Pa. Responders Concerned About Coverage Gap

Aug. 11--YORK, Pa. -- You are involved in a serious car crash in Chanceford Township. Your injuries are life-threatening, and your survival hinges on immediate medical care provided by a paramedic.

A paramedic's ability to quickly get to you might take a blow in the coming months, some York County emergency medical providers say.

On Wednesday, a spokesman from WellSpan's York Hospital said that the healthcare system plans to discontinue ambulance, paramedic and emergency medical technician services to the community.

Along with staffing its own EMS team, Medic 97, WellSpan leases emergency medical technicians for basic life support services and paramedics for advanced life support to various ambulance companies in the area -- some of which have not been able to afford to hire their own trained personnel.

When WellSpan's staff is gone -- which will be in the next 90 to 120 days, depending on individual contracts -- some ambulance companies will have to pull paramedics from farther away.

A clear example is in Red Lion, where a WellSpan medic unit is stationed.

Brogue Ambulance depends upon that station's paramedics when it calls for the most serious, life-threatening situations.

"This is definitely not a good thing for everybody," said Nelson Tome Jr., chief of the two-truck ambulance company that serves all of Chanceford Township and part of Lower Chanceford Township.

Brogue, he said, has another option when WellSpan vacates.

It can pull paramedics from the nearby Yoe Ambulance Service, which has a mobile intensive care unit, or MICU, licensed to carry paramedics and emergency medical technicians on the same vehicle.

If Yoe's trucks are out on other calls, Tome said, Brogue Ambulance can meet en route to an emergency room with paramedics from Memorial Hospital.

But that takes an extra 10 minutes, he said.

"Usually, 10 minutes with a cardiac arrest or a child patient can make a difference," Tome said. "It can help get a patient back to life if they get the drugs early enough."

Unlike EMTs, paramedics can administer IVs and other medications, Tome said.

They can run electrocardiograms in the ambulance and send the information to the hospital, so doctors can prepare for that patient.

"It's basically an emergency room on wheels," Tome added. "Anything the ER can do, they can do in the back of an ambulance."

'It's going to be rough'

Brogue's backup, Yoe Ambulance Service, expects to be even busier with calls for advanced life support services.

"This has the potential to affect us indirectly," Yoe EMS Chief Ted Hake said.

Since 1972, the service has contracted for coverage with York Township, Windsor Township, Yoe and Dallastown.

Half of Windsor Township is being covered by Red Lion EMS, which will be losing the same WellSpan paramedics that also serve Brogue.

"We're open to exploring the relationships with new municipalities, but it will have to be a partnership and they will have to think about what level of service they're willing to pay for," Hake said. "We cannot provide free service and we know that wouldn't be appreciated by the four municipalities that make up the current community we serve."

Dover Area Ambulance Club is facing the same challenge as Brogue.

The ambulance company relies on Medic 98 -- a joint venture between Memorial and York hospitals -- for paramedic services, said EMS coordinator Peggy Durnin.

Medic 98 is housed at the Dover Township Volunteer Fire Department, she said.

Once WellSpan discontinues its service, the unit will be down to just one provider from Memorial, Durnin said.

Dover Area Ambulance, which serves a 75-square-mile coverage area, picks up paramedic service from West York when both providers at Medic 98 aren't available.

WellSpan's decision, she said, will strain resources more.

"Paramedics are going to be coming from further away if the one we have here is not available," she said. "If we have to pull a provider from say, Hanover, Grantley or West York, it takes them a while to get here. Medic 98 was just around the corner."

Durnin said the ambulance company is evaluating the possibility of becoming its own MICU -- a move the group tried several years ago.

It's a big expense, she said, between hiring trained paramedics and buying the necessary insurance and equipment, including cardiac monitors, medications and IVs.

"With all this happening, it's going to be rough," Durnin said. "Our area definitely requires more than one paramedic. They're out all the time as it is."

For some EMS units, little effect

Memorial Hospital provides similar services to the ones being discontinued by WellSpan.

Along with staffing Medic 98, the hospital has its own employed EMTs and paramedics and five advanced life support ambulances.

Jason McSherry, spokesman for the hospital, declined to comment about the effects WellSpan's decision could have on the resources at Memorial.

"I don't know if we know all the details," he said. "We haven't had a chance to evaluate how that is going to impact the services to the community as well as the services we provide."

The changes won't affect everyone.

White Rose Ambulance, the primary 911 responder for York city, has hired its own in-house paramedics since 1996, said James Arvin, the company's president.

"It will probably affect most other services in the county, except us," he said.

At Canadochly Valley Ambulance Club, the changes with WellSpan coverage mean very little, said Ed Peashey, president.

The 30-person volunteer company uses a Memorial Hospital "chase truck" -- a paramedic unit that drives separately following the ambulance -- that is stationed in Hellam.

"The only effect on us is that WellSpan has a unit in Red Lion that responds rarely into our area if Memorial is not available," Peashey said.

Similarly, Northeastern Area EMS in East Manchester Township uses Memorial Hospital's medic units, stationed at the Emigsville Fire house, on a first call basis, said chairman Gary Cardasso.

"We never got York Hospital's ALS up here," Cardasso said. "Maybe two times a year. It was very seldom."

If all nearby paramedics are on the road, in a rare instance, he said, Northeastern could depend on Medic 98 in Dover Township.

"I'm hoping that doesn't happen," he said. "If that's the only thing available, we'll just race to the hospital. I'm not going to sit and wait for Dover's medic unit to come."

EMS elsewhere

Lancaster General Hospital isn't in the business of emergency medical services.

The hospital hasn't been, at least, since Ron Baier can remember. He has worked at Lancaster General for 11 years.

Baier serves as a liaison for the hospital to emergency medical service providers.

"I'm the individual face that EMS can relate to," he said.

But that's as far as the hospital's involvement in EMS service goes.

"At one time some advanced life support services were owned by the hospitals," he said. "That was so long ago. It has not been a model for us for a long, long time."

Wellspan's take

Barry Sparks, WellSpan spokesman, said that the health system is confident that the level and quality of advanced life support and basic life support will be maintained by existing services.

"In York County, the current number of private ALS and BLS providers adequately meet the needs of the communities," he said.

WellSpan will discontinue EMS service to different areas in 90 to 120 days, depending on individual contracts with ambulance providers.

Sparks said it is "uncertain at this point" how many jobs will be eliminated as a result of the decision.

Copyright 2013 - York Daily Record, Pa.