PFD/AMT Journal Star Articles--June 2021
LET PEORIA FIRE GIVE EMERGENCY HEALTH CARE
My comments in 2021---
1. This was the first of many JS opinion articles I would write over the course of the next 20 years.
2. I had a very smart family member telling me that I did not want to submit the article below for publication. But I did it anyway.
3. I was drawing a line in the sand and didn't realize it. By questioning OSF and AMT, the business community in Peoria would not be happy with me.
Let Peoria firefighters give emergency health care
November 17, 2002
By DR. JOHN CARROLL
Picture this: you're at home and your father grabs his chest, collapses and becomes unresponsive. You run to the phone and call 911.
A rescue truck from your local fire department arrives, and firefighters begin administering care. They work courageously but are only allowed to provide basic life support, which limits what they can do. The paramedics in the ambulance, which will arrive a few minutes later, are licensed to provide advanced life support, which is the most comprehensive pre-hospital emergency care available. The extra time your father has to wait is critical.
As your father deteriorates,.lt is obvious he needs to be transported to the hospital. However, the firefighters can't do that either; only the ambulance can transport.
Unfortunately, the above is not an uncommon scenario in central Illinois. The knowledge of this reality caused me to read with skepticism and dismay an advertisement touting Advanced Medical Transport's (AMT) perfect score from an accrediting commission. Central Illinoisans should not be deceived into thinking that we have ideal emergency response services. AMTs local monopoly does not serve us well.
In many other Illinois communities, such as Rockford, municipal fire departments, which frequently arrive before the private ambulance, are certified to begin advanced life support immediately. They are able to provide the critically ill patient with life-saving medications, airway management and treatments not available to units that are relegated to basic life support capability.
In Peoria paramedic advanced life support is provided exclusively by AMT. Precious minutes spent waiting for advanced life support to arrive may decrease the survival odds for the critically ill patient.
There are many unanswered questions regarding this dangerous situation. Why can't Peoria's firefighters be certified at a higher level? Why have obstacles been created when the Peoria Fire Department has attempted to upgrade its level of service during the last decade? Why don't the hospitals insist that the Peoria Fire Department advance its status? Why should a Peoria-area heart attack victim have to wait additional minutes for a private agency to arrive to receive advanced life support?
Some Peoria firefighters do have advanced life-support training but are not even permitted to use their training to help a fallen cOlleague at the scene of a fire. Does this make sense? Is "duplication of services" a valid argument against fire departments receiving advanced life-support training when it is, in most cases, AMT that would be doing the duplicating? The three local hospitals helped create AMT. Is there a conflict of interest here?
As a physician who worked at OSF St. Francis Medical Center for 20 years, I know that the AMT paramedics, municipal firefighters and volunteer fire departments do their very best under difficult circumstances in urban, suburban and rural areas. The many firefighters I have spoken to have been frustrated that they have not been permitted to attain and use these life-saving skills. Lives hang in the balance during these crucial minutes, and care that is late or sub-optimal contributes to poor outcomes. The Peoria firefighters know this all too well, as they have witnessed patients deteriorate when they couldn't even "load and go."
With the budgetary crisis in the city of Peoria, it would behoove all of us to take an unbiased look at another scenario. If the Peoria Fire Department were allowed to upgrade its pre-hospital care, a valuable service would occur and possibly a new source of revenue for the city. AMT says it took in $7 million in the year 2000.
Pre-hospital patients cared for by Peoria Fire Department paramedics would be billed in the same manner as AMT bills its patients - insurance, Medicare and Medicaid. If initial capital expenditures, mostly in ambulances, were deemed prohibitive, the Peoria Fire Department could provide advanced life support for the emergency victim at the scene, then turn to a private agency to transport the patient to the hospital. The cost-benefit ratio would be on the patient's side.
However, the will has to exist to implement change. The hospitals' boards of directors and the City Council need to be given accurate data to make the most prudent decision as to what is really best for the pre-hospital patient. Unfortunately, the majority of Peoria's medical community has no idea how and why important decisions have been made regarding these emergency medical services. They need to know.
Saving lives, not monopolizing emergency medical services, should be the goal.
Dr. John Carroll formerly worked in the emergency department at OSF St. Francis and is founder of the Haitian Hearts program.
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Medical Control of EMS is Essential
November 2, 2002
Dr. John Carroll's recent essay concerning emergency medical services (EMS) should provide a stimulus for each of us to review and understand the pre-hospital services available in our community. I have been fortunate to work with the pre-hospital EMS program since 1976, when the three Peoria hospitals cooperated to form a single ambulance company from the Ace and Green Cross private services.
In the past 25 years, the system has evolved from two paramedic ambulances stationed at hospitals to multiple paramedic response vehicles positioned in a flexible pattern throughout the community with highly skilled emergency trained dispatchers providing pre-arrival instructions to distraught families when 911 is called.
I want to provide this background to reassure the citizens of Peoria that our response system of firemen trained in defibrillation and paramedic transport vehicles is the standard of care throughout the country. Please be aware that the EMS system response varies from community to community. Each community must decide what level of service to support.
In Peoria, the fire department arrives first approximately 50 percent of the time and is equipped with a defibrillator, oxygen and equipment to manage airway problems. Paramedics, when not first on the scene, are typically arriving one to four minutes later in an appropriate window for medication use after the patient has been defibrillated or resuscitation has begun. Plans are presently finalized for training firemen to use medication in initial patient care.
For an EMS system to function well, medical control is required. A physician trained in EMS must review medication use and procedures done in the field. Our system, when surveyed by the Illinois Department of Public Health and a national non-profit ambulance accrediting body, has been recognized as providing top-quality medical care and medical supervision.
The issue simply is not about patient care but about funding, budgets and utilization of resources in the community. We have an excellent system of pre-hospital care. The system is constantly being reviewed for improvement in quality. As the community becomes more informed about pre-hospital emergency care, most will recognize that we have an outstanding system of dispatch, fire and paramedic response that is a source of pride for those that know it best.
Dr. Rick Miller, Emergency medicine attending physician
Former Director, Emergency Medical Services
Former Chair, Department of Emergency Medicine
OSF Saint Francis Medical Center
Comments in 2021--
Dr. Miller would change the rules behind the scenes several years later after a man died in a Peoria restaurant.
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An early article (early 2000s) written by me regarding Peoria's EMS--
Restricting life support to AMT endangers lives
Let Peoria firefighters concentrate on fighting fires
Just imagine your house catches on fire. A lengthy time passes prior to the firefighters arriving, so it burns to the ground. The reason for the delay was that the crew normally at your fire station had been called out on an emergency medical call. This left nobody at the station to provide protection against a fire. If firefighters are to assume the additional duties of providing advanced life support and transporting of patients to area hospitals, the above scenario may become reality.
I lived and worked in your community for three years and feel that this would be an unnecessary duplication of services. Advanced Medical Transport (AMT), a local, private company, was formed in cooperation with the three city hospitals. It has provided quality care and transport in your community for many years.
The AMT paramedics have only one job - to provide emergency care and transport for those in need. Therefore, they are experienced, up to date and able to dedicate all their time and effort toward this end.
AMT crews, like the fire department, are located at several key locations throughout the city to provide rapid, immediate response to the sick and injured. Their response times are as quick as the fire department's, and their recent accreditation site evaluation found them to provide excellent care.
In a previous article, Dr. John Carroll stated that providing advanced life support would be a revenue generating opportunity for the Peoria Fire Department. However, for services to be compensated, patients must not only receive care from the fire department, they must also be transported to a health care facility by the department.
This, of course, would cost the city a great deal of money, as ambulances, medical supplies and equipment would need to be purchased. Additionally, it would not be surprising if there would be a request to hire even more firefighters. This would be in response to a need to provide fire protection coverage when those that were supposed to be doing this in the first place were out on an emergency medical call. This would be expensive and simply not justifiable.
I have read about talks of cutting firefighter positions. A recent Forum letter commented that there should be no cuts in firefighter's positions because of already extreme work demands, and I agree. It seems that there is plenty for the Peoria firefighters to prepare for and perform in their current daily jobs. Why then increase their responsibilities even more by having them acquire and maintain skills needed to provide quality ALS care?
Dr. Todd A. Nelson
Asst. medical director, EMS medical director
Holy Family Memorial Medical Center
Manitowoc, Wis.
Comments in 2021--
Dr. Nelson was a recent graduate of the University of Illinois-OSF Emergency Medicine Residency. He was most likely recruited by his old bosses at OSF to write this article.
He is from the house of no stating that the PFD paramedics should not be giving advanced life support and transporting patients. It is ironic that he was Project Medical Director in his area where he was allowing his fire department firefighters to wear big boy pants and function as paramedics. But for some reason he did not want the PFD from doing the same.
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City explores giving fire department more power -- However, proposal taken off Peoria City Council's agenda
PEORIA - The city of Peoria wants to upgrade its fire department from offering basic life support services as it does now to becoming an intermediate service that can also administer medication in emergency situations.
''The fire department has been given the power by the city to explore the possibility of going into ILS (intermediate life support),'' said Fire Chief Roy Modglin. ''Intermediate life support is one step higher than what we are allowed to do at this time.''
At the intermediate level, firefighters would be able to administer drugs and other medication in addition to instituting a defibrillation program that will increase the chance of survival for those who suffer a heart attack. A proposal to make this happen was on the Peoria City Council's agenda for this week, but it recently was retracted.
For 15 months, representatives of Advanced Medical Transport, the fire department and the city have been meeting to discuss the issue and possibly develop a collaboration program with AMT. The latter group would provide the necessary training.
One caveat of the proposal was that it didn't let the fire department enter the ambulance business for a certain number of years, said at-large Councilman Jim Ardis, who is involved in the negotiations. Most ambulance services are certified to provide advanced life support services - which is yet another step higher.
For years, AMT has balked at the fire department entering this arena. AMT is an independent not-for-profit organization initiated by the three Peoria hospitals. It has been providing ambulance and wheelchair van transportation services to 22 communities in the Peoria area for more than 10 years.
