Thursday, Feb. 21, 2008

District 11 ambulance service: 'We will not be bullied'

by Clarke Davis

District 11 Emergency Medical Service operates a fully licensed ambulance service under the direction of a physician and will continue to do so unabated and without kowtowing to the county ambulance service.

Those are the words that more than 100 people heard when they attended a District 11 board meeting Feb. 12 concerning ambulance service at Valley Falls.

“We want a mutual aid agreement with the county ambulance service, but we will not be dictated to. We will not be bullied,” said Rick Johnson, District 11 attorney.

The meeting came as a response to the inability of the two ambulance services to reach a working agreement and the perceived threat by the county to put District 11 ambulance out of business.

A five-page mutual aid document was created by the county ambulance service and County Attorney Mike Hayes. District 11 asked for only two changes in that document, namely:

1) Instead of neither party having the ability to cancel paramedic assistance, District 11 asked that it have the option to cancel in minor cases after assessment of the patient, (Jefferson County is staffed with paramedics, District 11 is not.) and

2) The agreement required that the county be the transporting agency for all patients, which was unacceptable to District 11.

District 11 believed that under this agreement, without the changes, it could not move a patient until a county ambulance arrived and it could not transport a patient once the county showed up. In other words, the ambulance service would be out of business.

The governing board has hired a national law firm that specializes in emergency medical services to work with Johnson and it has determined that no county resolution supersedes state law.

District 11 will continue to operate as it has since 1983 and “in the small number of cases where our intermediate EMTs might require the services of a paramedic, we will notify the county and request that their paramedic board our ambulance and assist us in providing care during transport,” Johnson said.

“We would hope that any agency from which we request mutual aid would provide it when asked, just as we would provide it to them, if asked,” Johnson said.

The attorney informed the crowd that the county’s actions were only for the purpose to commandeer local patients — in the ambulance business, reimbursement is made only to the service that transports the patient to the hospital.

“If you want to see what the county is truly up to here, all you have to do is follow the dollars—the dollars follow the transport,” Johnson said.

“When you consider that the county’s desired approach would only further delay patient care and add little, if any, benefit to the already high level of care we deliver, it becomes even clearer that this is about dollars and cents — the county wants the insurance money from district residents,” he said.

The two sides are not at complete loggerheads. Johnson credited Hayes with suggesting that the two medical directors for the ambulance services see if they can come to terms.

Johnson believes the doctors’ only concerns will be what is best for the patient and has hopes they can have an effect in bringing the two groups together. (Update: The paper has been informed that this idea was shot down by the county commissioners.)

The District 11 EMTs were given unanimous support from the large crowd who attended. Many took the opportunity to give testimony from past experiences:

—They don’t know where I live, one person said, referring to the county service. She said it took the county 45 minutes to reach her home once, but local EMTs would arrive within 11 to 13 minutes.

—It’s comforting to have people you know show up.

—What do we need to do to keep it? Get a contract out on the man? (referring to whomever is trying to dictate their will over District 11.)

—The 25 years of service has left a fantastic record proving it’s a needed and desired service and has operated with good judgment, sound logic, and has never faced a lawsuit.

—It’s neighbors helping neighbors.

—For years it operated on donations, bake sales, and memorial money. All of the residents of Sunset Haven signed a letter of support and a letter by Kendall State Bank officer Gary Coleman was read.

Concerns were raised over the county dispatch service with one person asking if the 911 service could refuse to alert District 11.

Johnson said he could not believe 911 dispatch would jeopardize someone’s life over the dispute, but that legally District 11 was prepared to meet any challenge and that meant going to court if necessary.

A Nortonville resident wanted to know why District 11 was not making runs into that community. Ambulance chief John Gordon said that’s a decision made between the county and local officials in that community. He said there are people who have his private phone number and if called they still go.

Johnson said the local philosophy—and that of the medical director—is “scoop and run.” Time in getting to a Topeka hospital is too vital to wait, but that if a paramedic is needed, District 11 will meet the county ambulance at the junction of K-4 and 92 (the same as in the past) where a paramedic will be invited to board District 11’s ambulance. District 11 can also summon an air ambulance for the patients in greatest need of full medical attention.

“The patient will not be moved from one ambulance to another,” Johnson said.

The EMTs can start a patient’s IV, but unlike a paramedic they cannot administer any kind of drug.

Gordon said there is one person on the local ambulance crew who is thinking about acquiring paramedic status, but that it takes a couple of years and a lot of dedication to accomplish. He said there are grants available and the local board would help someone financially who wanted to undertake it.

District 11 is financed with donations and insurance collections. It receives no tax dollars.

The Jefferson County Ambulance Service collects insurance and is funded by a county tax levy that is currently 1.8 mills taking in $262,000 in taxes this year. Taxpayers in District 11 support the county service.

The crowd left the meeting being told that there was little else they needed to do. Attending the meeting and showing up in large numbers was expression enough that the District 11 ambulance service was wanted and needed.

They were assured by Johnson that the “county cannot shut us down and they will not.”