Ambulance Providers Speak Against Mich. County Ordinance


 
 

Julia Zaher | | Monday, May 5, 2008


FLINT, Mich. -- Representatives of two area ambulance companies urged the Mundy (Mich.) Township Board to oppose a county ordinance they say could put local ambulance companies out of business and potentially endanger residents.

Jim Grady, director of operations for Patriot Ambulance Service in Flint Township, and Harry Swartz, owner of Swartz Ambulance Service in Mundy Township have been speaking to city councils and township boards throughout the county, urging local leaders to oppose the county's plan.

"I want to stay in business and I want to continue to serve this community," said Swartz. "My concern is for the residents."

Passed by the county board of commissioners last December, the ordinance aims to improve communication between 911 dispatch and paramedics and to reduce ambulance response times. It calls for ambulances to be equipped with 800 megahertz radios and automatic vehicle locators (AVLs), for emergency medical service personnel to be certified, and for ambulances and response vehicles to be inspected.

Swartz and Grady said they have long asked the county for the means to fix any problems in response times - including requests for 800 megahertz radios that would provide direct communication with the county's 911 dispatch center and for the ability to post ambulances in various locations instead of the current requirement to remain at a base station. Swartz has said the commissioners have denied the requests.

County Commissioner Jamie Curtis, D-Burton, told the Grand Blanc News the needed technological changes to the system would not be happening without the county ordinance.

"If the private ambulance companies went out and bought AVLs and then got training for 800 megahertz radios and all that stuff ... we might not be having (this) conversation today. But they've never done that. They showed no initiative to better the system on their own. None. Period," Curtis said.

Swartz and Grady claim most of the area's 10 ambulance companies would be shut out of bidding on the county contract because they aren't large enough to handle half the county as would be required. Swartz warned that splitting the county into two service zones would create a monopoly and leave the county vulnerable to the demands of out-of-area conglomerates concerned more with profits than people.

But Curtis said zones could be a moot point.

Swartz and Patriot ambulance services filed a lawsuit in Genesee County Circuit Court in March against the Genesee County Board of Commissioners, the county's Health Department, Medical Control Authority and 911 Consortium to halt the implementation of the ordinance.

"If we implement what we agree upon and let everything else go to the judicial system and say it takes two or two and a half years ... there may not be a reason to have zones," Curtis said. "There may not be a reason to go out for bid. It may correct itself. I don't think county residents should be held at a disservice pending that outcome."

The county's Health Department and Medical Control Authority oversee ambulance service and hope to fully implement the commissioners' plan by the first of next year. The Health Department would hire a so-called "ambulance czar."

Only county-contracted EMS providers would be dispatched from 911, which means township or city ambulances would never receive emergency calls. That could make it difficult, if not impossible, for local municipalities to opt out of the new system.

"We've heard one side of the story ... I think it's imperative that we hear from our county fathers," said Mundy Township Clerk Rick Frost.

The board will invite several county commissioners to appear at a future meeting.

INCREASED EFFICIENCY

Having all the diagnostic labs and equipment in one area will enhance the speed at which doctors can treat emergency patients, Dorogy said.

The centralization of services in the heart tower will increase efficiency so much that staff size can be reduced a bit through attrition and reassignments, Richardson said.

Patient floors are designed so that supplies are stored in a central core, which will be staffed by specialized workers who can access 3,000 items in one place. Clinicians will no longer need to leave the area to track down supplies, Richardson said. This will also reduce traffic in hallways around patient rooms.

The heart institute features a central monitoring room that will be staffed by "super-skilled" monitor technicians who can identify heart rhythms, Richardson said. For the first time, they will be able to monitor the vital signs even of patients walking around or being wheeled to a procedure.

Patient rooms and labs feature greater flexibility than in the past. A CT scan can be taken in some endovascular labs, so the patient doesn't have to be moved. Every bed in the building has a monitor that doctors can use to examine images from heart catheterizations and other tests, and every patient bed can be converted to a critical care bed, Richardson said.

EKGs can be taken from any patient room and viewed by doctors at their homes or offices.

"I'll never have to leave my computer to get test results from different sources, like stress tests," Dorogy said.

COST AND STAFFING

Building such a large new facility will impact the hospital's debt load and staffing.

About $50 million of the cost was funded through public bonds issued in 2005, and the rest was covered by the hospital's operating reserves, said Rhonda Perry, the chief financial officer. This has not affected the hospital's ability to keep enough cash on hand to operate the hospital for about 300 days, she said.

"It really has not bled down that reserve," Faulk said.

Originally, the heart building was envisioned to include only half its eight floors, he said. But more were added to accommodate doctors' offices and to take advantage of the last major piece of property on the same block with the rest of the hospital, Faulk said.

By the time construction was completed, however, many heart doctors had decided to locate their offices elsewhere, Faulk said. Only one practice will be in the building. This left an entire floor empty, but Faulk said it was deliberately left as a shell and can be converted to patient rooms in the future.

He said although the hospital could have collected rent from doctors whose offices were there, the amount was never meant to be a significant source of income and would merely have covered operating costs.

Doctors and hospital officials say they hope that in the long run, the new facility will attract more heart doctors to Macon.

This is important because there is a national shortage of heart specialists caused by some inaccurate predictions in the industry, Richardson said. On top of that, many of the Medical Center's heart doctors are due to retire soon.

"Young physicians often want to be in big cities like Atlanta," Dorogy said. "If you get them here and they see (the center), they'll never leave it."

Richardsonsaid the Medical Center took a hit when some heart specialists took jobs at Coliseum Medical Centers, which started an open-heart program in 2002. But the hospital has since recovered to its previous physician staffing levels, she said.

To contact writer S. Heather Duncan, call 744-4225.




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