The majority of municipal fire departments provide ambulance services says Pete Stehman, information service manager of Associated Firefighters of Illinois in Springfield. According to the association's figures, in Illinois there are 16 union fire departments with 100 or more firefighters. Of this number, at least 13 of them or 81 percent transport patients. There are eight fire departments that serve populations of 90,000. Of this, six departments or 75 percent handle transportation.
AMT is willing to help the fire department advance to the intermediate level, but it does not want the department to transport patients, said Andrew Rand, AMT executive director.
''They can provide more comprehensive care than they do now,'' Rand said. ''It's a powerful system, and in fact we agreed to provide that training free.''
Rand said Ardis had also proposed a franchise agreement where both parties would collaborate on improving services.
''We were going to receive hazmat training and decontamination procedures from them because we are on the frontlines of bioterrorism and decontamination,'' Rand said.
The point of contention however, Ardis said, is AMT's insistence that the city keep out of the ambulance business for an extended period of time.
''That's one of the issues that has fluctuated a lot,'' Ardis said. ''It has been anywhere from four years to 10 years. My impression is that we aren't going to commit to anything longer than four to five years.''
Proponents of letting the fire department transport patients argue that the fire department should be in the ambulance business because it is usually first on the scene of an emergency situation and provides basic life support. They argue that two or three minutes can make a difference in saving a life. In addition to transporting patients, proponents want the firefighters to be able to administer the necessary drugs and bill the patient for the service.
The proponents have written several letters to the editor recently publicizing their stance.
Rand disputes that the fire department is usually the first responder.
''That is absolutely false,'' Rand said. ''They keep propagating it but their response time doesn't jive with their records.''
Rand said he's obtained fire department records through the Freedom of Information Act which shows otherwise.
In addition, Rand said that while the fire department responds to all calls with lights and sirens, the AMT uses lights and sirens only half the time. ''We prefer not to risk life and limb of citizens when there is no immediate emergency,'' he said, adding that if a person had a minor injury, an additional two or three minutes would not make a difference in that situation.
Rand also said the fire department has stated it is not interested in providing ambulance service.
''All of the discussions have been that the fire department wants to do intermediate life support, and it does not want to transport patients. That has always been the position. That was what the agreement was written to address; to balance the collaboration of both parties,'' Rand said.
But, city officials have not ruled it out.
''If we want to have a highly trained fire and medical department in the city, there is nothing that AMT can do to prevent us from doing so,'' Ardis said. ''That is a policy decision. I don't think that anybody can make the argument that anybody would not want the best trained people to be there for them all the time in case of an emergency. Why would you not want that?''
Rand said he requested that the proposal not be presented to the Council at this time because City Manager Michael McKnight had advised the council not to adopt it. McKnight did not return Journal Star phone calls.
''I don't think it is appropriate for that agreement to come up, and what we have asked the city to do is sit down and see what it takes to solve 15 months of negotiation,'' Rand said.
While Rand is confident that all the differences will be resolved, Mayor Dave Ransburg said he did not know when the subject is likely to come before the council.
''Will it come back on? I don't know,'' Ransburg said. ''It may never come up again.''
Another part of the proposal is for AMT to pay the city a fee of $60,000 a year for using the city's dispatch system. Currently, they pay nothing.
''All that the city provides to AMT is an address to an emergency situation,'' Rand said. He said the service is not comparable to what other departments, such as the Peoria Sheriff's Department, receive.
''The city's dispatch center actually follows a deputy to that whole call,'' he said. ''With AMT it is not even dispatching; it's simply messaging from their computer to ours.''
Dual dispatch of paramedics not unique to Peoria
Re. criticisms that have been written by Dr. John Carroll and Dr. Diane Weis regarding the care given in the pre-hospital setting in Peoria:
I serve as the Emergency Medical Services (EMS) medical director for the Peoria area, the largest EMS system in Illinois. The care given is exemplary. Dual dispatch of basic providers and advanced paramedic providers is not unique to Peoria. This model has developed through national pre-hospital medical research and input of the Peoria Medical Advisory Board, which has representatives from five area hospitals.
The system works because multiple hands may be needed at the scene of an accident or a cardiopulmonary arrest. Basic EMTs and paramedics work side by side evaluating patients, taking vitals, applying monitors and defibrillators, and loading patients into ambulances. This team approach actually improves patient care while simultaneously freeing up the firefighter to return to a station.
-Without belaboring the details of the case presented by Dr. Weis of the ''blue'' five-year-old Haitian Hearts child, her allegations of inadequate care are unfounded. Specifically, the EKG was absolutely not ''backward,'' as alleged. Perhaps one of AMT's paramedics can instruct Dr. Weis on proper EKG interpretation. The basic EMTs of the Peoria Fire Department did exactly as trained, within an acceptable time frame.
Loading patients rapidly and haphazardly into a waiting ambulance is antiquated, dangerous and adversely affects patient care. There are limited ''load and go'' situations, generally limited to trauma patients. Finally, no advanced procedures would have been indicated in this case.
AMT provides an essential community service with multiple, basic-level provider agencies throughout the region. This occurs not because rural agencies are prohibited from obtaining advanced status but because there is significant cost in training and equipment. Recently, AMT also was recognized for volunteering to transport psychiatric patients for the sheriff's department without charge to Peoria County. This is only the tip of the iceberg.
Next time Dr. Weis decides to criticize, she should get her facts straight.
Dr. Jim Hubler
EMS Medical Director
OSF Saint Francis Medical Center
Peoria
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My Forum Article Submission (Not published by JS)
8 December 2002--
I am compelled to respond to Dr. Jim Hubler's recent forum opinion. Dr. Hubler is the Emergency Medical Systems Director at OSF-SFMC.
During Dr. Hubler's defense of Advanced Medical Transport (AMT) pre-hospital care, he referred to the nationality of my 5-year-old patient. Why his nationality would be deemed important is problematic. A patient's country of origin is not significant in a medical emergency. Also, patient confidentiality needs to be respected, as I am sure Dr. Hubler very clearly understands.
Black-skinned patients can in fact be blue when their blood does not carry enough oxygen. Dr. Hubler may have underestimated the severity of this child's illness. My patient was very blue due to his severe congenital heart disease. The AMT paramedics told me that they were unable to measure the child's oxygen level because they did not have the monitor on their ambulance. This monitor is considered standard of care and routinely used virtually everywhere in the developed world. (My patient's oxygen was measured at 66% in the ER. Any number below 90% is considered poor.)
Dr. Diane Weis' comments were true that the ECG performed by the AMT paramedics was technically inadequate. The leads placed on the child were not placed in the standard locations. (In addition to the time and cost, the ECG's utility even if properly performed would have been negligible for this patient.)
Dr. Hubler stated that the Peoria Fire Department did exactly as trained within an acceptable time frame. I agree completely. The PFD arrived at the child's home 4 minutes after dispatch. The problem, however, was AMT's time. AMT arrived 11 minutes after they were dispatched and then spent 17 more minutes on scene duplicating the PFD's clinical assessment. Much time was wasted with a very sick child that the PFD was not allowed to transport.
Thus, I strongly question the "exemplary care" described by Dr. Hubler. However, I do not fault him or the paramedics involved. They are simply responding to their handlers. The integrity of Emergency Medical Services in Peoria is currently being challenged. Virtue honors the fundamental humanity of all patients and requires subordination of self-interest. Emergency health care providers have a tremendous opportunity now to reaffirm their commitment to the people of Central Illinois.
John A. Carroll, MD
Peoria
Comments in 2021--
As mentioned above, the patient in the case above was a Haitian Hearts patient. I brought him from Haiti and I took care of him when he arrived in the ER at OSF. He had severe Tetralogy of Fallot which is the most common cause of congenital cyanotic heart disease.
He was in bad shape that day. And a pulse ox had not been measured when he was transported.
Dr. Weis was correct. The limb leads of his ECG were not correctly placed.
However, it is important not to lose the forest in the trees. My main problem with EMS in Peoria is not what the AMT medics did on the street. My main problem is that the PFD Paramedics were being held back and not encouraged to upgrade their level of care for the people of Peoria.
It is interesting to look back on Dr. Hubler referring to the five-year-old as a Haitian Hearts patient. Maybe he knew something the rest of us did not know. (Keith Steffen, OSF's Administrator, had been saying behind the scenes that he was going to stop Haitian Hearts and also commented behind the scenes that Haitian kids made him "want to puke." It would be a short amount of time later when OSF would ban any Haitian Hearts patient from receiving repeat medical care at OSF and this would cause young lives to be lost.
Dr. Hubler went on to resign as Project Medical Director at OSF after serious arguments with Andrew Rand. Plus, Hubler was working "too closely" with the PFD to get four Engines to become Paramedic. And Hubler moved to the Proctor Emergency Department and started his own EMS agency based out of Proctor, now called Unity Point-Proctor.
Oh, and by the way. I am in contact with the young patient above who has grown into a wonderful young man and is doing very well. And believe it or not, he works at OSF.
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Doctor's letter about heart treatment unwarranted
I read in disbelief Dr. Jim Hubler's Dec. 8 Forum criticism (''Dual dispatch of paramedics not unique to Peoria'') of Dr. Diane Weis' Nov. 25 Forum letter (''Restricting life support to AMT endangers lives'') concerning the congenital heart patient as well as Dr. Weis' alleged lack of knowledge regarding the ECG report.
As the coordinator of the Haitian Heart program and as a registered nurse, I felt it was unprofessional for Dr. Hubler to say it was a Haitian patient. Does that mean a different level of care? What about confidentiality? What does nationality have to with patient care?
I was present when this child was brought into the emergency room. If Dr. Hubler would have researched the situation, he would have found Dr. Weis' comments regarding the error of the ECG and the lack of a pulse ox were in fact correct. He should look into the facts next time before making such unwarranted remarks.
Anne Wagenbach
Haitian Hearts coordinator
Peoria
AMT wants city to sign 10-year contract -- Members of ambulance service want exclusive rights to transport patients
PEORIA - Representatives of Peoria's sole ambulance service want the city to sign an agreement giving them exclusive rights to continue treating and transporting patients for the next 10 years.
