Warren County selects Matrix Consulting to study fire staffing; EMS medication-exchange rollout and medical director plans outlined

Assistant Chief Madaco told the Warren County Board of Supervisors on Oct. 8 that a competitive RFP process produced eight proposals and that Matrix Consulting Group was selected as the top offer to conduct a comprehensive fire and rescue staffing and station study. "Matrix Consulting Group was selected as the top offer," Madaco said, and the county will receive the full RFP packet and a proposed contract at the next meeting.

Madaco summarized the firm's six-task scope: a project kickoff and steering committee, internal stakeholder meetings and an existing-conditions assessment, a community risk assessment using probability–consequence analysis, an evaluation of current deployment and resource levels, demand and capital-need projections using firm-specific modeling, and delivery of draft and final reports. He said the study would take about 12 months with an additional 12-month evaluation period and estimated the contract cost at not to exceed $68,000 to be paid from the department’s cost-recovery fund balance.

Board members asked about prior studies. Madaco said the last independent analysis took place in February 2009 but described the new effort as more data-driven and focused on forecasting deployment needs rather than recruitment strategy.

On emergency medical services, Madaco briefed the board on the county’s medication-exchange program. He said the county has submitted controlled-substance regulation paperwork and that Valley Health System has agreed to allow the county to retain approximately $29,000 worth of medications currently in existing drug kits, which substantially reduces startup costs. The county plans to install a Pyxis medication cabinet and begin staff training on Oct. 28.

Madaco estimated initial medication procurement at roughly $12,000 and noted that about $4,000 of that cost is attributable to 25 vials of injectable Narcan. In response to supervisors’ questions, he said the vials are single-use once opened and dosing varies by patient weight: "It's 1 time use. Once we crack it, once we stab it, once we draw out of it, we waste the remaining drug that's in it." He added many common medications the county buys come with a guaranteed two-year shelf life, while some cheaper options carry a one-year expiration.

Madaco also warned that the Virginia Office of EMS is experiencing fiscal uncertainty after reported criminal charges and a cited shortfall; he said the county expects the ‘4-for-life’ revenue to continue but that the state has begun reducing funding for some services, such as statewide EMS reporting systems. Locally, he recommended procuring an electronic dosing/protocol system (roughly $9,000) to replace the pediatric Broselow tape approach the state once supplied.

Finally, Madaco updated the board on the county’s operational medical director (OMD). He said the current OMD is leaving his physician group; the county will seek an independent-contractor OMD through procurement, proposing about 20 hours per month (10 hours in person) with compensation for services rendered on a quarterly basis. "We will ultimately be back before the board recommending we retain an OMD, and provide compensation for that level of service," Madaco said. The current OMD has agreed to continue without compensation through year end to allow the county time to transition.

What’s next: administration will place the Matrix Consulting contract and related procurement documents on the next meeting packet for formal authorization to execute, and staff will return with recommended contract language and any implementation-cost estimates for the medication program.