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It should be noted that the additional responsibility for Sebastian has been accomplished without the Fellsmere Division being adversely affected. Although the schedules reflect that the shifts were scheduled to be covered as referenced above, there were shifts in which individ- uals failed to appear for duty for various reasons. When this occurred, efforts were made to locate an individual to pull the duty. On some occasions individuals could not be located and the Sebastian area would be covered by the Fellsmere Volunteer Ambulance Service from Fellsmere as was approved by the Emergency Services Coordinating Committee -on an interim basis until staffing could be improved. The fleet currently being utilized at the Sebastian Volunteer Ambu- lance Service is in need of improvement and steps are being taken to correct this deficiency. Arrangements have been made with the Town of Indian River Shores to purchase a 1980 Chevrolet modular type ambulance with very low mileage which should be delivered prior to August 1, 1988 to Fellsmere. Currently, the two vehicles being utilized have high mileage and maintenance costs are extreme. This problem was externally created due to the.fact that the former Sebastian Volunteer Ambulance Squad Board of Directors had to sell a relatively new modular unit being utilized by Sebastian since May 3, 1988, to satisfy a lien on the vehicle. A grant application for matching funds from HRS has also been submitted to acquire an additional vehicle for use by the service; The financial status of the Fellsmere Volunteer Ambulance Service, which includes the Sebastian Division appears to be solvent. The Finance Director has actively sought and obtained substantial funding since the additional responsibility for the Sebastian service was assumed. Copies of the Treasurer's Report for both divisions as of June 30, 1988 are attached and made a part of this report. The Fellsmere Volunteer Ambulance Service is insured through the firm of Burke, Bogart & Brownell, Inc., and is adequately insured under policy number UL61050739A. A copy of the insurance policy is avail- able for review in the Department of Emergency Management Services. ALTERNATIVES AND ANALYSIS Dr. Tom Moore, EMS Medical Director has expressed concern that the coverage at the Sebastian location was falling below the standard for quality assurance. He felt that this would result in a deterioration in -the quality of care. He felt it was important for the staffing problems to be resolved in a timely manner. He also described the hospitals' willingness to provide funds to hire EMT's to fill the gaps in shifts not fully staffed. The other EMS BLS providers in the County recommended renewal of the Certificate of Public Convenience and Necessity for Fellsmere to con- tinue.service in the North County area. They viewed the service as a vital and necessary part of the overall EMS operation in the County. Improvement in the operation of the North County EMS service was alluded to by the service providers. As referenced above, the issue of adequate staffing continues to dominate as the major concern in the short and long term for both divisions of the volunteer service. Additional requirements for EMT certification mandated by HRS and in-service training have prompted some EMT's to allow their certificates to lapse. The volunteer squads continue to actively recruit new personnel for training and pay the tuition for those who will commit to the in-depth training. The Fellsmere Volunteer Ambulance Squad does not anticipate that they will be able to staff the total twenty-eight shifts at the Sebastian Division in the immediate future. Currently, staff utilized at the Fellsmere location pull a significant amount of the shifts at the AUG 16 1988 19 BOOK 73 t' , 449 L