''Every time you turn around the fire department is proposing to start up ambulance service,'' said Andrew Rand, Advanced Medical Transport executive director. ''We want to create some stability . . . who needs to be in fear of municipal takeover? It's a distraction to our principle goal of tending to patients.''
Rand made those comments and others during a Thursday meeting with the Journal Star's editorial board and on Friday. His independent not for-profit organization backed by Peoria's three hospitals has provided ambulance service to 22 Peoria-area communities for more than 10 years.
For several years, city officials have discussed the option of allowing the Fire Department to expand its role to include transporting patients to the hospital and providing advanced life support, the highest level of paramedic care.
That would mean upgrading the current highest level of fire department service from basic life support - which happens to be the lowest level as well - in addition to creating a new substantial revenue stream for the city by billing patients.
But Dr. George Hevesy, director of Emergency Medical Services and chairman of the emergency medicine department at OSF Saint Francis Medical Center, says it's not that simple.
If Peoria firefighters took up that role, he claims it would threaten to fragment the current EMS system and potentially jeopardize patient care.
''Does that mean two ambulances will be racing to be first at the scene?'' Hevesy asked, adding that firefighters also might then be distracted from their primary role.
Moreover, Rand said the change ''could produce catastrophic events'' by destroying the core of AMT's business which Peoria now provides, and in turn would affect the service they provide outside the city, eventually putting the business at mortal risk.
Fire Chief Roy Modglin said on Friday he couldn't yet comment on the proposal.
Proponents of letting the Fire Department transport the patients argue that the department is usually first on the scene of an emergency situation.
Additionally, a number of already-employed firefighters have the training necessary to employ the expanded role.
Still, Rand asked why city officials would want to risk millions of dollars by tampering with what he called an already excellent service that doesn't cost taxpayers a dime.
Another part of the proposal, which will be up for discussion during the next City Council meeting Tuesday night, is for AMT to pay the city a fee of $60,000 every year for using the city's dispatch system.
Currently, AMT receives the service for free.
The proposal would also have AMT provide free training to Peoria firefighters to help upgrade their status to intermediate life support, meaning firefighters would be able to administer some drugs and start intravenous fluids, which they presently cannot do.
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Firefighters' union opposes AMT deal -- Contract lacks penalties, leader says
PEORIA - The union representing the city's firefighters opposes a proposed agreement with Peoria's sole ambulance provider, saying it not only blocks firefighters from branching into ambulance transport but also lacks teeth.
Tony Ardis, president of Firefighters Local 50, said Advanced Medical Transport of Central Illinois has operated too long without a city contract, unlike other companies in their position.
But he says the current proposal lacks, for example, penalties for poor response time or failure to meet specific standards - terms typically outlined in contracts.
''This is basically guaranteeing they will not have any competition from the city for at least six (to 10) years,'' said Ardis, who met with the Journal Star editorial board Monday.
Andrew Rand, AMT's executive director, argues his company's record speaks for itself. AMT is the only private ambulance agency in Illinois and one of about 70 nationwide to be nationally accredited by the Commission on Accreditation of Ambulance Services.
''I think our track record stands for itself,'' Rand said.
The proposed franchise agreement - up for council discussion tonight - would allow AMT to treat and transport patients in Peoria for the next 10 years and requires AMT to begin paying $60,000 a year for use of the city's dispatch system.
It also states city firefighters may upgrade training from basic to intermediate life support so they could administer some drugs and start intravenous fluids.
At-large Councilman Eric Turner, who placed the item on the agenda, said it could be brought to a vote. He noted the city cannot afford to go into the ambulance business.
''I will support firefighters in terms of keeping their jobs. . . . One thing I cannot support is any expansion of government services in any department in the city,'' he said. ''We cannot pay for what we've got now.''
Ardis, however, wants the city to go into the ambulance business, which would require an even higher level of training, up to advanced life support or the paramedic level.
He says it would cost $2.38 million for the city to buy four ambulances, hire 30 paramedics to staff them, buy equipment and pay for training. The paramedics' pay would be similar to firefighters, who make from $33,000 to $44,000.
If the city charged residents fees similar to AMT and handled all of the city's 911 emergency calls, Ardis estimates the city could collect $4.2 million the first year.
The money would stay within the city, rather than go to a private company, Ardis said. But Rand says any profit AMT generates goes back into the community, whether it's for heart defibrillators or contributions to the Heartland Clinic.
If the city did get into transport, it could add two more ambulances in the second year, Ardis said. Under that scenario, he said the 12 fire engines that now respond to emergency calls would continue to do so, along with ambulance teams.
Rand said the number of ambulances in service for AMT ranges from five to 10, depending on the level of need.
City says no to AMT -- Agreement would have kept firefighters from upgrading skills
PEORIA - The City Council narrowly voted down an agreement Tuesday that would have prevented city firefighters from upgrading their medical training or moving into the ambulance business anytime soon.
But that should not be an indication that the city wants to edge into the business provided by Advanced Medical Transport of Central Illinois, the subject of the proposed agreement.
Fire Chief Roy Modglin - who encouraged the council not to pass the agreement - stressed the city had no plans to start transporting patients, a statement later echoed by the fire union president.
Modglin said the issue instead revolved around the Fire Department's desire to upgrade from basic to intermediate life support, which allows them to administer some drugs and start intravenous fluids.
''No private business, not-for-profit should be allowed to limit the level of (medical) service provided to citizens,'' he said. ''If this City Council wants to allow our city firefighters to be doctors, that should be our prerogative.''
The proposed agreement with AMT would have prevented city firefighters from upgrading to advanced life support - the highest level - and entering the ambulance business for at least the next six to 10 years.
It also would have required AMT to pay the city a fee of $60,000 a year for using the city's dispatch system - an amount some on the council said was too low.
After a request to defer the issue was voted down, the council voted 6-5 against the proposed agreement with AMT. Voting against were 1st District Councilman Clyde Gulley Jr., 4th District Councilman Bill Spears, 5th District Councilman Patrick Nichting and at-large Councilmen Gary Sandberg, Chuck Grayeb and Jim Ardis.
Andrew Rand, executive director of AMT, said he was surprised by the vote.
''We'll still be a highly qualified provider of medical care. We will find a way to collaborate (with the city) for everyone's best interest, most importantly the citizens,'' said Rand, who has argued allowing firefighters to handle transport would fragment the city's emergency system and likely drive AMT out of business.
Modglin said while the firefighters' union has been studying the possibility of doing ambulance transport for some time, it doesn't mean the Fire Department is moving in that direction.
''With all due respect to the union, they have their plans and the city has their plans and maybe they don't always coincide,'' he said.
At-large Councilman Eric Turner, who initially requested the agreement be approved, said he expects the issue will return to the council at some point after further negotiation.
Turner said he supported the agreement because it would have blocked the city from entering new territory that he estimated would cost millions.
''We've got a deficit situation this year. It would be great to get into the transport business. But this is the real world,'' he said.
Others on the council said the agreement would not have held AMT accountable for its performance - something Gulley said led him to vote ''no.'' After the meeting, he said he still supports most of the agreement.
Ardis said he felt this issue boiled down to ''egos and insecurities. I won't say who's got what but if the shoe fits, wear it.''
AMT is an independent, not-for-profit organization backed by the three Peoria hospitals. It has been providing ambulance and transportation services to 22 communities in Peoria and Tazewell counties for more than 20 years.
It responds to an average of 20,000 emergency 911 calls and 10,000 non-emergency calls annually.
In other news Tuesday, the council:
* Approved an agreement with the YWCA outlining what money the agency will receive or must repay depending on whether state and federal officials sign off on a plan to place transitional housing for homeless women and children in the North Valley.
If they receive those approvals, the YWCA can retain $75,000 in city funds and get $150,000 in federal funds. If not, the agency must repay the city $75,000 by Aug. 15.
The YWCA hopes to begin construction of five duplexes on a vacant lot along Glendale. That property falls outside a national historic district which has so far stood in the way of the YWCA's plans to demolish a 1930s apartment building at 801 NE Perry Ave.
* Voted to indefinitely table possible changes to the way pushcart food vendors are regulated.
My Comments in 2021--
An amazing article. Chief Modglin was hitting it all on the head. If this would have passed, AMT and OSF would have been successful keeping the PFD from upgrading their service for the people of Peoria.
OSF and AMT failed here...but just temporarily.
However, the PFD would still be held to Basic-D. No upgrade for them quite yet. But it was coming. Stay tuned.
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City doesn't need to be in ambulance business
Rockford, population 143,609, loses at least $2 million a year on its city-owned ambulance service. Taxpayers ante up 50 cents for every dollar an ambulance trip costs.
Asked if he can envision a way Rockford's ambulances could turn a profit, Finance Director Andre Samuels chuckles and says, ''We'd just like to break even.''
Brian Caputo, finance director for Aurora, population 112,892, says the city hasn't tried to separate emergency service costs from firefighting costs but ambulance service ''definitely does not'' make a profit. ''It costs us money.''
Naperville, population 128,300, collects $535,000 a year in ambulance fees but spends $2.4 million to run ambulances. John Morris, acting finance director, says no rate increase he recommends, and he's preparing to recommend one, will close the gap. To make a profit, he says fees ''would be astronomical.'' Insurers wouldn't pay them.
East Peoria, population 22,638, gets tossed out as a community that makes a profit off ambulances. It doesn't. In the most recent year it spent $814,000 for the service and took in $505,000, according to City Administrator Tom Brimberry. But the paramedics who man the ambulances are cross-trained to fight fires, and Fire Chief Roger Aylward believes that makes the service ''very efficient'' for a community East Peoria's size. The city gets a firefighting boost in an emergency.
Pat Mullen, district chief of emergency medical services for the Naperville Fire Department, periodically surveys Chicago suburbs for ambulance rates and other details. He received 133 responses to his most recent inquiry. He found no cash cows.
''I don't believe, based on the information I have, that anyone makes money or even breaks even on ambulance service,'' he says.
Peoria, population 112,892, comes close to breaking even because it is not in the ambulance business. City taxpayers do provide some support services, such as dispatch, and firefighters supply backup and help with hard cases that require lifting or extra personnel.
