No Membership, No Ambulance

[EMS49393]

Ambulance refuses call

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Ambulance Refuses to Respond to Rural Medical Call

McCrory - Medical emergencies happen everyday, and patients expect an ambulance to come quickly when they call for one. Channel 7 News, however, has learned of an ambulance company that refused to come in certain cases and the next-nearest service was more than 30 miles away.

Melissa Bumpers, 57, was at her home in McCrory when she fell to the ground around noon December 31. When a neighbor called 911 for her, the dispatcher promised an ambulance would get to her soon but Woodruff County Ambulance Service had its only two units out of the county on other calls. The only other service in the county, Southern Paramedic, which was not obligated to respond, initially refused to go on the call. This was the radio call that ensued:

SOUTHERN PACIFIC: "Medical Dispatch. What's your emergency?"

911 OPERATOR: "Yes, ma'am. This is Alex at Woodruff County. I need your Augusta unit, southern, it is 10-8, right?"

SP: "Uh, huh."

911: "I need it to go to McCrory for me....I have got a lady who is unconscious. Her neighbor found her on the floor and can't get her to respond."

SP: "You all don't have any units to go to McCrory?"

911: "No, we do not."

SP: "'Cause I don't think we can take the call."

911: "Yes, I assure you, you can."

SP: "Does she have a membership?"

911: "I do not know that."

SP: "You don't know?"

911: "No."

SP: "Understand. We can't take it."

911: "Okay, thank you."

911 Dispatch Log: "I then called my supervisor for some guidance what to do. She advised me to get an ambulance, so I called North Star (Searcy)!"

While the 911 operator worked to get an ambulance from North Star in Searcy more than 30 miles away, Southern eventually agreed to make the run.

SOUTHERN PACIFIC: "Medical Dispatch. What's your emergency?"

911 OPERATOR: "Yes, this is Alex with Woodruff County. I need your unit to go to McCrory NOW."

SP: "Excuse me?"

911: "I need a unit in McCrory. I have a possible heart attack."

According to a dispatch log, it took 25 minutes for an ambulance to arrive, and relatives tell Channel 7 News by that time, Mrs. Bumpers had already died.

(O.C. Bumpers, Victim's Husband)

"It's frustrating. The only thing I can say is if they have some kind of problem going on, they need to straighten it out in case it happens to somebody else. They really could have saved somebody else's life if not her's. The situation going on right now, it's just a sad situation."

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(Chief Deputy Jim Harrison, Woodruff Co. Sheriff's Office)

"I was born and raised in Woodruff County. This is my county. The job I have, I help people and I cannot understand why somebody would refuse to help somebody in need."

It's not just a problem for the residents of McCrory, but for anyone who travels through the area.

(Gary Padget, Southern Paramedic Service CEO)

"It's a major highway. It's very well traveled. You have tourism that comes through to go to Greers Ferry Lake....There is a lot of traffic there, so if you have a major wreck and there is no ambulance, you have a problem."

Padget says his company stationed an ambulance in McCrory last year and asked the McCrory City Council to place his ambulance service on the 911 rotation.

(Gary Padget, Southern Paramedic Service CEO)

"The city council constantly gave us, 'Well, let us think about it and evaluate it,' and time rocked on and they didn't do that so we felt like, 'If you don't need our services then we will leave,' and we did."

McCrory Mayor Ronnie Pittman says the council followed the advice of the Arkansas Municipal League.

(Mayor Ronnie Pittman, McCrory)

"The council felt we should not be involved in the decision making of which ambulance each citizen uses. That should be their choice, use any ambulance they wanted to use."

But Padget says it comes down to money, and if Southern Paramedic isn't on the 911 rotation, the company can't afford to keep a unit in McCrory and would have to break its current contract with the nearby city of Augusta to respond to emergencies there. So, right now Southern is refusing most calls to McCrory.

(Gary Padget, Southern Paramedic Service CEO)

"If you're not welcome, you have no tendency to go somewhere."

Channel 7 News asked Mayor Pittman if the city would reconsider putting Southern on the 911 rotation, but he said he has not heard from anyone with Southern since the ambulance service closed its McCrory office.

