Baptist Ambulance concerns addressed at Obion County Commission meeting July 26
The Obion County Commission met July 26, at the Obion County Mayor’s Office with 19 Board members present.
Commissioner James Gray submitted the following letter to all Commissioners, prior to the meeting, about concerns that were brought to his attention of deficiencies with the local contracted ambulance service provider, Priority Ambulance, d/b/a Baptist Ambulance Service.
“My Fellow Commissioners,
In April I had a small group of concerned citizens bring to my attention deficiencies in our local contracted ambulance service provider, Priority Ambulance DBA Baptist Ambulance Service. I have since been gathering data from FOIA requests and first-hand accounts from various sources that shows a consistent pattern of substandard service, or often no service, to the citizens of Obion County.
It is important to note that the legislature this year voted, and the governor signed into law a bill that made ambulance service an essential service that all counties must provide for their citizens. I believe that we could potentially be held liable for the inadequate service provided by Baptist Ambulance, as we entered into an agreement with Baptist to allow them exclusivity to provide ambulance service to the county.
The first, and most alarming, issue is the lack of an ambulance in the county and the abuse of our neighbor counties’/ambulance service’s mutual aid. In a 1003-day sampling of the service’s calls, 269 or 26.8% of the days at some point there was not a Baptist Ambulance available to respond, and the county had to rely upon mutual aid. Baptist is often running transports that tie up ambulances needed in the event of emergency (for those unfamiliar with the ambulance industry, transports result in more miles and more profits). This practice is direct evidence of the ambulance service and management’s greed, allowing and encouraging transports over emergency responses to build their bottom-line, an expense greater than dollars to our citizens. (Another item to consider here is the fact that since 2009 in Tennessee, 16 hospitals, 13 of which are rural, and 5 in Kentucky, one of which serviced the north portion of our county, have closed, increasing transport distances and times.)
The contract specifies that Baptist Ambulance Service is to provide service to Obion Co., but they provide no service to the City of South Fulton and certain areas in the northern area of the county. South Fulton and these rural citizens pay a subscription service to another ambulance service. No one else in the county is charged with having to pay said subscription service.
Another area of concern is the inadequate staffing of ambulances. ALS, which is a paramedic and EMT onboard, is the service in the county that is required. Often this is not met, having units staffed with AEMT’s and BEMT’s (advanced emergency medical technicians and basic emergency medical technicians) or in one case just in the past week, only two BEMT’s. This delays the administration of lifesaving medicines and causes issues with our fire departments. Some departments have paramedics on staff, and if the fire department responds alongside, or in most instances before the ambulance service, the paramedic is then charged with abandoning the fire department and riding enroute to the hospital with the ambulance, as a paramedic cannot pass a patient off to a lower level of care (i.e., an AEMT or BEMT). This results in short staff and loss of a medical professional on staff for the fire department.
I spoke with John Copeland of Baptist Ambulance Service on April 27th and highlighted these issues. He stated it was a mixture of previous management as well as a staffing shortage in the industry. In my research, all the neighboring services struggle to staff, but they do not suffer the level of incompetence of Baptist Ambulance Service. Even in offering a $10,000 sign- on bonus, Baptist cannot find paramedics, AEMT, and BEMT to fully staff the rigs in the county. The opinion in the industry is that the equipment and rigs, along with the culture, is such that even the bonus and high pay is unattractive.
Management’s laissez-faire attitude toward maintenance and safety is evident in the condition of the equipment and rigs. I have witnessed, and have been informed by first responders, former staff, and others in the community, of the poor maintenance and disregard for providing an acceptable standard of care. One rig operates with three separate damaged and/or malfunctioning cardiac monitors to do what one properly working monitor would do. One recent consequence of substandard equipment and resources was poor care for a young child whose foot was impaled—upon arrival to the scene, the ambulance was not stocked properly with gauze or sheers. Another issue reported around the county is the unit with inoperable/malfunctioning lights. I reported this to Copeland in his capacity as management at Baptist back in April, and it appears to have yet to be remedied, which is not just a safety issue but a violation of state statute. Lastly, to highlight the disrepair and corner cutting to preserve their bottom-line, it is often reported that one unit has to carry coolant in the rig and stop mid-transport and fill the radiator to avoid overheating, instead of repairing the unit. All of these are issues that could have or could lead to serious disaster or potential death of patients being transported by the ambulance service.