But, by and large, Peoria taxpayers are out of the ambulance business because a not-for-profit organization called Advanced Medical Transport (AMT) is in it. The firefighters union tried to change that seven years ago and failed. It's trying again and is getting a hearing at City Hall, which cannot have another $5 million deficit year.
Union President Tony Ardis argues that the city could turn as much as a $1.9 million profit by letting the fire department do what AMT does: respond to emergencies, make hospital trips and bill for services. Presently firefighters either precede or follow AMT to emergencies, but patients can't be billed twice.
''The argument is to make money for the city, a substantial amount of revenue,'' Ardis says, as well as to offer better, quicker care than AMT does. One scenario calls for Peoria to hire 30 more firefighters and buy and equip four ambulances the first year of service, more the second.
At Tuesday's City Council meeting Fire Chief Roy Modglin said his department has not proposed running ambulances. He quickly added that the city ''shouldn't close its door to money-making opportunities.''
However, logic suggests that ambulance service would be a moneylosing opportunity for local taxpayers. Firefighters make higher salaries and have better benefits than AMT employees. By serving five counties and 22 communities, AMT benefits from the economies of scale. It's made the capital investment. It has the experience.
And then there's the problem of demographics.
According to AMT, private insurance pays for only 21 percent of emergency transports in the city. Medicare pays 42 percent and Medicaid 20 percent. Fifteen percent of AMT's riders are uninsured. AMT charges $495, plus mileage, for emergency trips. But Medicare pays as little as $144, Medicaid $93 and most of the uninsured nothing. A budget a firefighters committee drew up in August overestimates the number of insured, underestimates the Medicare volume and omits Medicaid.
On Tuesday the council rejected a 10-year agreement with AMT that would have kept the city out of the ambulance business for at least six years. In return, firefighters would have been allowed to upgrade their certification and Peoria would have received $60,000 to compensate for dispatching ambulances. There may have been valid reasons to reject the proposal, namely the absence of public debate and the indication on the agenda that action was not intended. But the belief that there is money to be made off ambulances was not one.
Peoria-area people are well-served by an ambulance service that taxpayers subsidize only minimally and that the medical community backs with near unanimity. A supportive letter the emergency services directors at all three Peoria hospitals wrote last month to the City Council says Peoria ''has one of the most clinically sophisticated, cost-effective EMS systems in America.''
James Hubler, EMS Director at OSF St. Francis, says that if Peoria were to go its own way, area residents would end up with a fragmented system that would damage the quality of care. Ardis argues that the hospitals' judgment is biased because they helped set up AMT and share some high-ranking personnel. Could be.
But when the experts say a system as critical as ambulance service is best left the way it is, Peorians should be extremely reluctant to throw it out, whether or not money could be made. When there is only money for taxpayers to lose, then the discussion should end.
Given that the fire department is the city's second-largest, a serious examination of options for cutting costs is in order. But going into the ambulance business should not be among them.
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Comments in 2021--
The JS states for the first time that the hospitals that support AMT may have biased judgement regarding the PFD upgrading their services for Peoria.
Do you think?
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My comments in 2021--
In 2004, when Matrix Consulting looked at the EMS response times of AMT and the PFD, they found that on average the PFD was responding about 2 minutes quicker than AMT. -----
Don't let ambulance service control firefighters
Kudos and thank you to those Peoria City Council members who voted ''no'' to the Advanced Medical Transport agreement. If the agreement regarding ambulances comes before them in any other form, they should vote that down, as well.
There is no part of this agreement that is a benefit to the residents of Peoria. If anything, it is dangerous and sets a precedent that could affect how city government is run for many years to come.
To those council members who voted yes, what part of this agreement is in any way helpful to any resident of Peoria? The city fire department could not start up an ambulance service (transporting patients) without the City Council approving a large sum of money for its startup. There is no way that can happen in 2003 or any time soon. So is the problem that those council members cannot contain themselves from voting ''yes'' on anything that comes before them? Is that why they need a six- to 10-year binding agreement to keep them from spending that money when it is not in the budget?
Why would anyone want to limit the fire department from improving life-saving skills when the opportunity arrives now or at any other time? Why would anyone want to vote on an agreement with any private business, not-for-profit or otherwise, that so limits any city department?
The fire department has not even yet proposed getting into the ambulance business. Why was this agreement rushed to the floor and voted on before residents had a chance to give input on the matter?
This was not only an unnecessary agreement, it was a dangerous one for every person in the city. Whose best interests do those City Council members have in mind? It surely isn't mine or any member of my family.
Sherry Harris
Peoria
My Comments in 2021--
Ms. Harris comments hit it on the head.
Why would anyone want to restrict the PFD firefighter paramedics from giving the best possible care at the scene of a medical call?
In 2003, the PFD paramedics could not function as paramedics at the scene. A few years later, Rick Miller the PAEMS medical director would change the rules behind the scenes which would allow the PFD paramedics to function as paramedics when AMT arrived.
The idea was to keep AMT as the only ALS and transport agency in the city of Peoria. Now, in 2021, most of the PFD Engines are Paramedic and can function independently at an EMS call. In other words, the PFD no longer has to wait for AMT to arrive to give the patient the highest level of emergent medical care.
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When OSF gets challenged, they ask someone in the community to come to their defense to argue for them. This was to happen multiple times over the next few years with EMS and with Haitian Hearts. -----
There is no part of this agreement that is a benefit to the residents of Peoria. If anything, it is dangerous and sets a precedent that could affect how city government is run for many years to come.
To those council members who voted yes, what part of this agreement is in any way helpful to any resident of Peoria? The city fire department could not start up an ambulance service (transporting patients) without the City Council approving a large sum of money for its startup. There is no way that can happen in 2003 or any time soon. So is the problem that those council members cannot contain themselves from voting ''yes'' on anything that comes before them? Is that why they need a six- to 10-year binding agreement to keep them from spending that money when it is not in the budget?
Why would anyone want to limit the fire department from improving life-saving skills when the opportunity arrives now or at any other time? Why would anyone want to vote on an agreement with any private business, not-for-profit or otherwise, that so limits any city department?
The fire department has not even yet proposed getting into the ambulance business. Why was this agreement rushed to the floor and voted on before residents had a chance to give input on the matter?
This was not only an unnecessary agreement, it was a dangerous one for every person in the city. Whose best interests do those City Council members have in mind? It surely isn't mine or any member of my family.
Sherry Harris
Peoria
Upgrading emergency skills won't compromise services
This letter is response to several other articles recently written about the Peoria Fire Department upgrading its level of emergency medical service (EMS). For the record, I have been involved in fire-based EMS for over 20 years and have been employed by the East Peoria Fire Department for the past 161/2 years. I am writing this as a concerned individual and no way representing the East Peoria Fire Department.
Upgrading the level of emergency medical service of the Peoria Fire Department is an excellent plan. Anyone who is truly concerned with the welfare of the citizens of Peoria should strongly support this effort.
Articles have been written stating that if the Peoria Fire Department upgrades its level of EMS, its response to structure fires or other emergencies would somehow be compromised. A recent article even quoted a local hospital's emergency medical director questioning the Peoria Fire Department's response.
The fact is that the Peoria Fire Department already responds to emergency medical calls (911), auto accidents and many other types of emergencies requiring medical treatment. They do this while maintaining the best coverage of the rest of the city possible by reallocating resources, just like all other emergency service agencies, including Advanced Medical Transport. In reality, no one agency in any community has the resources to maintain ''ideal'' coverage all of the time, no matter what they might say.
The cost/revenue issue has also been brought up. There would, without a doubt, be a cost involved in upgrading the level of EMS provided by the Peoria Fire Department, but those involved should look at those costs as an investment that will provide a return to the community. Money generated through billing could be used to offset expenses, and lead to a much-improved ability to provide emergency medical treatment to the citizens, who should be in the forefront of the decision-making process.
With the current budget problems facing the city of Peoria, I won't even try to suggest which type of service the Peoria Fire Department should move towards. Those types of decisions should involve the mayor, City Council, Peoria Fire Department and the Peoria-area EMS system medical director. It is my opinion that no private business should be directly or indirectly involved in making decisions for the city.
If the Peoria Fire Department upgrades its level of EMS, no other agency should feel threatened. If all involved would take an honest look, they would have to admit that, just like on the Illinois River, there's not an overabundance of resources (including ambulances or paramedics) available. All parties involved should be able to work together in order to provide the best services available to the citizens of the community.
Mike Vaughn
Washington
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My Comments in 2021--
Mike states that the decision making of what type of upgraded services should in part by made by the citizen of Peoria. He also warns that allowing a private business (like AMT) to make a governmental decision is not good.
The Peoria Area EMS Project Medical Director was not pro PFD upgrading their services. There was and still is a huge amount of conflict of interest which has not served the citizens of Peoria well.
In the mid 2000s AMT got a 20 year contract with the City of Peoria. And even though AMT is providing a governmental function for Peoria, they will not release their response times to emergency medical calls. Thus, no transparency.
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This letter is response to several other articles recently written about the Peoria Fire Department upgrading its level of emergency medical service (EMS). For the record, I have been involved in fire-based EMS for over 20 years and have been employed by the East Peoria Fire Department for the past 161/2 years. I am writing this as a concerned individual and no way representing the East Peoria Fire Department.
Upgrading the level of emergency medical service of the Peoria Fire Department is an excellent plan. Anyone who is truly concerned with the welfare of the citizens of Peoria should strongly support this effort.
Articles have been written stating that if the Peoria Fire Department upgrades its level of EMS, its response to structure fires or other emergencies would somehow be compromised. A recent article even quoted a local hospital's emergency medical director questioning the Peoria Fire Department's response.
The fact is that the Peoria Fire Department already responds to emergency medical calls (911), auto accidents and many other types of emergencies requiring medical treatment. They do this while maintaining the best coverage of the rest of the city possible by reallocating resources, just like all other emergency service agencies, including Advanced Medical Transport. In reality, no one agency in any community has the resources to maintain ''ideal'' coverage all of the time, no matter what they might say.
