipal and fire department leaders Tuesday at the Youngsville Fire Hall. It had been presented to the county commissioners earlier in the day.

The study found that the “single largest concern” is a lack of personnel for daytime coverage, Monday through Friday.

“Across the Commonwealth, personnel is the single biggest concern of all ambulance services,” the study, prepared by EMS Peer Consultant Ken Hellendall, said.

“We are seeing that statewide,” he told officials. “In your region … you lost 636 EMTs since 2014.”

Helldendall said, within that demographic, that 38 percent of EMTs and medics between the ages of 37 and 42 have left the service.

“That should worry you about the next generation of leaders,” he said.

While no one would argue that the EMS situation in Warren County and across rural Pennsylvania is a serious challenge, Hellendall highlighted what officials in the county are doing well.

He said he was “surprised and very pleased” to learn that the average response time was under 14 minutes. “That’s good. You’re doing well there.”

However, he noted one department failed to respond to 65 percent of its calls, which he said was “unacceptable.

“That’s not fair to those people and the visitors of your county.”

From an infrastructure perspective, Hellendall praised the equipment and facilities in the county.

The ambulances are in “great condition. Some of them are old but they’re in great condition.”

“You’re using them and spending the money appropriately,” he said.

The buildings that house those ambulances are “nothing fancy” but evidence that, he believes, officials are “spending your money in the right places.”

He was also highly complimentary of the EMS commission that started in the southeast corner of the county but is quickly picking up more and more members.

“You need to look down that route as you move forward to becoming more of a team,” he said, stressing that it was not his recommendation that the county go to a paid service or that any existing ambulance providers disband.

“You’re at a turning point in a good way,” he said, suggesting that the commission model puts the county a year ahead of most other places. “Most of the places I go, none of that has been done.”

“You realized the need to fix the system a while ago.”

Hellendall then identified three challenges – no sustainable funding, a critical workforce shortage and below-cost reimbursement from Medicare and Medicaid – facing Warren County “the state and probably most other states.

“It’s not just Warren County. It’s everywhere. These are issues everywhere.”

The rest of the presentation focused on recommendations to address those issues.

He was clear that EMS in Warren County needs to be a mix of paid staff and volunteers.

“You’re going to need some paid people,” he said. “Without volunteers in EMS, this system will fail.”

He spoke about the importance of recruitment and retention as part of that effort.

“You need to spend time and effort recruiting people,” he said, and recognizing people for the work they do.

His main administrative recommendation was to develop a formal EMS authority, which would require all municipalities and departments joining.

Each department would maintain its autonomy.

“It would allow you to have a mothership with all your ambulances which are currently in place,” he said, and expand the grant options that might be available.

He proposed the authority be staffed by one person as a manager, who works during the day on weekdays during the “most difficult period” from a response perspective.

That person would have the “ability to move” resources to “make sure the county is covered and your response times stay short.”

He then presented a rough phase approach on how to get there.

“Something has to be done,” calling the commission a “huge step forward…. We can continue to help. You have a lot of work to do that we can help with. All this is a recommendation.

“You have to decide where to go from here. … The authority gives you a chance to grow.”

“We’re getting older but we have to leave the next generation with something to work with,” Paul Pascuzzi said. “We’re much better off than a lot of our neighbors.”

He said that an EMT class through the Northern Pennsylvania Regional College currently has 32 students signed up with only 24 seats, meaning there is a wait list.

“(The) good news is people are interested in becoming EMTs in Warren County,” he said.

“It has been a long process to work with the state to finally come to a conclusion with an EMS study,” Pascuzzi added. The study “has some really serious discussion to present to you.”