TEMSA Snapshot: James Campbell of MCHD

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James Campbell is the Chief of EMS at Montgomery County Hospital District (MCHD). He also serves as a TEMSA board member.

Chief Campbell joined MCHD in June of 2018 from the City of Celina Fire Department, where he served as the EMS Captain for four years. He helped to develop an EMS system in one of the fastest-growing cities in the DFW Metro area. In May of 2018, he received the City of Celina Employee of the Year Award for his efforts and contributions to the community. He began his EMS and Fire career in 2002 in Fayetteville, North Carolina. Upon returning to Texas in 2008, he joined the City of Celina Fire Department. Chief Campbell is currently pursuing a Bachelor’s Degree in Emergency Health Sciences from The University of Texas Health Science Center. Chief Campbell is committed to working closely with the Board of Directors, other first responder agencies and hospital partners to continue a successful and collaborative healthcare model in EMS.

TEMSA recently sat down with Chief Campbell to look at a snapshot of his agency over the past 12 months.

PPE and supplies. What challenges have you faced? 

James Campbell: Very early during our COVID-19 response our biggest PPE struggle was sourcing gowns.  To combat this problem, we did our due diligence by researching different materials, the intricacies of the virus, and established a partnership with a local fabric and uniform design company.  Through that partnership we designed and purchased a reusable gown that solved the problem while simultaneously setting the organization up for the future safety with respect to PPE.   We were able to get gloves, but not consistent quality or sizes.

PPE. What sources are you utilizing?

James Campbell: We have setup accounts with various vendors for gloves, but our supply of gloves/masks has been consistent.  SETRAC has done well offering PPE in our region as well.

Staffing. Do you have plans for augmenting your staff? Are you relying on the state request for staffing?  

James Campbell: We have augmented staffing to meet our minimum staffing plan needs.  We have had to move District Chiefs (field supervisors) to ambulances, reduced daily PTO allowance, increased the hours EMS administrative staff cover open ambulance shifts, and we’ve adjusted our hiring process to successfully on board new employees in safe and more efficient manner to name a few.

Staffing. Is your delivery of EMS impacted by a decrease in your available staff members? 

James Campbell: We have had a significant number of employees out secondary to COVID-19, and ambulances have been shut down as a result.  This has impacted fatigue, call volume, and responses times.

Staffing. Have you experienced a lot of turnover since the start of Covid? 

James Campbell: We have not. Our 2019 turnover rate was 8 percent, and in 2020, the turnover was 7.7 percent.

Staffing: Have you furloughed staff as a result of Covid? 

James Campbell: No.

Reimbursement. Have you been able to navigate federal funding opportunities – CARES, FEMA, HHRSA for uninsured, etc.? Have you relied on federal funding?

James Campbell: We have not relied on the funding, but have been able to navigate it and have received some CARES funding.

Reimbursement. During Covid, have you had a delay in reimbursements from your normal payment sources?

James Campbell: No.

Reimbursement. Has a revenue decrease during Covid resulted in a difficulty in your ability to respond?

James Campbell. No.

Response. Have you witnessed changes in hospital turnaround times as a result of Covid-19? 

James Campbell: Yes, during the COVID-19 peaks we have seen surges in hospital volume which has resulted in an increase in emergency department turnaround times.  We have worked collaboratively with our hospital partners on multiple plans to combat the wait times.  For example, this recent EMS1 article highlights our utilization of FSEDs.

https://www.ems1.com/transport/articles/alternate-destinations-engaging-freestanding-emergency-department-partners-fGceEJ8HHxGcZ3Je/

Response? Has the increase in Covid-19 impacted your ability to cover your response area?

James Campbell: Minimally, but yes.  Secondary to PPE and exposure control management, some area first responders have staged prior to EMS arrival which has impacted initial patient contact at times.

Transports. How do your transports now compare to the time period before Covid surfaced in March 2020?

James Campbell: We initially saw a decrease in March/April 2020, but have now returned to our normal volumes, comparatively.

Balance billing. Are you familiar with the new balance billing laws in Austin and Washington?

James Campbell: Yes, I follow TEMSA’s discussions at the state and federal level.

Balance billing. Have you had discussions with your billing agency about the new balance billing laws and the potential threats to the EMS exemption?

James Campbell: Yes, our billing department is internal and we have had these discussion and potential implications.

Commercial insurance. Do you have concerns that most commercial insurance companies keep EMS agencies out of network? 

James Campbell: Yes, but we are optimistic that some resolution will come and that our potential conversation surrounding our ET3 plans will further shed light on this situation.

Vaccination. Are you having difficulties getting your staff vaccinated? 

James Campbell: As of today, no.  We have good partnerships with our local hospitals which vaccinated our employees who wanted the vaccine.

Vaccination. Is your EMS agency helping administer vaccines to the public? 

James Campbell: Yes. Our Department of Emergency Management and area hospitals have asked if our paramedics could administer the vaccines at mass sites, which we have been able to successful staff and complete.  We have been working collaboratively at each level to ensure we have an efficient and safe process.

Employee wellness. Do you have resources for getting assistance to your employees for mental health, counseling, etc.  

James Campbell: Yes.  We have agreements with a variety of area counseling and mental health resources in place so we can have both routine and acute availability when needed.

Employee wellness. Do you have a program that you have initiated since Covid-19 to monitor your employees?

James Campbell: Yes. The best thing we have implemented is an Employee Health Monitor.  We developed this position in our internal ICS structure to monitor daily symptom screening as well as daily calls to those employees who are out secondary to COVID-19. Our medical directors have also been highly engaged with employee health rounding and communication regarding COVID-19 and vaccination.

James Campbell speaking at EMS EVOLUTION 2019.