The cost/revenue issue has also been brought up. There would, without a doubt, be a cost involved in upgrading the level of EMS provided by the Peoria Fire Department, but those involved should look at those costs as an investment that will provide a return to the community. Money generated through billing could be used to offset expenses, and lead to a much-improved ability to provide emergency medical treatment to the citizens, who should be in the forefront of the decision-making process.
With the current budget problems facing the city of Peoria, I won't even try to suggest which type of service the Peoria Fire Department should move towards. Those types of decisions should involve the mayor, City Council, Peoria Fire Department and the Peoria-area EMS system medical director. It is my opinion that no private business should be directly or indirectly involved in making decisions for the city.
If the Peoria Fire Department upgrades its level of EMS, no other agency should feel threatened. If all involved would take an honest look, they would have to admit that, just like on the Illinois River, there's not an overabundance of resources (including ambulances or paramedics) available. All parties involved should be able to work together in order to provide the best services available to the citizens of the community.
Mike Vaughn
Washington
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My Comments in 2021--
Mike states that the decision making of what type of upgraded services should in part by made by the citizen of Peoria. He also warns that allowing a private business (like AMT) to make a governmental decision is not good.
The Peoria Area EMS Project Medical Director was not pro PFD upgrading their services. There was and still is a huge amount of conflict of interest which has not served the citizens of Peoria well.
In the mid 2000s AMT got a 20 year contract with the City of Peoria. And even though AMT is providing a governmental function for Peoria, they will not release their response times to emergency medical calls. Thus, no transparency.
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Buy a few used ambulances for the fire department
According to the Journal Star, Peoria's interim city manager, Steve Van Winkle, recommends keeping Fire Station 11 open. Residents in that area will find that consoling, but they need to realize what the Peoria Fire Department can and can't do for them in emergency medical situations.
The department is only allowed to provide basic life support. This means no IV, no breathing tube and no advanced life support medication. Firefighters cannot transport sick or injured people. Patients must wait for Advanced Medical Transport paramedics to transport them and provide advanced life support if necessary. AMT is the only provider in Peoria allowed to give both services.
Would Mr. Van Winkle and the city agree to purchase a few used, low-priced ambulances for the PFD? At the same time firefighters who have been trained as paramedics would be allowed to use their skills assessing patients, administering advanced support as necessary and providing support for the PFD ambulance at the scene. Not every firefighter needs to or should be a paramedic. On the other hand, 90 percent of 911 emergency medical calls do not need AMT's advanced life support services. Seems like a compromise may be appropriate.
This two-tiered response has been used successfully by many municipal fire departments around the United States for years. With changes supported by the medical literature, Peoria's emergency medical system could be quicker, more efficient and much improved.
As stewards of public health care for their constituents, local community leaders must become increasingly knowledgeable about emergency medical systems. Quality service for the people in Fire Station 11's territory and for all of Peoria, not profit for an individual ambulance company, needs to be the goal.
Dr. John A. Carroll
West Peoria
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According to the Journal Star, Peoria's interim city manager, Steve Van Winkle, recommends keeping Fire Station 11 open. Residents in that area will find that consoling, but they need to realize what the Peoria Fire Department can and can't do for them in emergency medical situations.
The department is only allowed to provide basic life support. This means no IV, no breathing tube and no advanced life support medication. Firefighters cannot transport sick or injured people. Patients must wait for Advanced Medical Transport paramedics to transport them and provide advanced life support if necessary. AMT is the only provider in Peoria allowed to give both services.
Would Mr. Van Winkle and the city agree to purchase a few used, low-priced ambulances for the PFD? At the same time firefighters who have been trained as paramedics would be allowed to use their skills assessing patients, administering advanced support as necessary and providing support for the PFD ambulance at the scene. Not every firefighter needs to or should be a paramedic. On the other hand, 90 percent of 911 emergency medical calls do not need AMT's advanced life support services. Seems like a compromise may be appropriate.
This two-tiered response has been used successfully by many municipal fire departments around the United States for years. With changes supported by the medical literature, Peoria's emergency medical system could be quicker, more efficient and much improved.
As stewards of public health care for their constituents, local community leaders must become increasingly knowledgeable about emergency medical systems. Quality service for the people in Fire Station 11's territory and for all of Peoria, not profit for an individual ambulance company, needs to be the goal.
Dr. John A. Carroll
West Peoria
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City needs independent study of ambulance service
Peoria's new city manager, Randy Oliver, is organizing a commission to study emergency medical services (EMS) in Peoria. The editorial board of the Journal Star pleads for a fiscally responsible decision regarding these services. Local physicians need to insist that both fiscally and medically responsible choices are made for pre-hospital patients.
The EMS services in Peoria are provided by two agencies. Advanced Medical Transport (AMT) provides the only advanced life support service and transport of patients. This company is supported by Peoria's three hospitals and governing boards. AMT grosses over $7 million per year and desires a 10-year contract to remain the only paramedic and transport agency in Peoria. The second agency is the Peoria Fire Department. Firefighters arrive quickly at the scene, but can provide only basic life support and are not permitted to transport patients.
The Peoria Medical Society needs to consider the following questions: Who will compile and interpret the statistics regarding local EMS care? What EMS issues will be analyzed? What is the response time for the Peoria Fire Department versus AMT to an emergency? How much time elapses from the 911 dispatch call until the electrical shock is administered to a patient in full cardiac arrest?
When AMT arrives at the scene and begins its advanced life support, have the patients waited longer than necessary? What percentage of Peorians survive and walk out of the hospital after suffering a cardiac arrest? Are Peoria's trauma patients transported quickly and efficiently with the "scoop and treat" philosophy? How does Peoria compare to other cities in the U.S. and Canada that have state-of-the-art EMS? Might it not be responsible and medically important to allow Peoria firefighters to advance their skills (such as improved airway control and IV medication administration) to improve patient outcome?
The most important question is: Can Peoria's EMS system be studied in an independent and unbiased fashion? The same doctors, administrators and boards of directors that made questionable decisions 10 years ago are still in absolute control today.
Thus, the Peoria Medical Society needs to do exactly what the first sentence of its mission statement professes: To promote the health and general welfare of the Peoria public. Peoria's pre-hospital patients have never been in a more perilous situation. Encourage Oliver's study to ask the correct questions and answer them using scientific rigor. Then and only then will fiscal and medically appropriate decisions be made regarding EMS in Peoria.
Dr. John Carroll
Peoria
Peoria's new city manager, Randy Oliver, is organizing a commission to study emergency medical services (EMS) in Peoria. The editorial board of the Journal Star pleads for a fiscally responsible decision regarding these services. Local physicians need to insist that both fiscally and medically responsible choices are made for pre-hospital patients.
The EMS services in Peoria are provided by two agencies. Advanced Medical Transport (AMT) provides the only advanced life support service and transport of patients. This company is supported by Peoria's three hospitals and governing boards. AMT grosses over $7 million per year and desires a 10-year contract to remain the only paramedic and transport agency in Peoria. The second agency is the Peoria Fire Department. Firefighters arrive quickly at the scene, but can provide only basic life support and are not permitted to transport patients.
The Peoria Medical Society needs to consider the following questions: Who will compile and interpret the statistics regarding local EMS care? What EMS issues will be analyzed? What is the response time for the Peoria Fire Department versus AMT to an emergency? How much time elapses from the 911 dispatch call until the electrical shock is administered to a patient in full cardiac arrest?
When AMT arrives at the scene and begins its advanced life support, have the patients waited longer than necessary? What percentage of Peorians survive and walk out of the hospital after suffering a cardiac arrest? Are Peoria's trauma patients transported quickly and efficiently with the "scoop and treat" philosophy? How does Peoria compare to other cities in the U.S. and Canada that have state-of-the-art EMS? Might it not be responsible and medically important to allow Peoria firefighters to advance their skills (such as improved airway control and IV medication administration) to improve patient outcome?
The most important question is: Can Peoria's EMS system be studied in an independent and unbiased fashion? The same doctors, administrators and boards of directors that made questionable decisions 10 years ago are still in absolute control today.
Thus, the Peoria Medical Society needs to do exactly what the first sentence of its mission statement professes: To promote the health and general welfare of the Peoria public. Peoria's pre-hospital patients have never been in a more perilous situation. Encourage Oliver's study to ask the correct questions and answer them using scientific rigor. Then and only then will fiscal and medically appropriate decisions be made regarding EMS in Peoria.
Dr. John Carroll
Peoria
Giving away defibrillators a diversion by AMT
Advanced Medical Transport (AMT), Peoria's ambulance company, is in the middle of a well-publicized giveaway campaign. It is "donating" automatic external defibrillators (AEDs) to organizations in Peoria. These machines can shock and restart a heart.
As AMT advertises, for each minute during a cardiac arrest that the patient does not receive an electrical shock, there is a 10 percent decline in the chance of survival. Unequivocal evidence exists confirming the critical relationship between time to shock and survival.
So why was AMT allowed to shock people's hearts for years before the Peoria Fire Department was allowed to? The importance of using electricity during a cardiac arrest has been known for decades. In 1992, the American Heart Association recommended that basic life support units, such as the Fire Department, should carry and use AEDs. Children have been taught quickly and effectively how to use an AED. So what delayed the Fire Department from using this life-saving apparatus?
The AED giveaway by AMT and its powerful supporters is timely but very diversionary. Their concerted efforts will attempt to preserve their status as the only paramedics in Peoria, while keeping the fire department at its present status as a basic, non-transport entity. How many more Peorians will suffer and die before this scandal is stopped?
Peoria physicians and the rest of Illinois' pre-hospital care providers know why this "plays in Peoria." Do you?
Dr. John A. Carroll
West Peoria
Advanced Medical Transport (AMT), Peoria's ambulance company, is in the middle of a well-publicized giveaway campaign. It is "donating" automatic external defibrillators (AEDs) to organizations in Peoria. These machines can shock and restart a heart.
As AMT advertises, for each minute during a cardiac arrest that the patient does not receive an electrical shock, there is a 10 percent decline in the chance of survival. Unequivocal evidence exists confirming the critical relationship between time to shock and survival.
