08-24-2017 Hartford City Council continues discussions to retain Medic 1 at a special meeting, then,
Hartford City Council continues discussions to retain Medic 1 at a special meeting, then, at workshop, proposes to vote on resolution to drop service contract at August 28 meeting
By Nancy Albright
At a special meeting held on August 16 the City Council resumed discussions around retaining Medic 1 Ambulance as Hartford’s emergency services provider for 2018.
Three issues have officially been under discussion since March 7, 2017: That Medic 1 to station an ambulance in Hartford on a routine basis; the emergency dispatch protocol; and the Hartford ambulance being put into use as a transfer vehicle.
As explained in March by Medic 1 Operations Manager Bob Hale Hartford and Watervliet Township share the cost of one emergency vehicle. An ambulance is stationed in both communities on a regular basis.
Hale explained further that emergency vehicle operations are coordinated by Van Buren County Central Dispatch, the county-wide hub for emergency fleet logistics. Medic 1 does not contact other providers directly to request backup when needed to transfer patients.
Asking the questions
Mayor Ted Johnson opened Wednesday evening’s discussion by voicing his dissatisfaction with Medic 1’s response time to a 911 call he placed at 4:04 a.m. on Wednesday, August 16, 2017. Johnson stated that by his estimate the emergency vehicle arrived at his home approximately 35 minutes after he placed the call. His call was answered by Cass County 911 services where he was requested to answer a series of questions, which subsequently resulted in the call being routed to Van Buren County 911 where he answered another series of questions.
There are two Van Buren County 911 operators on duty during the early hours of the morning. If both operators are engaged on other calls the phone system automatically routes calls to Cass County 911. Cass County routes calls back to Van Buren County as soon as Van Buren is available. Hale explained that the call routing issue has nothing to do with Medic 1. The protocol is out of Medic 1’s control and the ambulance service is not in a position to change it. Hale did however offer to act as an advocate on behalf of Hartford to bring the problem to the attention of the proper Van Buren County authorities.
City Commissioner Ron Burleson asked Hale how Medic 1 is dealing with the high level of road construction currently taking place in Hartford. He believes an ambulance always sitting in Hartford would lower response times in light of the construction on I-94.
Hale said that Medic 1 adjusts routes based on travel information received from the Van Buren County Road Commission and current reports state I-94 is passable. When asked about the construction project at Red Arrow Highway and 72nd Street, Hale said the project is now complete and that ambulances traveled through the construction with the exception of a couple of days where drivers adjusted their routes.
Township trustee John McClellan told the council that he has heard no complaints from the public. He asked the council if any of them have complaints about Medic 1 service, to which all responded “No” with the exception of Mayor Johnson.
Weighing the options
Hartford resident Judy Sinclair asked the council if they have investigated other emergency service providers such as Pride Care or spoken with other municipalities. “You need to look at the pros and cons of other emergency services.”
Medic 1’s base response time for Priority 1 calls is 12 minutes. Pride Care’s base response time for Priority 1 calls is 8:59. Pride has 21 vehicles, 13 of which are on the road 24/7 covering 530 square miles in Van Buren County. Medic 1’s fleet consists of 13 vehicles, six of which are on the road 24/7 serving a population of 125,000 residents in both Van Buren and Berrien counties.
Medic 1 operates the only paramedic training program in Southwest Michigan and requires mandatory training on a quarterly basis. Fifty percent of current staff has ten or more years of paramedic experience, and rotating crews among stations provides a variety of experience in various medical emergency scenarios. Pride Care EMTs receive training from an accredited college on a regular basis, requiring 45 hours to renew certifications, and suggests that paramedics continue professional education with external agencies on a monthly basis.
Paramedics from both providers receive training and are certified in the same programs, such as Advanced Cardiac Life Support and Pediatric Advanced Life Support.
Regarding staffing issues, Hale and Pride Care CEO Bill Mears agreed this is a national problem. There are increasingly fewer applicants for EMTs and training programs are costly and time consuming, a 1-1/2 year course of study costing anywhere from $7,000-$10,000. Medic 1 has hired a professional recruiting firm specializing in paramedic recruitment, and the ambulance service pays training fees for good employees and offers discounts.
When short-staffed, Pride Care utilizes a mandated policy to keep all designated vehicles on the road. If volunteers are not available to cover, paramedics are drafted and must report to work. Medic 1 also follows a mandated policy, but doesn’t like to use it; failing to report results in points against EMT records. According to Hale, “Me and my boss will go on the road at any time if required.”
