(Published Monday, February 26, 2007 11:34:25 AM CST)
A d v e r t i s e m e n t
By Mike Heine Gazette staff
Lives are being saved by a Walworth County program that dispatches private paramedics to supplement volunteer emergency medical technicians, but the system still has kinks, officials say.
Two ambulances sometimes are dispatched when only one is needed, resulting in more than twice the cost for patients, said Chris Ebert, Elkhorn assistant fire and rescue squad chief.
"Patients are getting two bills when a lot of times it wasn't medically necessary," Ebert said.
Without a major metropolitan center, Walworth County has mostly volunteer emergency medical technician crews. They are sent to emergencies by 911 dispatchers at the sheriff's department and at three city police departments.
Since June, more advanced life-saving techniques have been provided through a cooperative effort between Aurora Lakeland Medical Center, Mercy Walworth Medical Center and Hospital, three private paramedic services and more than a dozen volunteer EMT squads.
The Advanced Life Support program, developed by doctors and emergency medical service coordinators at the two county hospitals, set new protocols for private paramedics to supplement volunteer EMT squads.
Paramedics have more training and medications than EMTs.
Under the new protocols, paramedics are automatically sent to reports of patients with difficulty breathing, chest pains, severe allergic reactions, cardiac arrest, extensive burns, drowning or near drowning, major trauma, unstable low blood pressure, severe hypothermia and overdoses.
Before, paramedics were dispatched only after volunteer EMTs arrived and asked for help. Now, the paramedics are sent on all serious calls.
"Dozens of people are alive or are doing better because they've had these services available to them," said Chief John Kramer of Delavan Rescue Squad Inc., one of three paramedic companies in the county.
The two others are Paratec and Medix ambulance services.
The effort came about because, "We were seeing too many cases where the patient really wasn't getting the service they should have," said Kevin Kennedy, EMS coordinator at Mercy Walworth.
But the program has flaws, according to local emergency service providers.
Paramedics sometimes are needlessly sent to calls because dispatchers aren't trained to gather enough information, Ebert said.
Ebert and Elkhorn Fire Chief Rod Smith don't fault the dispatchers. They blame a lack of training.
"They're arbitrarily sending people to these calls with no background information, and people are getting billed these (extra) rates when dispatchers have no background to screen it," Ebert said.
"(Dispatchers) don't know how to pick medical information out on the phone call," Ebert said. "We're not against the ALS program. We just want to implement it better."
Smith said the best solution would be to have all dispatchers receive emergency medical dispatch training and certification.
But that's at least a few years off, after dispatch centers get more staff.
Emergency medical dispatchers stay on the phone longer and can better assess the need for paramedics, said Communications Capt. Jay Maritz of the Walworth County Sheriff's Department.
A response from a volunteer ambulance can cost between $250 and $600. If a paramedic ambulance is sent, too, that can add $500 to $600 to the bill, Ebert said.
Insurance usually covers the bills, and for Medicare or Medicaid patients, a combined bill is split between the volunteer and paramedic squads, said Aurora Lakeland EMS Coordinator Mark Messina.
"The county is working real well on this," Messina said. "It's not perfect, but (ALS) is the next best step that we can get at this point.
"You're looking at an allegiance between two hospitals and the private sector to make something work in a situation where we don't have the right answer," Messina said, "but we're doing the best we can until we get the budget to put the proper system in place."