So why was AMT allowed to shock people's hearts for years before the Peoria Fire Department was allowed to? The importance of using electricity during a cardiac arrest has been known for decades. In 1992, the American Heart Association recommended that basic life support units, such as the Fire Department, should carry and use AEDs. Children have been taught quickly and effectively how to use an AED. So what delayed the Fire Department from using this life-saving apparatus?
The AED giveaway by AMT and its powerful supporters is timely but very diversionary. Their concerted efforts will attempt to preserve their status as the only paramedics in Peoria, while keeping the fire department at its present status as a basic, non-transport entity. How many more Peorians will suffer and die before this scandal is stopped?
Peoria physicians and the rest of Illinois' pre-hospital care providers know why this "plays in Peoria." Do you?
Dr. John A. Carroll
West Peoria
Fire study not so 'objective'
Re. the Journal Star editorial of May 24, "Pursue most objective study of Peoria Fire Department":
The article states that Matrix Consulting would be the most objective consulting firm to evaluate the Peoria Fire Department because City Manager Randy Oliver states that it is. What the editorial does not state is that two members of the five-member panel agreeing with Oliver are Andrew Rand, director of Advanced Medical Transport (AMT), and Dr. Rick Miller, an OSF employee and physician in charge of all ambulances in the Peoria area, including AMT.
Their expertise does not include how the fire department should fight fires or fiduciary issues regarding the firemen's pensions. Rand and Miller simply want to make sure AMT will continue as the only paramedic and transport service in Peoria for the next several decades and hope that Matrix Consulting will agree. Amazingly, they expect taxpayers to pay $79,000 for this "objective" study.
Dr. John Carroll
Peoria
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Re. the Journal Star editorial of May 24, "Pursue most objective study of Peoria Fire Department":
The article states that Matrix Consulting would be the most objective consulting firm to evaluate the Peoria Fire Department because City Manager Randy Oliver states that it is. What the editorial does not state is that two members of the five-member panel agreeing with Oliver are Andrew Rand, director of Advanced Medical Transport (AMT), and Dr. Rick Miller, an OSF employee and physician in charge of all ambulances in the Peoria area, including AMT.
Their expertise does not include how the fire department should fight fires or fiduciary issues regarding the firemen's pensions. Rand and Miller simply want to make sure AMT will continue as the only paramedic and transport service in Peoria for the next several decades and hope that Matrix Consulting will agree. Amazingly, they expect taxpayers to pay $79,000 for this "objective" study.
Dr. John Carroll
Peoria
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Peoria's medical mafia limiting emergency care
Re. July 16 editorial, "Send corrupt health facilities planning board to morgue":
The Journal Star states that in Illinois, "Any board with this much authority over this much money becomes a trough of corruption." Truer words could not have been written. For 30 years lobbyists, attorneys and politically connected people have influenced the decisions made by this nine-member board regarding construction of new hospitals and expansion of existing ones in Illinois.
Unfortunately, similar conflicts of interest and cronyism are currently occurring in Peoria. The stakes are very high here with lives and money on the line.
In Peoria we have one paramedic transport company, Advanced Medical Transport (AMT). Its medical director is Dr. George Hevesy, who happens to be the medical director of OSF-St. Francis' emergency department. Dr. Hevesy is salaried by both OSF-St. Francis and AMT. OSF is the main supporter of AMT and is also the base station for all emergency medical services in central Illinois.
The AMT board of directors, composed of prominent Peorians, has the support of the OSF-St. Francis board of directors. Dr. Hevesy's relationship with the Illinois Department of Public Health in Springfield, which regulates paramedics and ambulances in the state, is well known in emergency medicine circles throughout Illinois. And finally, the Peoria City Council, which will decide if AMT remains in total control of paramedic care and transport in Peoria for the next decade, will consider the findings and recommendations of a California-based consulting firm.
Some members of the council suspect a pre-existing relationship between AMT and this California firm. One needs a scorecard to keep track of this local health care travesty.
In the meantime, the Peoria Fire Department continues to respond to medical emergencies, can only provide basic life support (not paramedic care) and cannot transport patients, even with its one ambulance. The PFD obviously does not enjoy the support of the above-named individuals, boards and state agencies.
The real loss, of course, is for Peorians who suffer an out-of-hospital medical emergency. State-of-the-art, pre-hospital emergency care is not offered in Peoria, not because we can't, but because our medical mafia will not allow it.
Dr. John Carroll
Peoria
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Re. July 16 editorial, "Send corrupt health facilities planning board to morgue":
The Journal Star states that in Illinois, "Any board with this much authority over this much money becomes a trough of corruption." Truer words could not have been written. For 30 years lobbyists, attorneys and politically connected people have influenced the decisions made by this nine-member board regarding construction of new hospitals and expansion of existing ones in Illinois.
Unfortunately, similar conflicts of interest and cronyism are currently occurring in Peoria. The stakes are very high here with lives and money on the line.
In Peoria we have one paramedic transport company, Advanced Medical Transport (AMT). Its medical director is Dr. George Hevesy, who happens to be the medical director of OSF-St. Francis' emergency department. Dr. Hevesy is salaried by both OSF-St. Francis and AMT. OSF is the main supporter of AMT and is also the base station for all emergency medical services in central Illinois.
The AMT board of directors, composed of prominent Peorians, has the support of the OSF-St. Francis board of directors. Dr. Hevesy's relationship with the Illinois Department of Public Health in Springfield, which regulates paramedics and ambulances in the state, is well known in emergency medicine circles throughout Illinois. And finally, the Peoria City Council, which will decide if AMT remains in total control of paramedic care and transport in Peoria for the next decade, will consider the findings and recommendations of a California-based consulting firm.
Some members of the council suspect a pre-existing relationship between AMT and this California firm. One needs a scorecard to keep track of this local health care travesty.
In the meantime, the Peoria Fire Department continues to respond to medical emergencies, can only provide basic life support (not paramedic care) and cannot transport patients, even with its one ambulance. The PFD obviously does not enjoy the support of the above-named individuals, boards and state agencies.
The real loss, of course, is for Peorians who suffer an out-of-hospital medical emergency. State-of-the-art, pre-hospital emergency care is not offered in Peoria, not because we can't, but because our medical mafia will not allow it.
Dr. John Carroll
Peoria
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Fire department good, AMT better -- Results of $79,000 study tell city to replicate stellar service of ambulance company
PEORIA - Peoria's Fire Department "provides a very high level of service," and its private ambulance service "really borders on the exceptional," according to California-based consultants hired to examine both services.
The Matrix Consulting Group of Palo Alto, Calif., walked the City Council through highlights of its 150-page, $79,000 study during a policy session Tuesday night. City Manager Randy Oliver pushed for the study, hoping an independent review would help the city develop long-range strategies and sidestep what has become a near annual debate over the fire department's budget.
Last year, debate over whether to close Fire Station 11 on Florence Avenue held up the overall budget for months before the council decided to keep it open, but cut its staff.
Most of the report was filled with relatively benign suggestions, such as looking into spending $240,000 on a system to pre-empt traffic lights. Indeed, at-large council member John Morris admitted he was looking for "more transformational, maybe even uncomfortable" recommendations.
Matrix did say the city dispatch and fire departments need to improve their initial handling of calls. Also, a city Peoria's size needs two battalion chiefs working at all times.
"That's one of the things you need to deal with immediately," Travis Miller, Matrix vice president, told the council. "About 25 percent of the time, you're managing operations in the field with one battalion chief. At least in the short term, you should fund that through overtime."
Fire Chief Roy Modglin said the report was "what we've been telling (the council) for years."
"Overall, I'm pleased with what they came up with," Modglin said. "A lot of it is substantially what we've been saying. Even (former) Chief (Ernie) Russell said some of this. But I do disagree with some things."
For instance, Modglin said a recommendation to close Station 3 because its calls can be covered by overlapping stations
"may look good on paper, but it wouldn't work in reality.
"Station 3 (near Bradley University) was the busiest one in town last year. It covered over 1,900 calls. And the stations surrounding it, which would supposedly pick up its calls, are the second, third and fourth busiest in town," Modglin said.
The study suggested planning for a new station on the northwest side of the city, which will cost an estimated $2.5 million to build and $1 million annually to operate. It also proposed closing Station 3 only if call volume continues to grow northeast of the city. Then, Matrix recommend re-opening Station 17 on Skyline Drive and staffing it with Station 3 personnel. They stressed working out an agreement with Peoria Heights to help cover costs, since a majority of Station 17's coverage area is within the village.
Modglin also noted political problems with that.
"I've been here 34 years, and I can remember only two occasions where they called us for assistance. The volunteer departments do not call the city of Peoria for assistance," Modglin said.
Modglin also disputed some of the data Matrix had on how long it takes firefighters to get out of the station, saying they've found glitches with the computerized "time stamp."
Matrix said Advanced Medical Transport, the city's not-for-profit, private ambulance company is very well managed, and the city should try and replicate the service. Training and outfitting firefighters to respond and transport medical calls will lose the city about $3.4 million a year.
"AMT does it, and does it well, for nothing. No cost to the city," Miller said.
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My Comments in 2021--(I sent the majority of these comments to the Journal Star in 2004 for an Op-Ed submission, but my article was not printed.)
In 2004, the PFD was Basic-D and nontransport. In 2021 8/12 PFD Engines are Advanced Life Support and nontransport.
Data crucial to provide metrics for evaluating EMS and ambulance service in Peoria was largely missing from the Matrix report.
According to the Matrix report, the current EMS System in Peoria is supervised by the Illinois Department of Public Health (IDPH) which maintains a district office in Peoria. In 2004, when I spoke to a representative in this office, he told me that he was unaware of the contents of the Matrix study and that he had only general data from AMT. He was unable to answer my specific questions regarding how Peoria pre-hospital patients suffering from chest pain, breathing problems, cardiac arrest, or trauma had done over the last decade.
The Matrix report stated that AMT's performance data was also submitted to the project medical director (the doctor in charge of all EMS and ambulances in central Illinois) who is located at OSF St. Francis Medical Center. When I spoke with the emergency medicine services manager who works for the project medical director in the EMS office at OSF, she told me that they had no aggregate data regarding how AMT performed in 2003 or for any year.
