Tuesday, August 16, 2016

Allegany County: Future of advanced level medical care in jeopardy

The future of advanced life support services currently provided by ambulance services in Allegany County could be in jeopardy. The plan, under consideration, could put one Allegany County ambulance service out of business. The Western Regional Emergency Medical Advisory Committee (WREMAC) is considering a plan to eliminate one level of care. The WREMAC consists of physicians and responders from every county in Western New York. The group is authorized by law to determine which levels of care can be offered. Currently in New York, there are four levels offered by ambulance services. They are:
  1. Emergency Medical Technician-Basic (about 227 hours of training). EMT-B
  2. Advanced Emergency Medical Technician (about 400 hours) AEMT
  3. Emergency Medical Technician-Critical Care (about 600 hours of training) EMT-CC
  4. Emergency Medical Technician-Paramedic (about 1,100 hours of training) EMT-P
The WREMAC is considering ending the EMT-CC program (The primary advanced care program offered in Allegany County). Instead, the group wants providers to move up to the paramedic level. In September, the WREMAC will again consider the proposal, which has been under study for the past several years. The closest paramedic program is in Olean. Most providers in Allegany County are trained at the Crossroads Center in Belmont, where there is no paramedic course.
"This plan will put us out of business," said Dan Marsh, owner of Medical Transport Service (MTS), which operates ambulances, wheelchair vans and the "Medic 700 Fly Car." Marsh said the measure would "put advanced life support back 20 Allegany County." He called the situation "dire." MTS has operated for the last 37 years. Medic 700 began service in 1995. Marsh said "there are very few skills a paramedic can do that a critical care tech can't." Marsh said his staff and volunteers countywide would not likely want to almost double the training time, plus travel to Olean. While the WREMAC acknowledges there could be some short-term pain for places like Allegany County, it believes patients would ultimately benefit from a higher level of care. At it's June meeting, one WREMAC member said as long as the CC program continues, it will be a roadblock to a higher level of care. It's an issue that has been debated for decades. MTS currently employee's 11 critical care techs and 4 paramedics. They contract with Jones Memorial Hospital in Wellsville to provide all advanced life support transfers when the patient doesn't go by helicopter. Marsh said at the very least, if the plan is approved, Medic 700 will go away. Currently, Medic 700 serves squads in Allegany County as well as Wellsville-bound ambulances from Steuben and Potter Counties.Marsh said he plans to contact every ambulance squad in Allegany County and alert them of the potential WREMAC action.
John Fleischman is an EMT-P who works with Medic 700 and is also a chief with Wellsville Ambulance. He said eliminating the critical care program would all but end advanced life support in the county.
Don Zajicek is the Captain at Amity Rescue. He said the move would be "devastating." He said it was "foolish" and is the result of downstate pressure.
Jeff Luckey is the Director of the Allegany County Office of Emergency Management, which sponsors the training programs. He called the potential move "dire" and "disgraceful." He was also worried about the loss of MTS. "They provide a lot to the county," he said. The Director also said "we need all levels." "People could die," he added.
Allegany County is part of the Southwestern Regional EMS Council. According to Marsh, the Regional Council does not support the action.
RNN also spoke with several critical care technicians who said they would not invest another 1,100 hours in training to upgrade. They are all volunteers. One provider, who asked not to be identified, said "This isn't Buffalo. I work 8-11 hours a day...I'm not going to drive to Olean for several months. I have a family and my current training doesn't hurt. If the plans goes through as you say, then you'll hear a big sucking noise...that will be the sound of all the volunteers being swept away." He added, "ya know...they (WREMAC) seem to have no problem asking me to double my training time, increase my requirements and ongoing training, when nobody pays me a damn dime...Help thy neighbor? Only if WREMAC allows it."