By Barbara Ellestad
[NOTE: While conducting the interview with Fire Chief Andrus, we responded to a fire emergency in his vehicle, which had emergency lights and sirens operating in full. I was appalled at the number of vehicles that did not heed the emergency warnings and the law that requires all vehicles to pull to the side of the street, stop fully, and allow the emergency vehicle to safely pass through. Drivers need to pay attention and obey the law.]
Things are changing in the Mesquite Fire Department as Fire Chief Jayson Andrus marks his first anniversary in the job. “We are evolving from strictly being a firefighting operation to one of emergency medication assistance,” Andrus told the Mesquite Local News in an exclusive interview. “Our roles are changing so we need to adapt.”
The fire chief explained that 87 percent of the department’s calls are medically related. He knows that exact number because of the changes he has implemented in the last year.
“We are more data-driven now than ever before. We know exactly how many calls we get per hour throughout the year because we track and record everything. When an elected official or citizen asks us a question, we have a very good handle on the answer. Our answers come from data now and not just a guess or gut instinct. The days of just standing up and ‘firing away’ are coming to an end.”
Indeed, Andrus used data charts to show that the bulk of emergency calls, 68 percent, occur between 8 a.m. and 8 p.m. “The department never tracked in detail the use of overtime shifts. Because we track that now, we’ve rearranged our overtime shifts to match that workload instead of just guessing when we’ll need extra firefighters,” he said. “That has reduced our costs and made us more efficient.”
Based on a suggestion by former Councilman Dave Ballweg, the fire department has made another significant change that Andrus said will save thousands of dollars on ambulance costs.
“We make a significant number of Inter-Facility Transports (IFTs) from our local hospital to others in St. George and Las Vegas,” Andrus said. An IFT run to St. George takes department personnel about four hours to make. An IFT run to Las Vegas takes about five hours.
“We were using our fully-equipped high-end ambulances to make the transports. Mr. Ballweg suggested purchasing a less expensive van ambulance that costs half as much as a full-size ambulance for many of our transports. We still have the same equipment on board, we still provide the same level of care, but the vans are less expensive to operate.”
A full-size ambulance costs about $280,000 while the smaller van ambulance costs about $143,000. Equipment costs for both size ambulances run about $50,000.
Andrus pointed out that the new vehicle is cheaper to operate while saving on routine costs and significantly reduces the annual miles driven by the larger ambulance units. The useful life of the larger units will be extended thus saving the city the cost of replacing expensive equipment as frequently.
He explained the fuel efficiency and higher gas mileage of the smaller van will save taxpayers thousands of dollars over the next few years. “We’ll be able to buy a new ambulance in what we save in fuel costs over the next few years.”
When it comes to IFTs, Andrus is making more changes, many of them based on data the department now collects and uses in the decision-making process.
About 78 percent of ambulance calls are billed to Medicare or Medicaid. Private insurance-billed calls run about 16 percent. The remaining 6 percent are paid by individuals.
Regardless of the cost of the ambulance run, the two government agencies only reimburse the department between 38 and 51 percent. Medicare and Medicaid patients are not required to pay the difference. Private insurance reimbursements generally run 100 percent of the billed rate.
The department is consolidating ambulance call billing into three overall rates, plus mileage, which Andrus says will make record-keeping easier and more consistent. “It will also allow us to ensure we’re billing for every call at the correct rate,” he said. “We’re not totally there yet and that’s on me. But we’re making significant progress.”
Andrus added, “The city council also approved increased billing rates during the recent budget hearings, which will bring us more in line with the rest of Clark County.”
The department is also instituting a new tracking system to ensure every call is billed and collected upon to help increase revenues.
Reflecting on his first year in the top job, Andrus said “It’s been a hard year, I’m not going to fool you. But it’s been a good year. We have great staff. Deputy Chief [Shawn] Tobler and Sonja [Robinson] have been a tremendous help. We are constantly working to make our department better and serve the community as well as we can.”
He regularly meets with his shift captains and other department personnel. “A large part of what I do now is explain the ‘whys’ of what we’re doing. We didn’t necessarily have that in the past and it was frustrating to me when I was working in the field.”
Andrus said, “Our main concern is taking care of our community. That is our number one job.”