Monday Morning – Can Somebody Drive You to the Hospital?

Thanks to some persistent poking around by the local newspaper, the citizens of Buffalo, New York, are starting to learn what Life with Rural/Metro is really like.  On February 20 we passed along a report by the tv station WGRZ-TV about a call for seizures where it took the ambulance 48 minutes to arrive on scene (Firegeezer report HERE).  Not only was there a paucity of units available to run emergency medical calls that day, but the dispatcher arbitrarily downgraded the call to a low priority which bumped it farther down the waiting list.

That and some recent similar events apparently prompted the Buffalo News to take a look at what's going on with the city's first line of medical emergency care and yesterday they published a report titled Sinking to Level Zero, which refers to the point where no ambulances are available for a call.  After conducting several interviews with people in all levels of the fire department and other city agencies and citizen groups, the writer Matthew Spina has put together a story that should be enlightening to the taxpayers.  Cherry-picking his story, I list a few conclusive remarks worth paying attention to:

• Nearly every day in Buffalo, ambulance service sinks to "Level Zero" — city dispatchers have no ambulance available because all rigs provided by Rural/Metro Medical Services are busy.

• "Sometimes it's really shocking, like at 3 o'clock in the morning when nothing else is going on," one city fire official said of Level Zero.

  Aside from Level Zero, there are other signs of strain on Rural/Metro in Buffalo. The company last year required nine minutes or more to reach an average 570 calls a month that warranted lights and sirens, according to one Erie County measure.

• "Here's what bothered me so much: They came up the road without their lights on, without a siren on. They acted like it wasn't even an emergency," said Jim Rogan, president of Black Rock Riverside Little League Football.

  A player broke his leg in practice last fall. In obvious pain, the 12-year-old waited about an hour for the ambulance, Rogan said. Later in the season, a player with a concussion waited about 45 minutes at Riverside Park, Rogan recalled.

• The (Erie County) executives say that when the city is at Level Zero, Rural/Metro probably has more ambulances off the city's lineup that can be dispatched to a serious call.

  The dispatchers are unaware of those other ambulances because Rural/Metro chooses to keep them unaware. Rural/Metro wants to prevent the ambulances — or "cars" in industry lingo — from going to people calling 911 with minor needs.

  "If we keep putting cars in the system, they are going to keep saying, 'We've got the sniffles. We've got an ankle sprain,' all sorts of stuff," Rural/Metro's Adin J. Bradley said of the ailments to which city dispatchers still must send an ambulance.

It is obvious that Rural/Metro is shunning calls that may end up as "no service" which will not be billable, but are also permitting dispatchers to downgrade calls purely to distort their contracted response-time obligations for serious emergency incidents.

Rural/Metro photo

While I don't agree with Rural/Metro's practices, I can't entirely fault them for trying to cut down on "my finger hurts" calls.  Whether ambulances should be dispatched for trash calls like that are a political decision made by the citizens themselves through their elected representatives.  But when they choose to shunt a governmental responsibility onto a for-profit business instead of a tax-supported agency, then there will always be this sort of conflict.  The City Council has to decide which way they want to go, respong only to true emergencies or run everything.  If they choose the latter, then they will have to pay for it and quit trying to dodge the reality of it.

But the Buffalo City Council has another reality that they need to address, but probably will try to dodge it also.  Rural/Metro's contract with the city expires this year and there is talk about putting out calls for bids to encourage some competition to provide better service for the citizens.  But there's a big roadblock to that reasonable expectation and it's called payola.  Again from Spina's article:

However, four months before the new pact would begin, Buffalo's request for proposals has not been published, so companies cannot even present their offers. With each passing week, any would-be newcomer to the city has that much less time to assemble a fleet of ambulances and corps of medics to start taking calls July 1.

Also, Rural/Metro and its state political committee have given more than $5,000 to Mayor Byron W. Brown's campaign fund. The company employs Michael L. D'Orazio, the fire commissioner who was in office when it signed the deal in 2005. It also enjoys good relations with its City Hall monitor, the Emergency Medical Services Board, dubbed "the ambulance board."

It's a good article, but necessarily lengthy, so set aside some time to read the entire STORY HERE.

First, we have to set aside some time to get our own equipment checked out for today, so while you get started on that, I'll get some more coffee going.  See you back in the day room.

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