The continued abuse of mutual aid, the poor management of equipment, and the understaffing in time will only result in serious damage or possible death to our citizens, and makes the county vulnerable to potential lawsuits, of which we will more than likely lose once any competent attorney makes a simple FOIA request.
I believe this can be remedied. TCA (7-61-103 ) - Provision of private or nonprofit ambulance service regulations that states in order to protect the public health and welfare, any county or city may adopt and enforce reasonable regulations to control the provision of private or nonprofit ambulance service. This allows the county to form an Ambulance Oversight Committee. I would urge you to join me in voting to create this board. I believe it should comprise commissioners, first responders, a representative from 911, and a representative from the hospital. I think all ambulance services operating in the county should provide one non-voting member to be present at all meetings to provide updates and reports to the oversight committee.
If interested in the raw data used to compile this letter, I will be glad to share.
Sincerely, James Gray”
Baptist Ambulance Service General Manager John A. Copeland and Vice President of Operations Eric Messer addressed the Commission with questions the Commission may have for Baptist Ambulance.
“We are changing to have a different mindset you could say to try and improve as things come up to make it better and without the community’s help we can’t do that. This is why we are here today,” Copeland said.
“Let’s be real about this. This is long overdue for us to come and stand in front of you guys. No question. Mostly, I am responsible for this. I have been with Baptist Ambulance for four and one half years. We actually purchased the ambulance service from Baptist Memorial Healthcare, all of them except in Golden Triangle in Columbus, Miss.,” Messer said.
“First, I apologize to you for waiting. Number one, for us not being here to come see you. It is long overdue. The second part is let’s talk about what has really happened before and during COVID that caused our issues. I will be very transparent. I’m not going to beat around the bush. I know a lot of you have done your research and I think that is great. Before COVID, we were running three to four ambulances per day. During COVID we got very busy. Union City is a very busy operation for us. There are two things that make it busy. You can’t look at the overall numbers and say they are covered up with transports. There are transports that go to Jackson or Nashville with an average time of about four hours. Intensive Care Unit beds were lost during COVID so we had to transport to Arkansas. We are not in control of this, the hospitals are. The government was giving a lot of money to people to stay at home,” Messer continued.
“We tried unprecedented things to get people to work. We gave $15,000 sign-on bonuses. We paid paramedics $22 to $30 per hour, and couldn’t get people to work. We have three ambulances running today. We are doing everything we can, and calling local areas to help us. The other problem, we did a partnership with Dyersburg State and recruit our own. We paid people to go to class and pay them $10 to $15 while they are in class, and in return we two years of service from them. If I were you guys, I wouldn’t be happy with us. I’m not happy with us. The community takes a big hit and we are doing everything we can to fix it. Our goal is to put more trucks in the community. We will work tirelessly to get this fixed,” Messer said.
Baptist Memorial Hospital does not own Baptist Ambulance. Baptist Ambulance pulled out of the hospital and have a new office on Rutledge Road. This was because there was not enough room and to have the numbers needed.
“Hiring in Carroll County and Obion County has been difficult since we have been here,” Messer said. “We didn’t get that first person when offering the $15,000 sign-on bonus.”
“I have a couple of concerns. One is the unprecedented amount of mutual aid calls Obion County has had to get mutual aid from Ken-Tenn Ambulance in Kentucky last year. When you were doing transports and we didn’t have an ambulance here it is very unprecedented,” Commissioner Ryan Ellegood said.
Messer said he didn’t think it was unprecedented, but this is an unprecedented time.
Ellegood said, “Your business cards, ambulances, letterhead, billing and your mailing address in Dallas, Texas has Baptist on it. Everything has Baptist on it, can you tell me a private insurance network that Baptist is in and Priority Ambulance is in?”
“We are in network with Sigma. I have written off everything that has come across my desk. There is a reason we are not in network with everybody. The reason we are not in network is providers like Blue Cross/Blue Shield of Tennessee pays us $160. Our cost is like $228. There are some we can’t get a network with. I’m just being honest,” Messer said.
Commissioners voted to form an Oversight Board to do investigating on the type of action to take with the ambulance service.
The remainder of the Commission meeting will appear in The Current’s Aug. 4 issue.
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