Edward Fowler has been in emergency services for nearly 40 years. At 57, he said he has one more big adventure left in him.
That adventure is taking place in El Reno, where Fowler is now serving as the city’s emergency management director. He’s helping the City of El Reno launch its own in-house Emergency Medical Services (EMS), meaning it will directly operate the newly established El Reno EMS Department. The service will go live July 1.
The city is transitioning from a contract with a private EMS provider that began in 2019. Fowler said the provider is in an “impossible spot” because insurance reimbursements aren’t keeping up with the costs of doing business. According to a report from the Centers for Medicare and Medicaid Services, ambulance agencies are, on average, under-reimbursed $1,526 per transport across all payer types.
The provider was contracted to offer three ambulances 24/7, and Fowler said that has been “hit or miss.” He also said there were challenges with meeting response time parameters.
“We sat down and started kind of studying … how is that impacting the city? How is that impacting our citizens, and what could we do to make that better?” Fowler said. “Because at the end of the day, these are our citizens, and we have the right and the responsibility to take care of our citizens.”
The model the city settled on is called a “third-service” model. Fowler said although the fire department and EMS work hand-in-hand, they will operate out of separate stations. This model isn’t common, he said, as cities that take over ambulance services often put them into the fire department.
“What happens is some of these smaller cities that put it in the fire department, they decide to make their firefighters become paramedics,” Fowler said. “So they start taking guys off the fire trucks and putting them on the ambulances in an effort to save money. And that is not the right way to do things.”
Fowler said the city has purchased three ambulances to fulfill the new in-house model. He said three trucks are necessary to serve El Reno’s population – especially amid city leaders’ recent decision to annex land along its eastern boundary.
The city will start with two staffed vehicles, with plans to staff the third after gathering data to justify it. Twelve emergency medical technicians (EMT) and paramedics are staffing the first two ambulances.
A separate operations manager will be available to jump on the third ambulance with an EMT in the meantime.
“That's really what the city's looking for is if we're having to do that even once a day, that's one time too many,” Fowler said.
The city hopes to improve coordination with other emergency responders through this new model.
“The interoperability is going to be far greater than what it's ever been before,” Fowler said.
Fowler said he moved back to Oklahoma from Arizona to take on the job of emergency management director. He said it’s been the “most rewarding, exciting and nerve-wracking undertaking.”
It’s one he believes will succeed.
“I’ve got another 10 years in me probably – and I can honestly see doing this project for 10 more years,” Fowler said. “That's a pretty cool feeling.”
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