To help the situation, Devin Barker, owner of Woodruff County Ambulance Service, says his company is in the process of adding a third ambulance to its McCrory base.

(Devin Barker, Woodruff County Ambulance Service Owner)

"I'm doing the solution that I think's best, is offer my community and my county another ambulance on the way so there is no problem."

But Deputy Harrison is concerned that is not enough.

(Chief Deputy Jim Harrison, WCSO)

"I just need some help in straightening this situation out. I need ambulance services to work together and to help the people of Woodruff County....[Otherwise,] someone is probably going to lose their life."

Bumper's relatives don't know whether a quicker response time would have saved her life, but they hope no one else ever has to go through a similar situation.

(Ellar Vann, Victim's Sister-in-Law)

"I pray that whoever, if you call, if someone calls, you don't tell them, 'I'm not coming because I don't have a contract with you over there.' I think you should come. If there is a need, I think you should lay aside whatever and just be there for the patient."

Channel 7 News' investigation uncovered the fact that not every city in Arkansas has an ambulance service, but the state says there is one in every county. Officials with the Arkansas Department of Health say help is on the way in the form of grants to upgrade emergency medical services across the state to make them ready for the new trauma system. More than $2 million is set to go to ambulance services that have applied for upgrades and special training.

[Chief1C]

What ever happened to just being there, for the people, who need help?

[medicKristina]

What ever happened to just being there, for the people, who need help?

I HAFTA AGREE!!! I can't even begin to explain how wrong this is on how many different levels. And no, I'm not a COO or CEO of an ambulance company and set up contracts. However, what happened to JUST HELPING and TO DO NO HARM???????

[Lone Star]

I've never understood the 'membership' thing, especially when it involves municipal services.

Since the municipality is providing those services, your tax dollars (property tax) is where their operational budget and funding comes from.

In some areas, there's also Community Devlopment Block Grants (CDBG). These grants help defray operational costs for 'essential services', especially in the less affluent areas.

If the municipality is providing 'essential services', then the 'memberships' are nothing more than that srvice 'double dipping' into the residents pockets. I do believe that is illegal.

I would have thought that when a call for mutal aid goes out, the assisting agency would waive 'membership status'. Refusing to treat a 'non-member'; wouldn't that quaify or onstitute a breech of duty to act?

For those of you that are part of a 'membership service', I have a question....

You have one truck available and two calls from two members...who has 'priority' (all things being equal, distance, severity of the call....

Secondly, do you bill your 'memebers' for services rendered? Is this in addition to the 'membership fees'?

[emtannie]

OK, I am probably going to ruffle feathers with this post….

I am still trying to understand the American way of healthcare. It is my understanding that the reason that ambulance services are, for the most part, private, not municipal, is because the population does not want the government to run their healthcare, but they want to have it run like any other private business. As such, as a private business, an ambulance company offers a service, and can refuse customers who don’t meet certain requirements, just like a car dealership, or a bank. Do I understand that right?

As well, if people want ambulance services, they have to pay for it, like any other privately owned service, like shopping at the grocery store or using a taxi service.

In this case, it is terribly sad that this woman died, and it is terribly sad that the one ambulance service already had 2 units out on other calls and could not attend. It is also sad that the other service was unwilling to respond. But, if I understand the US theory of ambulance services, as a private company, they were under no obligation to respond given their current contracts with municipalities.

It is a sad sad thing that this woman died. It is a sad sad thing that her family has to deal with that. It is a sad sad thing that everyone feels bad about it… but isn’t that the way it works?

OK, please realize that the above was written in a sarcastic bent. I know that the members here in the city are here because we want to learn from each other, and want to learn how other systems work, and how we can make our little corner of the EMS world a little better. I would love to have this article never been written because it never happened. I agree with those who have posted the opinion that we are there for the people.

But my question is: how can we be angry at the service that didn’t respond, when the system is set up as a profit-generating organization, and decisions are based on bottom line profits, not ethics?

[CBEMT]

OK, I am probably going to ruffle feathers with this post….

I am still trying to understand the American way of healthcare. It is my understanding that the reason that ambulance services are, for the most part, private, not municipal, is because the population does not want the government to run their healthcare, but they want to have it run like any other private business.