When cost was raised Medic 1 Board Chairman Pete Sinclair said that, “Medic 1 has the lowest rates in Southwest Michigan. I’m positive of that.” Medic 1’s basic 911 rate is $750.00; Pride’s is $895.00.
Pride Care uses Type II and Type III emergency vehicles. The Type II units are high-top vans with crumple points that are designed by OEM engineers specifically with safety in mind. Which type of vehicle is used depends on the community, some do ask for the Type III box vans. Type III vehicles have more space for equipment, patients and paramedics, but Type II vehicles have adequate space, more than air transport vehicles.
Both companies use 12-lead defibrillators which send EKGs from the scene directly to the hospital. Medic 1 carries Lucas CPR Compression Systems that perform automatic CPR, but Prides does not. Mears said that Medical Control feels chest compressions are more effectively performed by humans and the CPR device is not yet the gold standard, but if Hartford asks for the devices Pride will purchase them.
Both Medic 1 and Pride’s vehicles are equipped with all standard equipment, including invertors that allow for the use of specialized equipment needed for critical care transfers.
In response to a question asked by Commissioner Terry Tibbs regarding mutual aid, Mears said that Pride requests mutual aid on average one out of every five calls and that all emergency agencies require mutual aid, not just Medic 1. “That’s how it works throughout the country,” Commissioner John Miller agreed. “It seems like mutual aid and service should be commonplace.” Commissioner Dennis Goss asked the council, “If there is a fire do you care who puts it out as long as it’s put out? I think we need to look at this issue this way.”
Mears told those assembled that Pride Care has the competitive advantage. “I’m not saying we do a better job than Medic 1. Medic 1 is here to do a good job. The difference for us is that we have more resources. Our response times will be lower because Hartford sits in the center of our service area – the “doughnut hole” – and there are three ambulances within 10 minutes of here. Medic 1 has one ambulance dedicated to Hartford. We are 100 percent ready and willing to jump on board to serve the Hartford community.”
Mears explained that eighteen months ago Pride offered to build a shared sub-station off of I-94. There is not enough volume however – according to Medic 1 Board Chairman Pete Sinclair, an average of one call per day in the last year in Hartford – to warrant the building to be used only for the City of Hartford. Pride also uses a software program that allows users free access to see where vehicles are at all times.
Hartford resident David DeMorrow told the group that he is satisfied with Medic 1’s service, stating that, “I’m happy with Medic 1 because they provided my wife with a life-saving event when I found her not breathing.” Medic 1 was on scene five minutes after he placed the 911 call. “Why fix what’s not broken? Is it broken?” asks DeMorrow. Commissioner Ron Burleson stated that, “Yes, promises made have been broken.” When a member of the audience asked Burleson to provide an example, none was offered.
Township trustee John McClellan told the council that he has heard no complaints from the public. He asked the council if any of them have complaints about Medic 1 service, to which all responded no with the exception of Mayor Johnson.
Hartford resident and candidate for City Commissioner Helen Sullivan said that the City of Hartford Facebook page indicates that many want to keep Medic 1. “Until tonight no one has articulated these issues to the public. I would hate to see the baby thrown out with the bath water. Take your emotions out of this discussion and do what’s right for the City of Hartford. Maybe it’s not time to change services. Keep these lines of communication open.”
Discussion continues at workshop
At the August 21 City Council Workshop discussions continued after the council put forth a resolution for the city to opt out of using Medic 1 as the city’s ambulance service in February 2018.
The decision whether or not to opt out of using Medic 1 will be independent of the emergency services provider Hartford Township decides to use. Commissioner John Miller made the point that if the city and township were to use two different ambulance services then the possibility exists that if one service is engaged with one patient, then another patient may have to wait for another service. Miller stated, “Someone could die because we can’t work together.”
Pride Care CEO Bill Mears then commented that, “We have no problem sharing data and would be willing to share our proprietary software system with other entities free of charge.”
Miller asked Medic 1 Board Chairman Pete Sinclair if it is possible for Medic 1 to coordinate with other providers using available technology and requested that Sinclair raise the issue of sharing information between entities at the next Medic 1 board meeting. Sinclair replied that, “This would cost money and no one wants to spend it,” to which Commissioner Burleson responded that, “It sounds like we’re putting a price on someone’s life.”
Miller told Sinclair that, “It defies logic that you’re apprehensive to even ask the question. Find a place to start. The technology is there, it’s just not being utilized. If we don’t ask these types of important questions and begin to push forward we’re not going to get anywhere.”
The council plans to vote on the resolution at the regular meeting of the City Council to be held on August 28.