The discussion about Clark County’s EMS situation entered a new phase Tuesday with the first meeting of a joint committee examining operations and the current agreement.

The committee was created during the August joint meeting of the Winchester Board of Commissioners and the Clark County Fiscal Court with the task of reviewing the current operating agreement as well as EMS operations as a whole.

Winchester Mayor Ed Burtner, Clark County Judge-Executive Chris Pace, magistrates Chris David and Greg Elkins, and city commissioners JoEllen Reed and Ramsey Flynn were all appointed to serve on the committee.

Burtner, who was city manager when the Winchester Fire Department and the Clark County Ambulance Service merged in 1990, said the initial agreement called for the city and county to split any budget overages 50-50. Burtner said both the city and county were already financially supporting the ambulance from their respective budgets.

“It was a very difficult negotiation between the city and county,” Burtner said. “What we had to do was basically figure out a way to meld the ambulance service positions into the city.”

In 1997, the agreement was amended for the city to pay 55 percent of any expenses above the budget, with the county paying 45 percent. Those amounts, he said, were based on population in and outside of the Winchester city limits.

“I think we all agree this agreement is dated,” Davis said Tuesday.

Tuesday’s discussion largely centered around transfers from Clark Regional Medical Center, and what constitutes an emergency or non-emergency transfer.

Winchester Fire-EMS is struggling with a number of issues including increasing run volume as well as challenges in recruiting and retaining new firefighters, EMTs and paramedics. Winchester Fire-EMS Chief Cathy Rigney said previously adding staff would allow the department to take more transfers, which in turn generates more revenue.

After a staff increase to add 10 positions for a fourth ambulance was not included in the city’s fiscal year 2020 budget, the city commissioners voted 3-2 in July to add six positions as well as a budget amendment to fund the positions.

CRMC officials said previously they have had to call ambulances from other counties when Winchester Fire-EMS did not have staff available to take patient transfers.

Tuesday, Rigney said emergency transfers, which are being discussed, are from one health care facility to another, where an non-emergency transfer would be taking a patient home from the hospital.

Even if the department was fully staffed, Rigney said Winchester would not be able to handle all the transfers from CRMC.

“I’d like to see EMS get out of the business of non-emergency transfers,” Davis said. “I want emergency responders to be worried about emergencies.”

Elkins said he would like to see the county have more input on EMS expenditures than it currently has.

In recent years, the department has added single-role paramedics and part-time patient transfer specialists to the staff. Rigney said the department has continued to struggle with staffing.

Competition for paramedics and EMTs has grown has hospitals and others have begun hiring paramedics rather than nurses.

The committee is scheduled to meet again Oct. 2 at Winchester City Hall.