Something was obviously very wrong here. No data was available to see exactly how AMT was doing with the prehospital patient. Consistent with my conversations with the people mentioned above, the Matrix report contains absolutely no data about patient outcomes. The Matrix report stated that performance data was provided to IDPH and the project medical director, but my conversations with individuals from these offices indicate that this data has not been available, and thus not compiled or analyzed.
Over the years, AMT's Andrew Rand had told the media that AMT's arrival times at scene response were not later than the PFD arrival times. However, the Matrix report did not agree with Rand. To life-threatening emergencies in Peoria, the PFD arrival time was two minutes faster than AMT's arrival time. Matrix went on to say that medical research at the time showed that Advanced Life Support may help prehospital patients with chest pain and breathing problems. And research at the time showed that victims suffering severe trauma incur five percent increased mortality for each minute that they are not transported from the scene of the trauma. And in 2004, the PFD was not able to give Advanced Life Support when they arrived before AMT and, of course, not able to transport the patient. Of the more than 9,000 EMS calls the PFD responded to in 2003, 1,800 were for breathing problems, 900 for chest pain, and 1,700 for trauma. In none of these scenarios was the PFD allowed to give ALS care when arriving before AMT.
Based on the above, the Matrix report outlined a plan that would "increase the level of service" by allowing four fire department engines to be staffed with paramedic firefighters to respond to "targeted areas" in Peoria (like the far north side.) IF the PFD could provide ALS, lives could be saved. Matrix noted that "early establishment of IV fluids and certain advanced airway management will be beneficial in certain cases." The seriously ill or injured person would no longer have to wait for AMT to arrive to receive advanced interventions. (An IV was considered an advanced intervention in the Peoria system.)
Matrix did a cost analysis of the above and concluded that for a "relatively low cost of approximately $100,000 per year...the city could move to a four company ALS engine company system." What Matrix overlooked in 2004 was the fact that the PFD firefighters who are currently paramedics could provide their expertise for the four engines only if the project medical director would sign off. And this would have been difficult because the project medical director's supervisor at OSF is the corporate medical director at AMT.
The Matrix report stated that the PFD recently had acquired a transport capable ambulance. They stated that since there are no "service gaps" (i. e., AMT is always available), the PFD ambulance is not necessary. Many EMS provers in the Peoria are and families I had spoken with in the early 200os gave me numerous examples of service gaps in EMS response. Patients and Peoria firefighters have waited precious minutes for AMT to arrive at the scene. AMT has even called the PFD for help when the AMT finds themselves overextended responding to emergencies. Marix noted that AMT maintains the "proprietary nature" of it staffing and financial information. Juat imagine if the PFD wouldn't reveal where they were located or their operating budget. (A few years after Matrix, two ex AMT Paramedics explained to the Peoria City Council how delays in care they offered to people were detrimental.)
Matrix's conclusion that there were not gaps in service in Peoria was wrong. And the fact that the PFD had been obstructed for years advancing to ALS made the problem for the prehospital patient all the more dangerous.
In conclusion, looking back at 2004, evidence and healthcare statistics regarding kemergencuy medical services in Peoria were glaringly absent from the Matrix report. Conclusions based on invisible or nonpublished data are opinions and nothing more. IF Peoria's leaders were to make credible decisions about Peoria's EMS and ambulance services in 2004, their judgements were based on incomplete and biased reporting. And Peoria's EMS was to stay stuck in the conflict of interest that infiltrated it from multiple sources.
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Should Peoria Fire Department sell its only ambulance?
PEORIA - Peoria's Fire Department "provides a very high level of service," and its private ambulance service "really borders on the exceptional," according to California-based consultants hired to examine both services.
The Matrix Consulting Group of Palo Alto, Calif., walked the City Council through highlights of its 150-page, $79,000 study during a policy session Tuesday night. City Manager Randy Oliver pushed for the study, hoping an independent review would help the city develop long-range strategies and sidestep what has become a near annual debate over the fire department's budget.
Last year, debate over whether to close Fire Station 11 on Florence Avenue held up the overall budget for months before the council decided to keep it open, but cut its staff.
Most of the report was filled with relatively benign suggestions, such as looking into spending $240,000 on a system to pre-empt traffic lights. Indeed, at-large council member John Morris admitted he was looking for "more transformational, maybe even uncomfortable" recommendations.
Matrix did say the city dispatch and fire departments need to improve their initial handling of calls. Also, a city Peoria's size needs two battalion chiefs working at all times.
"That's one of the things you need to deal with immediately," Travis Miller, Matrix vice president, told the council. "About 25 percent of the time, you're managing operations in the field with one battalion chief. At least in the short term, you should fund that through overtime."
Fire Chief Roy Modglin said the report was "what we've been telling (the council) for years."
"Overall, I'm pleased with what they came up with," Modglin said. "A lot of it is substantially what we've been saying. Even (former) Chief (Ernie) Russell said some of this. But I do disagree with some things."
For instance, Modglin said a recommendation to close Station 3 because its calls can be covered by overlapping stations
"may look good on paper, but it wouldn't work in reality.
"Station 3 (near Bradley University) was the busiest one in town last year. It covered over 1,900 calls. And the stations surrounding it, which would supposedly pick up its calls, are the second, third and fourth busiest in town," Modglin said.
The study suggested planning for a new station on the northwest side of the city, which will cost an estimated $2.5 million to build and $1 million annually to operate. It also proposed closing Station 3 only if call volume continues to grow northeast of the city. Then, Matrix recommend re-opening Station 17 on Skyline Drive and staffing it with Station 3 personnel. They stressed working out an agreement with Peoria Heights to help cover costs, since a majority of Station 17's coverage area is within the village.
Modglin also noted political problems with that.
"I've been here 34 years, and I can remember only two occasions where they called us for assistance. The volunteer departments do not call the city of Peoria for assistance," Modglin said.
Modglin also disputed some of the data Matrix had on how long it takes firefighters to get out of the station, saying they've found glitches with the computerized "time stamp."
Matrix said Advanced Medical Transport, the city's not-for-profit, private ambulance company is very well managed, and the city should try and replicate the service. Training and outfitting firefighters to respond and transport medical calls will lose the city about $3.4 million a year.
"AMT does it, and does it well, for nothing. No cost to the city," Miller said.
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My Comments in 2021--(I sent the majority of these comments to the Journal Star in 2004 for an Op-Ed submission, but my article was not printed.)
In 2004, the PFD was Basic-D and nontransport. In 2021 8/12 PFD Engines are Advanced Life Support and nontransport.
Data crucial to provide metrics for evaluating EMS and ambulance service in Peoria was largely missing from the Matrix report.
According to the Matrix report, the current EMS System in Peoria is supervised by the Illinois Department of Public Health (IDPH) which maintains a district office in Peoria. In 2004, when I spoke to a representative in this office, he told me that he was unaware of the contents of the Matrix study and that he had only general data from AMT. He was unable to answer my specific questions regarding how Peoria pre-hospital patients suffering from chest pain, breathing problems, cardiac arrest, or trauma had done over the last decade.
The Matrix report stated that AMT's performance data was also submitted to the project medical director (the doctor in charge of all EMS and ambulances in central Illinois) who is located at OSF St. Francis Medical Center. When I spoke with the emergency medicine services manager who works for the project medical director in the EMS office at OSF, she told me that they had no aggregate data regarding how AMT performed in 2003 or for any year.
Something was obviously very wrong here. No data was available to see exactly how AMT was doing with the prehospital patient. Consistent with my conversations with the people mentioned above, the Matrix report contains absolutely no data about patient outcomes. The Matrix report stated that performance data was provided to IDPH and the project medical director, but my conversations with individuals from these offices indicate that this data has not been available, and thus not compiled or analyzed.
Over the years, AMT's Andrew Rand had told the media that AMT's arrival times at scene response were not later than the PFD arrival times. However, the Matrix report did not agree with Rand. To life-threatening emergencies in Peoria, the PFD arrival time was two minutes faster than AMT's arrival time. Matrix went on to say that medical research at the time showed that Advanced Life Support may help prehospital patients with chest pain and breathing problems. And research at the time showed that victims suffering severe trauma incur five percent increased mortality for each minute that they are not transported from the scene of the trauma. And in 2004, the PFD was not able to give Advanced Life Support when they arrived before AMT and, of course, not able to transport the patient. Of the more than 9,000 EMS calls the PFD responded to in 2003, 1,800 were for breathing problems, 900 for chest pain, and 1,700 for trauma. In none of these scenarios was the PFD allowed to give ALS care when arriving before AMT.
Based on the above, the Matrix report outlined a plan that would "increase the level of service" by allowing four fire department engines to be staffed with paramedic firefighters to respond to "targeted areas" in Peoria (like the far north side.) IF the PFD could provide ALS, lives could be saved. Matrix noted that "early establishment of IV fluids and certain advanced airway management will be beneficial in certain cases." The seriously ill or injured person would no longer have to wait for AMT to arrive to receive advanced interventions. (An IV was considered an advanced intervention in the Peoria system.)
Matrix did a cost analysis of the above and concluded that for a "relatively low cost of approximately $100,000 per year...the city could move to a four company ALS engine company system." What Matrix overlooked in 2004 was the fact that the PFD firefighters who are currently paramedics could provide their expertise for the four engines only if the project medical director would sign off. And this would have been difficult because the project medical director's supervisor at OSF is the corporate medical director at AMT.
The Matrix report stated that the PFD recently had acquired a transport capable ambulance. They stated that since there are no "service gaps" (i. e., AMT is always available), the PFD ambulance is not necessary. Many EMS provers in the Peoria are and families I had spoken with in the early 200os gave me numerous examples of service gaps in EMS response. Patients and Peoria firefighters have waited precious minutes for AMT to arrive at the scene. AMT has even called the PFD for help when the AMT finds themselves overextended responding to emergencies. Marix noted that AMT maintains the "proprietary nature" of it staffing and financial information. Juat imagine if the PFD wouldn't reveal where they were located or their operating budget. (A few years after Matrix, two ex AMT Paramedics explained to the Peoria City Council how delays in care they offered to people were detrimental.)
