COLUMBIA CITY — Four times this year Whitley County Commissioner Don Amber motioned to allow the Whitley County Sheriff’s Department to dispatch Lutheran EMS in South Whitley. All four times that motion died for the lack of a second.
Twelve times South Whitley Town Council President Randy Cokl pleaded with the board Sheriff Marc Gatton has taken the podium, as have residents from the South Whitley area, in support of allowing the county to dispatch for the EMS.
Each time, Commissioners George Schrumpf and Tom Western stood firm in their decision against allowing Whitley County to dispatch the Lutheran EMS. Though the Commissioners have been under fire, they say many factors play into their decisions.
Terms of the contract
Primarily, Schrumpf and Western do not support the plan because they are abiding by the county’s existing contract with Parkview, which dispatches all existing ambulance services in Whitley County.
For Western, it is an issue of ethics.
“Before I was a commissioner, [the commissioners] worked nine to 10 months on putting together a new EMS contract,” he said. “(They) spent a ton of time on it. We have a contract that is in place with Parkview, and so it would be totally unethical to break that contract — then we’d open ourselves up to a lawsuit. We have a contract.”
Schrumpf sees it as not only an ethical issue but a legal issue as well. Legal counsel advised them not to break Parkview’s dispatching contract.
In several of the public meetings, concerned residents and Cokl brought up the “backdoor out,” a way the commissioners can break the contract. While there is indeed an out, Schrumpf does not currently see it as necessary or appropriate.
The backdoor allows the commissioners, or conversely Parkview, to end the contract with a 180-day notice.
“If we’re not happy with them or they’re not happy with what’s going on with us, if we don’t hold up our contract, we could get the same thing,” he said.
While negotiating a renewal to the original contract in 2016, Schrumpf reports that Parkview cooperated on an issue brought up by Cokl and Amber. Inter-hospital transfers, they argued, occupied Whitley County’s then three ambulances more than was fair, leaving holes in coverage.
“We agreed, looked at the numbers and it was (leaving holes),” Schrumpf said. “We talked to Parkview and they said, ‘OK, let’s take care of that. We’ll put in three transfer ambulances, and we’ll use those before we use any of the Whitley ambulances.’ When I talked to Randy (Cokl) about that, he was happy they were going to do that, and Commissioner Amber was happy.”
While they applaud Whitley County dispatchers for their work and have no doubt in their capabilities to handle EMS dispatch, the commissioners see great benefit in using Parkview’s dispatchers for medical runs.
Parkview’s dispatchers are all paramedics who focus only on dispatching medical calls, while Whitley County dispatchers don’t have the same level of medical training, and have many other responsibilities.
Before Parkview took over Whitley County EMS dispatching, county dispatchers were certified as emergency management dispatchers. The county kept track of all ambulances, repositioned them as needed and took all medical-related calls.
EMD computer software prompts dispatchers with many questions. Going through this procedure takes time and, once a dispatcher begins a medical call, the dispatcher must follow the call until first responders arrive on scene. At times, only two county dispatchers are on-duty. If one becomes tied up on the phone for an extended time on a medical call, it makes for a difficult situation.
In one of the commissioners’ recent meetings, Schrumpf said that there had been times where county deputies have been told to wait as that precise scenario takes place.
“I don’t think that’s appropriate when we have an alternative. I truly don’t,” he said. “It puts our deputies at risk, and nowadays it only takes one time, so at this point to we really want to take that chance?”
Benefits of regional EMS
Parkview’s regional dispatch system brings some inherent benefits over putting the responsibility on county dispatchers.
“With Parkview’s regional coverage, there are more ambulances available than ever,” he said.
As ambulances are sent on calls, Parkview dispatchers relocate other ambulances in the region to make sure all areas are covered. For example, if Columbia City’s ambulances are dispatched to calls, a Churubusco or South Whitley truck may be relocated along State Road 205. Then, if there is another call in Columbia City, the ambulance would be closer.
“Every time a truck goes on a run, one moves so you’ve got coverage. Just because it’s not in that station doesn’t mean they don’t have coverage,” Western said.
With a large network always in communication, ambulances can back one another up if needed. One example of this in action was a charter bus crash last December.
“[Parkview] had the availability of seven or eight ambulances. Whitley County EMS would’ve had one maybe two,” Western said.
