Seward County EMS Director John Ralston leads his workers to the risers at Cottonwood Intermediate’s Patriot Day ceremony last fall. L&T file photo/Robert Pierce
By ROBERT PIERCE
• Leader & Times
Seward County EMS Director John Ralston was recently reappointed to serve a four-year term on the Kansas Board of Emergency Medical Services.
Ralston said responsibilities of the state board is primarily to oversee the functions of EMS in Kansas.
“We’re the regulatory agency of all the pre-hospital care as far as all of the ambulances, including the helicopters and planes and ground vehicles that provide care in Kansas,” he said.
Though he was not completely sure, Ralston said he believes KBEMS is the only state functioning board with actual legislators from the Kansas House and Senate on its board.
“None of the other places do,” he said. “They just have members of the specialties. We’ve got physicians. We’ve got administrators. We’ve got educators.”
Ralston has been on the KBEMS board since 2010. He said the board conducts a rotation of meetings once every other month between Thursdays and Fridays.
“It’s the first Friday of the meeting months,” he said. “The Thursday meetings are for the specific sections of the board.”
The board is made up of some committees, and Ralston serves on a few of those.
“I’m the vice chair of the investigations committee,” he said. “We meet on any investigations or complaints that we have had filed on anybody in the state. We discuss those and work really closely with the attorney general’s office to get those things taken care of.”
Ralston likewise serves on KBEMS’s education and examination committee, which takes care of new regulations and legislation that supports changes in the emergency response industry.
“We have to get those submitted and proposed to the executive committee so the executive committee can get them to the legislators to get them put into regulatory language,” he said.
Naturally, Ralston sees serving on the board as an honor, and while he believes doing so is a good thing, KBEMS has many of the same flaws as other commissions and boards.
“You go in there thinking you’re going to be able to change some things, and then you realize the processes are there,” he said. “The reason the processes are there is because is you have to make a decision based on 13 people coming to the conclusion of what that decision is. It makes it really difficult at times. You can’t solve everybody’s problems. You can’t regulate everybody.”
Ralston said part of the duty of KBEMS members is to look out for services in Western Kansas, many of which are volunteer, which he said adds to the difficulty of the board’s decision making process.
“We don’t want to implement something that’s going to impact that service having to close,” he said.
KBEMS also has a duty to protect the public, according to Ralston.
“It becomes a challenge,” he said. “We work closely with the state board of nursing. A lot of our stuff collates with them. Occasionally, nurses do work on ambulances.”
Ralston said the board sees regulatory change all the time, and most recently, the scoping process was examined and updated.
“It changed what an EMT could do and what an EMT advanced could do and what a paramedic could do,” he said. “It changed that across the nation. They were trying to get more states in line with a scope of practice as opposed to a protocol.”
Kansas was one of the first states to take this approach, and Ralston said many states are following suit and using the state’s model to do it.
“It didn’t go real smooth, but we’re getting down towards the end of it,” he said. “We lost a bunch of people because they didn’t want to go through the educational process.”
Ralston said serving on KBEMS has made him a better director.
“It’s made me more in tune with the changes,” he said. “I can predict the changes a little quicker. I can see them coming. I think it was something I needed to do. It was a goal when I started in EMS to eventually migrate up to all of it.”
Before he became director of Seward County’s EMS, Ralston worked as a firefighter and a medical training coordinator for a fire department.
“I worked in the field for many years,” he said. “I started in ’82 here in Liberal. I served on the Fire Service Training Commission, which is another governor appointment. That was up this month.”
Ralston said he still plans to serve in that capacity, but he said a new person is being sought for that position.
“I’d like to get somebody that’s more fire service oriented in there that’s closer to Topeka that can make the meetings,” he said.
Ralston likewise has served on the Advisory Council on Trauma for four years, and he described the people he meets and the things being discussed in his work on the boards he serves on as “interesting.”
“There’s a lot of people out there who care about health care, especially rural health care, and it’s a challenge to keep that going,” he said. “I applaud anybody that’s involved in it. It is a challenge to keep those people in those rural communities. The growing trend is going to work somewhere in a facility. It’s not the Dr. Grimes and the Dr. Holcombs who set up a practice, and they basically work themselves into the grave.”
Ralston said the new trends involves people who want to have weekends off and work with a big group of doctors.
“It’s what they’re looking for, and I don’t blame them,” he said. “That’s a challenge for medical communities to do that, and it puts a burden on all of us.”
Ralston said the KBEMS board has no term limits, and with a total of 13 members, nine appointed by the governor and four by legislative leadership, a good diverse population is one of the aims of the group.
“They don’t want just big city,” he said. “To run our ambulance service is a lot different than to run Sedgwick County’s. We don’t have as many people available to hire. We have to train our own, which takes time. We deal with different issues. They can put out a listing, and they can test a hundred people per position. It’s pretty competitive.”
Ralston has met many legislators in his time on the board and has likewise learned how laws and regulations are done.
“In dealing with that, it has really been entertaining to see how much a ‘with’ and a ‘for’ and an ‘a’ can change how an attorney interprets a regulation,” he said.
Like most medical organizations, KBEMS deals with the ever changing world of Medicaid, and Ralston said what has been done in many other places and proven successful are community health programs, which he said affect both health departments and EMS.
“It’s going to have to be something where you have a lot of physician input, a lot of nursing input, a lot of PA’s input, a lot of nurse practitioners input to make sure we have it rock solid before we implement it,” he said. “That’s going to be really a tough nut to crack.”