If Howard County’s two hospitals can’t cover every ambulance run in Kokomo, the next step for city and county dispatchers is to call neighboring volunteer fire departments for help.

And now that the Kokomo Fire Department Emergency Medical Service is no longer running, supporters of laid-off city firefighters aren’t the only ones questioning the new arrangement.

Last Monday, firefighters asked the Kokomo Common Council what would happen if Greentown, for instance, had to send an ambulance to Kokomo because all of the hospital ambulances were busy?

What if, they asked, something happened in Greentown while the Greentown ambulance was in Kokomo?

This week, the Howard County commissioners took up the same question.

Howard County Commissioner Dave Trine said Monday he has received several calls from county residents from Greentown, and County Assessor Jamie Shepherd said concerns have been raised in Russiaville.

“This is a public safety issue,” Trine said.

Ambulances from Greentown and Galveston have been called into Kokomo if no ambulance from Howard Regional Health System or St. Joseph Hospital are available, he said.

“The concern is who will cover Greentown and Galveston,” Trine said.

The Kokomo Fire Department suspended the operation of its two ambulances May 10 as a cost-saving measure. The city entered into contracts for the two hospitals to provide the ambulance service.

Howard County has contracts with both Kokomo hospitals to provide ambulance service throughout the county. The county is divided into two territories.

“This is a legal issue,” County Attorney Larry Murrell said. “The county has a three-way contract with Howard and St. Joseph.

“That contract may have been compromised,” he said. “It is an issue for the commissioners. There appears to be a public safety issue outside of Center Township.”

Nick Capozzoli, administrator for the Howard County dispatch center, said there are times the Greentown ambulance is out of service because of a lack of manpower.

Greentown requires an ambulance be dispatched on each fire run, according to Trine.

Tony Nelson, chief of the Greentown Volunteer Fire Department, said the department’s ambulance has been dispatched once into Kokomo in the past month.

Nelson said it has not been common for the Greentown ambulance to be dispatched into Kokomo when the city provided an ambulance service.

“I foresee there could be a problem,” Nelson said. “It may affect us, particularly in inclement weather when there are a lot of slide-offs.”

Last month, former Kokomo Fire Chief Scott Kern said he expected the number of times dispatchers needed to turn to neighboring communities for ambulance help would increase without Fire EMS running.

But Howard Regional Hospital System chief operating officer Ted Brown said Monday the hospital has been averaging three to four additional ambulance runs per day since Fire EMS went out of service.

He said the hospital has been able to absorb the additional runs with its current ambulance setup.

Last month, Lori Melton, the nurse manager in charge of Howard’s emergency services, said the hospital was hiring two additional staffers to expand the hospital’s ambulance service hours.

Brown said the hospital has one ambulance running 24/7, and said the second ambulance is running most of the time.

“We’ll continue to assess things, and we’ll meet with the commissioners or the mayor, as need be,” Brown said.

St. Joseph Hospital officials couldn’t be reached for comment Monday.

Howard Regional CEO Jim Alender said last month that all parties would need about six months to assess the true impact of the new arrangement.

Nonetheless, there’s already speculation on the “what ifs.”

Nelson said if the Greentown ambulance is in Kokomo, mutual aid would have to be requested from Taylor Township or Converse if an ambulance is needed in the town.

The two Kokomo hospitals provided advanced life support on the ambulances and the volunteers provide basic life support.

Nelson said if a hospital ambulance is on a basic life support run and there is a case of cardiac arrest, his department will have to do the best it can.

“We have to play the cards dealt to us,” Nelson said. “We have to prepare for what may happen.”

Nelson said concerns about ambulance coverage have been raised at Greentown Town Council meetings.

Capozzoli said ambulances from volunteer departments could be dispatched into Kokomo more often since the city no longer provides an ambulance service.

He said Howard Regional is considering adding a basic life support ambulance during the week.

Sheriff Marty Talbert expressed concerns that the county will be charged a higher fee for ambulance runs to the jail because of the advanced life support service provided by the two hospitals.

In the past, Talbert said a Kokomo Fire Department ambulance would be dispatched to handle minor injuries.

He said in the future, the jail may not accept any prisoner from the Kokomo Police Department in need of medical attention without a signed form from a doctor.

“Once a prisoner enters the jail they are the responsibility of the county,” Talbert said. “Kokomo is not going to pay for an advanced life support ambulance run.”

Brown, however, said the hospitals won’t charge for ALS services if only BLS services are warranted.

“It depends on the level of care,” he said. “If it’s BLS care, even if the ambulance has [paramedics] on it, it will still be a BLS run.”