A lesser discussed point, according to Western, is the number of trucks per person available through Parkview.
“We’ve got four trucks in this county, and by national statistics on EMS vehicles per population, we’ve got way too many,” he said. “National statistics say one truck for 40,000-50,000 population. We’re at 32,000 and we have four. I think it’s pretty good service.”
Duty as commissioners
As county commissioners, Western and Schrumpf say they must take a step back and look at what is best for the whole county.
For Schrumpf, Parkview’s contributions to the county are difficult to overlook.
“Parkview does a great job – they’ve made a commitment of $50 million to the community and 350 jobs,” he said. “It’s hard to ignore that as a Commissioner.”
Western worries about the insurance logistics that could get involved, which he argues have the potential to leave some South Whitley residents with a big ambulance bill.
“About 75-80 percent of the residents in Whitley County that are under employer-sponsored health insurance are Parkview preferred, so I wonder if you’re out of network with Lutheran and you get a $2,000 bill, is your insurance going to pay 50 percent or 80 if you’re out of network? That’s a concern,” he said.
Another major factor in their support of the Parkview dispatch contract is the money saved. The largest cost-saving measure is that Parkview accepted all the intrinsic liability in medical dispatching.
“If we make the wrong decision on what to ask, there’s an issue that we could get sued,” Schrumpf said. “We’d rather not have that liability if Parkview will take that on. Again, that was part of our contract.”
Because of this, the county dropped its EMD insurance, saving $14,000 per year.
Aside from the liability, Schrumpf also feels that the negotiations with the contract were financially good for the county.
“The contract was $250,000. We actually negotiated with the Whitley Community Foundation to provide $125,000 a year, so the only contract we have with the county is $125,000. I thought it was a good negotiation, I truly did.”
Both commissioners have concerns about Lutheran Health Network’s parent company, Community Health Systems, and their recent financial troubles. In 2015, the company’s stock values plummeted and the company tried to absorb the losses through selling more than two dozen hospitals in 2017 alone, according to their website.
“I hope they get it straightened out because we need that hospital in this area because the other one can’t handle it all. It’s nothing against the staff or nurses, it’s the corporate that has the problem,” Western said. “I’m concerned with getting hooked up with somebody until they get their act together.”
Schrumpf sees the issue now as a matter of semantics between Parkview and Lutheran. Parkview is willing to amend the contract to include South Whitley’s ambulance, and promises to dispatch whichever ambulance is “most appropriate” for a given situation. Lutheran, however, wants to be “primary.”
“When I told them (Krista Quinones and Pat Unger, representatives from Lutheran) that my concern was they wouldn’t accept that Parkview would dispatch, they agreed that Parkview has a good system and they were willing to work with them if they said they would be primary,” Schrumpf said. “Which is better, appropriate or primary? That’s where I’m coming from.”
He also worries about the communication – or potential lack thereof – between the ambulances will lead to ambulance chasing.
“This is a sensitive service; the ambulance service is life or death. To present another part of that to the system when there’s not a lot of communication, I wouldn’t want to see ambulance chasing,” he said.
Much of the finger pointing around the issue is related to the commissioners’ ties with Parkview. As a letter to the editor from Amber states, Amber was a former Parkview employee who was terminated the same day he voted against the contract in 2011 through when Parkview took over operation and management of the county’s ambulance service.
Western has family working for Parkview, including his son-in-law, but he insists it is not a component of his decision because the commissioners negotiated and approved the contract before his term.
While Schrumpf sits on a board for Parkview, it is not a general board but rather the board of directors for Parkview Whitley Hospital as a representative of the county. The board does not deal with contracts of any kind. It focuses on excellence of care in the hospital.
Additionally, he noted a county commissioner has sat on the Parkview Whitley board for a long time, before the contract was ever in place.
“I’m honored to be on the board to represent Whitley County, I don’t know why that’s a bad thing,” Schrumpf said.
Schrumpf receives a stipend for being on the board, but, “I make sure all goes to charity so I don’t have to worry about that.”
At the end of the day, Western and Schrumpf hope that Lutheran will accept the offer to dispatch through Parkview, and want their position to be understood. “I hope that they understand our situation legally, morally and ethically that we’re doing everything we can,” Schrumpf said.