EMS leadership

Creighton University EMS Education\

EMS Management EMS 470

2014

Bill Raynovich, NREMTP, EdD, Faculty

Strategic Planning Workshop

There are a few important things to know about planning.

1. Everybody hates planning sessions.

2. Nobody respects planners.

3. Strategic Plans are like Astrology, without the respect.

4. Planning doesn’t work.

5. Nothing ever goes according to plan.

6. If you fail to plan, you are planning to fail.

You need to have a strategic plan. You need to know how to do the process. This is a planning exercise to develop your planning skills.

Proprietor: Slumber Valley Ambulance, Inc. (SVA)

Location: Slumber, NE

Population: 80,000

Business Model: For Profit Proprietary Service

Your ambulance company was established 55 years ago by your grandfather who was the funeral director in Slumber Valley. You have enjoyed great community loyalty and you grew up in the funeral services and EMS business. Your father managed to keep up with the modern trends in EMS and SVA is now a well-respected EMS service in the region.

SVA has a contract with Slumber Valley Community to provide 9-1-1 EMS for a provision of $25,000 per year to cover special events such as the July 4th Annual Picnic and the High School athletic events. The community service contract terminates in 22 months and will need to be negotiated for renewal.

Mega American EMS (MA EMS) recently located an office with four transport units in Risky Valley (population 90,000), about 30 minutes north. Risky Valley 9-1-1 is covered by a paid municipal Fire-EMS department.

With increasing fuel and healthcare costs, along with other inflationary trends, your projected operating margin will be narrower than ever.

SVA has 10 paid paramedics, 14 paid EMT-Basics. Three of the paramedics recently announced to the service manager that they have an offer to go to work for Risky Valley for $1.00 more per hour and 1 extra week of vacation time per year.

The fleet of vehicles is aging and will need to be replaced in the next two years.

There is a new 300-bed long term care facility nearing completion half way to Risky Valley.

The Revenue and Expense balance was positive last year, showing excess revenues over expenses in the amount of $48,000, or approximately 9% of your gross revenues.

A building fund has a positive $46,000 balance.

With current demographic trends, payer profile mix, and reimbursement schedules, expected revenues are expected to be 4% lower the next fiscal year and are likely to be 8% lower within five years.

Consultant to Slumber Valley Ambulance, Inc. (SVA)

Location: Slumber, NE

Population: 80,000

SVA: For Profit Proprietary Service

SVA has a contract with Slumber Valley Community to provide 9-1-1 EMS for a provision of $25,000 per year to cover special events such as the July 4th Annual Picnic and the High School athletic events. The community service contract terminates in 22 months and will need to be negotiated for renewal.

Mega American EMS (MAEMS) recently located an office with four transport units in Risky Valley (population 90,000), about 30 minutes north. Risky Valley 9-1-1 is covered by a paid municipal Fire-EMS department.

With increasing fuel and healthcare costs, along with other inflationary trends, your projected operating margin will be narrower than ever.

SVA has ten paid paramedics and 14 paid EMT-Basics. Three of the paramedics recently announced to the service manager that they have an offer to go to work for Risky Valley at $1.00 more per hour and 1 extra week of vacation time each year.

The fleet of vehicles is aging and will need to be replaced in the next two years.

There is a new 300-bed long term care facility nearing completion half way to Risky Valley.

The Revenue and Expense balance was positive last year, showing excess revenues over expenses in the amount of $48,000, about 9% of gross revenues.

A building fund has a positive $46,000 balance.

With current demographic trends, payer profile mix, and reimbursement schedules, expected revenues are expected to be 4% lower the next fiscal year and are likely to be 8% lower within five years.

You have been hired to help guide SVA to solid fiscal health, or to make a recommendation that the organization take some alternative action.

Paramedic for Slumber Valley Ambulance, Inc.

Location: Slumber, NE

Population: 80,000

SVA: For Profit Proprietary Service

You have an offer to go to work for Mega American EMS (MAEMS) in Risky Valley, located approximately 30 minutes to the North. They have offered you $1 per hour higher base pay and an extra week annual vacation. The healthcare benefit package is about the same. You have recently taken your offer for better pay to the management of SVA and are expecting to hear back from them soon. The other paramedics and EMTs have also received offers to go with MAEMS but no one has made a final decision yet.

Slumber Valley Municipal Manager

Location: Slumber, USA

Population: 80,000

You are the Municipal Manager of Slumber, USA. Slumber Valley Ambulance (SVA), a for profit ambulance company, was established nearly forty years ago by a local funeral director. During these past 40 years, SVA has kept up with modern trends in EMS and is a well respected service in the region.

Your community has a contract with SVA to provide 9-1-1 EMS for a provision of $25,000 per year to cover special events such as the July 4th Annual Picnic and the High School athletic events. The community service contract terminates in 22 months and will need to be negotiated for renewal.

You been approached by Mega American EMS (MAEMS) which has recently located an office with four transport units in Risky Valley (population 90,000), about 30 minutes north. Risky Valley 9-1-1 is covered by a paid municipal Fire-EMS department. MAEMS is seeking to provide contractual 9-1-1 services for Slumber Valley. Their offer includes:

1. No annual contractual stipend, with guaranteed coverage of all community events at a flat fee rate of $250 per hour, which would include transfers to the hospital and a back up unit dispatched for additional coverage, as needed

2. Guaranteed 8 minute response time for all emergency calls (911 service) with a (95% performance guarantee that includes a substantial penalty schedule for under performance)

3. Established patient care and transportation fee schedules; approved by a municipal advisory board

With increasing municipal operating costs and projected increases, budget margins are projected to be narrowed and fall into deficit balances within three years. Furthermore, a deficit budget is not permitted by municipal code.

SVA has 10 paid paramedics and 14 paid EMT-Basics. The SVA operations manager approached you this week to inform you that several paramedics recently announced that they have an offer to go to work for Risky Valley with an increase in pay of $1.00 per hour and one extra week of vacation time per year.

The SVA fleet of vehicles is aging and will need to be replaced in the next two years.

There is a new 300-bed long term care facility nearing completion half way to Risky Valley.

The Revenue and Expense balance was positive last year, showing excess revenues over expenses in the amount of $48,000, or about 9% of the gross annual revenues.

SVA also has a positive $46,000 balance in a building fund.

With current demographic trends, payer profile mix, and reimbursement schedules, expected revenues are expected to be 4% lower the next fiscal year and are likely to be 8% lower within five years.

You, as municipal manager for Slumber, need to negotiate with SVA and MAEMS for provision of EMS services for your community.