The early 1970s marked a change in how the United States viewed the importance of pre-hospital emergency medical services (EMS). Much of the nation depended upon funeral directors utilizing hearses and mostly untrained individuals to respond to reports of injury or illness. The focus was on speed of transport to a hospital, rather than providing pre-hospital care of a patient. Changes in federal rules and regulations after passage of the Emergency Medical Services and Systems (EMSS) Act of 1973 led the Putnam County Funeral Directors Association to announce they would no longer provide emergency medical transportation by the beginning of 1976.
Indiana Governor Otis R. Bowen (44th Governor – 1973-1981), himself a family physician, recognized the need to make a change in how Indiana residents received pre-hospital care and transportation. Governor Bowen convened a Governor’s Conference on Emergency Medical Services during mid-1973 to address the absence of standards in care, lack of formal emergency medical training and concern that as funeral directors exited the emergency transport business, many areas of Indiana would be left without any pre-hospital care or transportation. That 1973 conference brought about the foundation of Indiana’s modern emergency medical services system, including the formation of the Indiana EMS Commission and designating 9-1-1 as Indiana’s statewide emergency access number.
The DePauw Volunteer Fire Company was formed in 1967 to assist the greater Greencastle area with fire suppression coverage. Following the 1973 Governor’s Conference, several DePauw University students participated in an 81-hour emergency medical technician (EMT) course held at St. Francis Hospital Beech Grove. Douglas Crichlow, Raymond Hill and Michael Lanning developed guidelines to include the concept of an emergency ambulance service to serve not only Greencastle, but all residents of Putnam County.
As a result of widespread community support, enough funds were raised to purchase an ambulance for $13,800.00. Sixteen DePauw University students completed the 81-hour EMT course in Indianapolis, going to school nights above and beyond their university class commitments. May 1, 1974 marked the launch date for Putnam County Operation Life (PCOL) as a division of the DePauw Volunteer Fire Company. The ambulance was stationed at a residence in Greencastle and volunteer crews responded to that location as the first fixed base of operations. The first call was on May 7, 1974 for a sick child. All told, PCOL ran 195 requests for emergency service during the first year.
In October 1974, Putnam County Operation Life was incorporated as a 501 (c) 3 non-profit, and became separate from the DePauw Volunteer Fire Company. PCOL remains a non-profit organization to this day.
At the close of 1975, Putnam County Operation Life had continued to evolve. Not only did DePauw University hold an 81-hour EMT course on campus, attended by many students, but several students already certified as EMTs completed additional paramedic-level advanced life support training in Indianapolis. This continued student commitment to PCOL resulted in the organization being granted provisional certification by the Indiana State EMS Commission as an advanced life support (ALS) provider.
NON-PROFIT COMMITMENT TO THE COMMUNITY
Recognizing the valuable service PCOL provided as a health safety net, the Putnam County Board of Commissioners executed a contract in May 1977 to provide service for the entire county. The first subsidy was $25,000.00 per year. That subsidy did not match the escalating costs of operating an emergency medical services agency which became busier each passing year. PCOL charged a “loading fee” of $45.00 and $2.00 per mile when a patient was onboard, however, the ability to recoup payment for such bills was difficult at times. PCOL entered into protracted negotiations with the Putnam County Commissioners, and eventually, the subsidy was raised in 1980 to $80,000.00 per year.
Up until 2016, the county subsidy remained $80,000.00 even with necessary large scale operational and personnel changes which would occur in the next 35 years – a remarkable feat for a non-profit organization. The original subsidy of $16,500.00 in 1974 would be equivalent to $245,000 today if adjusted for inflation since 1980.
In 2017, the Putnam County Commissioners and Putnam County Council increased the expenditure for provision of 9-1-1 emergency medical services to $400,000 for calendar year 2018, marking a crucial investment in the health of Putnam County residents and modernization of the pre-hospital delivery system that had been largely unchanged for the previous 15 years.
March 1979 was the first time a PCOL ambulance was stationed outside of Greencastle. Operation Life began rotating ambulances to a location in Cloverdale in an effort to provide better EMS coverage and shorter response times for Putnam County. In that same year, Putnam County Hospital moved to a newly-constructed facility on US 231 and for the first time offered 24-hour emergency room physician coverage.
The 1980s saw PCOL purchase a building at 513 S. Bloomington Street, a defunct gas station, which became the new headquarters. An adjacent building at 511 S. Bloomington Street was acquired in 1998 for conversion to administrative and training space. The old gas station was demolished, and a new four bay ambulance station with crew quarters was completed in 2000, fulfilling the vision of then Executive Director Dawn Broughton.
The 1990s reflected growth in Putnam County and increasing run volumes. Full-time staff were slowly phased in and the role of volunteers became less prominent, although a strong relationship with and participation by DePauw University students continued. After running approximately 350 calls during the first full calendar year of operations in 1975, PCOL was responding to around 2,500 calls annually by the turn of the century.
Expansion was not limited to the southern areas of Putnam County. Beginning in 2003, Operation Life was located in Roachdale for four years until the lease on the building they were housed in lapsed in 2007. Recognizing the need which already existed would increase with ongoing county growth, PCOL entered into a 30-year lease with Bainbridge and Community Volunteer Fire Department for the use of the east end of the department’s existing property and then built a new EMS structure. The station, completed in 2008, is staffed with a paramedic level ambulance.
After nearly four decades of utilizing various locations, PCOL constructed an EMS building in 2011 just north of downtown Cloverdale on land it had originally acquired years earlier. The facility constructed was larger than the Bainbridge facility, including twin ambulance bays and featured a natural gas driven emergency generator for uninterrupted operations during periods of inclement weather or large scale emergencies.
In 2015, Putnam County Operation Life was assigned to more than 3,300 9-1-1 requests for emergency medical assistance.
During 2016, we upgraded our cardiac monitors from the aging Zoll E Series to Philips MRx models, increasing our diagnostic and treatment capabilities drastically. This was a major investment in clinical infrastructure representing tens of thousands of dollars.
To meet the increased demands on our fleet and achieve the reliability expectations of our field crews and the general public, Putnam County Operation Life partnered with the County to purchase three Dodge RAM 4500 Diesel chassis and perform consecutive remounts. This provided our EMS agency with its first ever standardized fleet, with the final ambulance delivery completed in December 2017. These triplets have an expected front line service life of three years or 150,000 miles. An aggressive fleet replacement plan has been implemented, with the first ambulance slated for retirement in early 2020.