Ambulance transfer truck draws controversy

WASHINGTON — Washington County officials say they’ve heard negative feedback about the ambulance department’s Basic Life Support (BLS) vehicle, which it uses primarily to transport patients between hospitals for revenue.

The county plans to keep the truck in operation for now, but is seeking additional information in the coming weeks.

Supervisors said recent complaints from residents sparked the newfound attention on the BLS truck, which was approved for service almost exactly a year ago. While it’s brought in revenue from transfers as planned, the truck travels more than some anticipated, with one outlying trip as far away as Omaha, Nebraska reported over the summer.

“I have had several people in the public come to me and ask why we are doing transfers to Omaha and all over the state of Iowa,” Board Chair Richard Young said. “I wanted this on the agenda to revisit this and see if we should be doing this, and taking away from companies that do that kind of work to begin with.”

Officials highlight long distance runs as main concern

Travel distance was the most immediate concern of some supervisors. Bob Yoder said long distance transfers would lower the life span of the truck.

"The bottom line is, we’re putting a lot of wear and tear on our vehicles, especially to go to Omaha, that’s a lot of miles,“ he said. ”Is that really the direction we want to go?“

Another issue is the risk that resources could be out-of-county when they’re needed. While the BLS truck doesn’t need a paramedic aboard like typical ambulances, the one making the trip to Omaha did so with an overqualified crew, as a typical BLS team was not available.

It did so July 19, the middle of Washington County Fair week.

“The staff that made that trip to Omaha are full time 911 staff, either EMTs or paramedics,” Supervisor Jack Seward Jr. said. “I just wonder whether the cost for trips far away from home are worth it.”

Seward proposed that the service only be provided to people with a connection to the area, such as a residents of adjacent counties, others with plans to check-in at the area’s hospital, or an injury they got while in the county.

“Our tax money and our responsibility is to our citizens,” he said. “But if you’ve got somebody that’s not connected to Washington County that has to go from some place outside of our county some place a long ways away, that’s the policy that I think we ought to consider.”

Supervisor Marcus Fedler disagreed.

“I think it’s about the patient … why would you deny service to somebody, anybody, if you have it available,” he said. “A patient was happy that they were able to get to Omaha to do a treatment. I think that’s providing a service … I don’t think we should limit it, I think it should be a case-by-case basis with the understanding that we try to benefit Washington County as much as possible.”

The county plans to gather more data before setting hard rules on transfer distances. Supervisors said they’d ask the department for more data about transfer destinations in future reports.

“Maybe we could do it quarterly, say, ‘Where are the D3 trucks going?’ and just encourage the service to try to maintain as close to Washington County as possible,” Fedler said. “I think that would be helpful for everybody. It would put eyes on the actual transfers.”

Young said he expected the numbers soon.

“We can table this, put this on for next week, and get those figures from the service,” he said. “It should not be that difficult.”

Some worry about private sector competition

Many voiced concern that the ambulance would compete with private actors in the hospital transfer service, a prospect the conservative Board of Supervisors took issue with.

"If the private carriers were all busy, they need help really bad, that’s one thing, I’d be open to that much more,“ Yoder said. ”The question is, are we to be running competition to private business?“

Fedler said he didn’t see that competition happening.

“If there was a private sector actually suffering because we’re doing this, then I would say we need to cut back on it, but I don’t think there is,” he said. “We’re doing two transports a day, what that tells me is that they need this service and we’re providing it.”

Ultimately, supervisors said they didn’t have enough information to consider private sector issues.

“I don’t know, for those 421 transports, did they only call us? Did they call the other services and ask them first?” Young said. “Or did we call them and ask if they had any transports that day? I don’t know.”

The county plans to seek that data in the near future, however.

“We could reach out to the U or somebody, or the ambulance service can, and say, ‘Hey, we’re not trying to take away business from the private sector. Are we?’” he said. “We don’t know the answer to that, but it would be nice to know. And then we can more accurately make a decision.”

Advantages weigh against complaints

Fedler said he saw the transfer service as a potential training ground for new staff.

"What this potentially could do is be a training ground, for new EMTs to come on board,“ he said. ”It would give them an opportunity to sit with a mentor, and opportunity to talk with a patient, so it’s a good thing as long as it doesn’t trade off with 911 service … I think it’s a great opportunity for a training ground.“

Since the transfer truck charges for its service, Supervisors said it made an average of $310 per trip, though the amount varies widely by distance traveled.

Fedler said that was admittedly a plus, as the service wasn’t fully dependent on taxpayer dollars to remain active.

“I hate the word ‘profit’ in this case because we’re a government entity,” he said. “It’s (generated) $130,000, that’s roughly $6 for every man, woman and child in Washington County as a tax break.”

Supervisor Stan Stoops said he didn’t see a need for major overhauls at the moment, but was interested in seeking more information.

“If it ain’t broke, don’t fix it,” Supervisor Stan Stoops said. “There is revenue here, that’s not illegal … if it shows we need to fix it, then we fix it. Right now, I don’t see the need to fix it. I would be in favor of tweaking that policy (but) we don’t need to fix this.”

Comments: Kalen.McCain@southeastiowaunion.com