Layout Image

Are you ready for regionalization?

As we look around the nation and see in the media, there exists a bleak fiscal future for public safety. Many agencies have been forced to implement layoffs and furloughs. A recent Denver Post article entitled;

Front-line heroes subject to budget cuts, pay disparity

This article provided a global view of how budget and staffing cuts are affecting EMS systems nationwide including in the City of Detroit;

Detroit’s EMS system has been “decimated’ by layoffs, and other cities have had furloughs, layoffs and “rolling brownouts’ in which a response office shuts down for a day, said Don Lundy, president of the National Association of Emergency Medical Technicians, a federal advocacy group.

Retrieved from: Front-line heroes subject to budget cuts, pay disparity – The Denver Post

This has reduced agency budgets, added work load onto an already strained field staff.  Many EMS agencies are analyzing alternate cost-saving measures. One of the options which makes the most sense both fiscally and operationally is regionalization of agencies. This can be accomplished by consolidating, contracting or sharing services with other providers.

Things to consider as you look a regionalization;

Staffing Levels

You must examine current staffing levels, training levels and Unit Hour Utilization (UHU) numbers, of each agency. This includes a review of all job descriptions, pay policies, volunteer incentive programs, benefit policies, and labor agreements.

Call and Data Analysis

Make an evaluation of all available call data from the communications center, internal reports of each agency and aggregate the data for the proposed new service area.  This review of statistical reports is needed to accurately evaluate the response data to look for trends in volume.

Number of units and equipment

An analysis of each agency’s current call volume, as well as system wide including the source and timing of those calls and the current vehicle deployment patterns, to cover these calls.

Management of EMS

We will recommend any adjustments to the management structure of your EMS system. We will develop written guidelines for management to supplement the recommendations that we make.   Job descriptions will be provided for any positions that are recommended.


Review the true and full picture of the cost of operating EMS service. This should include reviewing budgets of the current and previous three fiscal years.  In most EMS systems there is a more efficient way to get a better quality of care for the same or less money than is currently being expended.

Your service just needs to be willing to change!!!!


Evaluate the need and the location and availability of current EMS deployment stations. Review where current, separate systems overlap. Review the number of vehicles and/or system status posting locations to best serve the community’s needs.

Management of EMS Agencies

Make an analysis of the current management structure of the EMS system. This must include reviewing the credential of the current system leaders, with an eye towards overlapping responsibilities .  An immediate area to focus on must include dispatch center staff and human resources, as these services can easily be consolidated for cost savings.

Potential Growth Areas / Marketing / Outreach

Conduct a review of growth opportunities within a defined region and explore new markets that exist in the area, and neighboring areas. Then conduct an analysis of cost / benefit of expanding current service models. By examining the service area, you can determine the most effective course of action. Review current public relations strategies.

The initial steps in this process must begin with the following:

  1. Be willing to make changes to your organization.
  2. Obtain buy in from local government officials.
  3. Be willing to make changes to your organization.
  4. Obtain buy in from other EMS agency leaders.
  5. Be willing to make changes to your business model.

Consolidation of EMS agencies can yield both short and long-term cost savings through economies of scale. The number one goal must be to enhance your service delivery, reduce response times which may be shortened by eliminating previous service-area boundaries.

This process is not easy. The first obstacle most often faced is the EMS folks themselves. The unwillingness of  EMS professionals, either paid or volunteer to remain open minded. We often forget although it is our turf, we are being protective. It may be at the expense of better service and ultimately better patient care.  The strength of any team is in numbers, just ask any youth sports coach. (I can speak first hand).

Once you decide consolidation is right for your service you must prepare an action plan complete with a time tables for the assignment of tasks. This can then later be developed in the business plan for the new agency.

Remember the key words are Willingness and Buy-in!!!

Feel free to contact us if you need guidance in implementing a regionalization plan. Our consulting team will give you a few ideas, and assess if we’re the right fit for your project.

What do you think? Share your thoughts!

Leave a Reply