You went wrong right there, so the rest of the post is pretty much moot.

There are more privates than municipals services, yes. But there are also far more private transports (dialysis, discharges, etc etc) than 911 transports. Since the municipalities aren't going to do that, it's by necessity. Not because we like it that way.

On the 911 side, there are far more municipalities running the EMS than privates. And even where the privates do run the calls, 95% of the time it's by contract that covers everyone within the city/county limits.

Now if this county service asked for what amounts to mutual aid from this private and they didn't get it, well, that's obviously not good, but its true that the private has no legal obligation to respond. I would think the goal at that point would be to get SOMEBODY ELSE, but I guess county dispatch didn't have a plan for that. Doom on them.

If it it was the private I used to work for, they can and will send a truck from 20+ minutes away if they have to- but they WILL send a truck to a municipality or facility requesting. I've been pulled from responding to a transfer to go to an emergency more times than I can count. Emergencies ALWAYS took priority. Maybe that makes us the exception, but it happens all the time.

Edited April 19, 2010 by CBEMT

[Dustdevil]

If they want to blame someone, they need to blame their own city council, who let the other ambulance service slip away. Hell, they weren't even asking for money, just a place in the rotation! The only reason to refuse an offer like that is politics.

[EMS49393]

Several have hit the nail on the head... No contingency plan. No "what if our trucks are out" plan.

Is it wrong to refuse to respond to another area? No, it's not wrong, it's highly UNETHICAL, but not wrong, nor illegal.

Is it wrong to be in charge of taking care of a community (a township, a county, etc.) and not have an emergency plan in place? Yes, very wrong. It's your job as an elected official to make certain that taxpayer money is being allocated to provide EMS, fire, and police services, or you're not protecting your community.

The problem has several parts, and neither side will ever admit fault, and ironically, it was this refusal to compromise that led to a story such as this.

The private service can't do it for free, and they state that if the county would have thrown them a bone with some 911 calls they would have played nice in the sandbox. Its a pile of BS (as I know of this services practices personally) but at least they were at one time willing to be in the area, and the town was unwilling to let them make a profit. So instead of refusing to run calls in the city that peed in your cheerios, how about send them a bill every time they call you to bail them out? Makes entirely too much sense. What am I thinking?

I'll tell you what the problem is, it's money and penises. It has nothing to do with the public or patients. It's the dollar and the pee pee size.

It's freaking sad.

Regarding the government health care issue in my country. There is no way Americans will go for this for long. They are already mad about how much they pay in taxes. Could you imagine if we had the taxes most other countries that have full services such as health care and EMS pay? Tea party that tax hike.

I am an average person with an average living. I paid roughly 10% in income tax last year. Its no wonder I can't get decent health care and my roads are covered in potholes. Most other countries would kill for 10% income tax, but what do you sacrifice with that?

[mobey]

Several have hit the nail on the head... No contingency plan. No "what if our trucks are out" plan.

Is it wrong to refuse to respond to another area? No, it's not wrong, it's highly UNETHICAL, but not wrong, nor illegal.

Hang on.....

Don't ethics dictate the difference between right & wrong? or is it strictly laws?

If some old lady is struggling to hold a door and get her walker through, I think the majority of people would say it is "wrong" of me not to help. Not illegal... just wrong.

Morals and ethics dictate right & wrong... therefor it is indeed, "Wrong" not to respond.

[EMS49393]

Hang on.....

Don't ethics dictate the difference between right & wrong? or is it strictly laws?

If some old lady is struggling to hold a door and get her walker through, I think the majority of people would say it is "wrong" of me not to help. Not illegal... just wrong.

Morals and ethics dictate right & wrong... therefor it is indeed, "Wrong" not to respond.

You and I would say it's wrong, because we are human and believe in taking care of people aside from profit. Morals and ethics do not dictate laws, and the law says they are not in the wrong.

My point is, where lies the flaw? The company acted in an unethical manner, but the government that writes the laws permitted this unethical behavior.

It's not a single-fold problem, it has many levels, and it's a fantastic lesson on the American Way.