Matrix's conclusion that there were not gaps in service in Peoria was wrong. And the fact that the PFD had been obstructed for years advancing to ALS made the problem for the prehospital patient all the more dangerous.
In conclusion, looking back at 2004, evidence and healthcare statistics regarding kemergencuy medical services in Peoria were glaringly absent from the Matrix report. Conclusions based on invisible or nonpublished data are opinions and nothing more. IF Peoria's leaders were to make credible decisions about Peoria's EMS and ambulance services in 2004, their judgements were based on incomplete and biased reporting. And Peoria's EMS was to stay stuck in the conflict of interest that infiltrated it from multiple sources.
-----------
Should Peoria Fire Department sell its only ambulance?
What will the city do with the one Peoria Fire Department ambulance that sits alone and unused? Will it be sold for something more important than saving people's lives?
In September, the Matrix Consulting Group evaluated Peoria's emergency medical services. Matrix reported that the fire department's average response time to life-threatening emergencies was almost two minutes faster than Advanced Medical Transport's. Since the fire department can only provide basic life support, patients frequently wait until AMT arrives for paramedic intervention.
One plan formulated by the consulting firm to improve service was to target certain areas with four non-transport fire department engines. These vehicles would be staffed by firefighter/paramedics who would provide advanced life support. The fire department has paramedics who could provide their expertise for these engines.
The problem is the two physicians who have controlled ambulances in Peoria for the last two decades don't support the fire department's advancing from basic life support service to advanced life support. Unfortunately, Peoria firefighter/paramedics are not allowed to use their paramedic skills at emergencies.
Matrix noted the fire departmetn has applied to the physician in charge of ambulances to outfit its only engine with various basic and advanced life support medications and equipment. That request was denied.
The boards of directors of our local "health-care industry," and the doctors who have been responsible for ambulances in Peoria, need to disclose their private interests and explain why selling the one and only fire department ambulance is beneficial to sick and injured pre-hospital patients in Peoria.
Dr. John Carroll
Peoria
My Comments in 2021--
Regarding rapid transport in trauma patients (car accidents, shootings, stabbings), there was widespread agreement that delivery of critically injured trauma patients to trauma centers save lives. Dr. Peter Rosen's Emergency Medicine Textbook--"...but the role of rapid transport remains unchanged for trauma care. Because critical patients often require surgical intervention to achieve stability, NO TIME should be lost in reaching definitive care."
Why hadn't the medical powers that be stressed this to the Peoria City Council while they were considering policy regarding whether the PFD should transport Patients?
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What will the city do with the one Peoria Fire Department ambulance that sits alone and unused? Will it be sold for something more important than saving people's lives?
In September, the Matrix Consulting Group evaluated Peoria's emergency medical services. Matrix reported that the fire department's average response time to life-threatening emergencies was almost two minutes faster than Advanced Medical Transport's. Since the fire department can only provide basic life support, patients frequently wait until AMT arrives for paramedic intervention.
One plan formulated by the consulting firm to improve service was to target certain areas with four non-transport fire department engines. These vehicles would be staffed by firefighter/paramedics who would provide advanced life support. The fire department has paramedics who could provide their expertise for these engines.
The problem is the two physicians who have controlled ambulances in Peoria for the last two decades don't support the fire department's advancing from basic life support service to advanced life support. Unfortunately, Peoria firefighter/paramedics are not allowed to use their paramedic skills at emergencies.
Matrix noted the fire departmetn has applied to the physician in charge of ambulances to outfit its only engine with various basic and advanced life support medications and equipment. That request was denied.
The boards of directors of our local "health-care industry," and the doctors who have been responsible for ambulances in Peoria, need to disclose their private interests and explain why selling the one and only fire department ambulance is beneficial to sick and injured pre-hospital patients in Peoria.
Dr. John Carroll
Peoria
My Comments in 2021--
Regarding rapid transport in trauma patients (car accidents, shootings, stabbings), there was widespread agreement that delivery of critically injured trauma patients to trauma centers save lives. Dr. Peter Rosen's Emergency Medicine Textbook--"...but the role of rapid transport remains unchanged for trauma care. Because critical patients often require surgical intervention to achieve stability, NO TIME should be lost in reaching definitive care."
Why hadn't the medical powers that be stressed this to the Peoria City Council while they were considering policy regarding whether the PFD should transport Patients?
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Peoria's medical mafia limiting emergency care
Re. July 16 editorial, "Send corrupt health facilities planning board to morgue":
The Journal Star states that in Illinois, "Any board with this much authority over this much money becomes a trough of corruption." Truer words could not have been written. For 30 years lobbyists, attorneys and politically connected people have influenced the decisions made by this nine-member board regarding construction of new hospitals and expansion of existing ones in Illinois.
Unfortunately, similar conflicts of interest and cronyism are currently occurring in Peoria. The stakes are very high here with lives and money on the line.
In Peoria we have one paramedic transport company, Advanced Medical Transport (AMT). Its medical director is Dr. George Hevesy, who happens to be the medical director of OSF-St. Francis' emergency department. Dr. Hevesy is salaried by both OSF-St. Francis and AMT. OSF is the main supporter of AMT and is also the base station for all emergency medical services in central Illinois.
The AMT board of directors, composed of prominent Peorians, has the support of the OSF-St. Francis board of directors. Dr. Hevesy's relationship with the Illinois Department of Public Health in Springfield, which regulates paramedics and ambulances in the state, is well known in emergency medicine circles throughout Illinois. And finally, the Peoria City Council, which will decide if AMT remains in total control of paramedic care and transport in Peoria for the next decade, will consider the findings and recommendations of a California-based consulting firm.
Some members of the council suspect a pre-existing relationship between AMT and this California firm. One needs a scorecard to keep track of this local health care travesty.
In the meantime, the Peoria Fire Department continues to respond to medical emergencies, can only provide basic life support (not paramedic care) and cannot transport patients, even with its one ambulance. The PFD obviously does not enjoy the support of the above-named individuals, boards and state agencies.
The real loss, of course, is for Peorians who suffer an out-of-hospital medical emergency. State-of-the-art, pre-hospital emergency care is not offered in Peoria, not because we can't, but because our medical mafia will not allow it.
Dr. John Carroll
Peoria
My Comments in 2021--
Over the years I have been told stories off the record by many people who are afraid to publically criticize OSF or AMT. Family members of people who have been prehospital patients and did not fare well are often afraid to talk.
A friend of mine lost a family member after AMT response time was 20 minutes. The person was in severe congestive heart failure and the AMT ambulance went at least part of the trip without lights and siren. As the patient would attempt to sit up in the rig in order to breathe better, he would be eased back into a supine position which made it more difficult for him to breathe. He died several hours later in the hospital. The Project Medical Director actually came to her home afterwords and spent three hours talking to her about the transport and outcome.
People in Peoria are afraid. They fear for their jobs and their kids' jobs, scholarships for their kids, etc. They fear being marginalized. They even fear being denied medical care if they speak out against OSF--I know this because they have told me.
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Re. July 16 editorial, "Send corrupt health facilities planning board to morgue":
The Journal Star states that in Illinois, "Any board with this much authority over this much money becomes a trough of corruption." Truer words could not have been written. For 30 years lobbyists, attorneys and politically connected people have influenced the decisions made by this nine-member board regarding construction of new hospitals and expansion of existing ones in Illinois.
Unfortunately, similar conflicts of interest and cronyism are currently occurring in Peoria. The stakes are very high here with lives and money on the line.
In Peoria we have one paramedic transport company, Advanced Medical Transport (AMT). Its medical director is Dr. George Hevesy, who happens to be the medical director of OSF-St. Francis' emergency department. Dr. Hevesy is salaried by both OSF-St. Francis and AMT. OSF is the main supporter of AMT and is also the base station for all emergency medical services in central Illinois.
The AMT board of directors, composed of prominent Peorians, has the support of the OSF-St. Francis board of directors. Dr. Hevesy's relationship with the Illinois Department of Public Health in Springfield, which regulates paramedics and ambulances in the state, is well known in emergency medicine circles throughout Illinois. And finally, the Peoria City Council, which will decide if AMT remains in total control of paramedic care and transport in Peoria for the next decade, will consider the findings and recommendations of a California-based consulting firm.
Some members of the council suspect a pre-existing relationship between AMT and this California firm. One needs a scorecard to keep track of this local health care travesty.
In the meantime, the Peoria Fire Department continues to respond to medical emergencies, can only provide basic life support (not paramedic care) and cannot transport patients, even with its one ambulance. The PFD obviously does not enjoy the support of the above-named individuals, boards and state agencies.
The real loss, of course, is for Peorians who suffer an out-of-hospital medical emergency. State-of-the-art, pre-hospital emergency care is not offered in Peoria, not because we can't, but because our medical mafia will not allow it.
Dr. John Carroll
Peoria
My Comments in 2021--
Over the years I have been told stories off the record by many people who are afraid to publically criticize OSF or AMT. Family members of people who have been prehospital patients and did not fare well are often afraid to talk.
A friend of mine lost a family member after AMT response time was 20 minutes. The person was in severe congestive heart failure and the AMT ambulance went at least part of the trip without lights and siren. As the patient would attempt to sit up in the rig in order to breathe better, he would be eased back into a supine position which made it more difficult for him to breathe. He died several hours later in the hospital. The Project Medical Director actually came to her home afterwords and spent three hours talking to her about the transport and outcome.
People in Peoria are afraid. They fear for their jobs and their kids' jobs, scholarships for their kids, etc. They fear being marginalized. They even fear being denied medical care if they speak out against OSF--I know this because they have told me.
-----
Should Peoria Fire Department sell its only ambulance?
What will the city do with the one Peoria Fire Department ambulance that sits alone and unused? Will it be sold for something more important than saving people's lives?
In September, the Matrix Consulting Group evaluated Peoria's emergency medical services. Matrix reported that the fire department's average response time to life-threatening emergencies was almost two minutes faster than Advanced Medical Transport's. Since the fire department can only provide basic life support, patients frequently wait until AMT arrives for paramedic intervention.
One plan formulated by the consulting firm to improve service was to target certain areas with four non-transport fire department engines. These vehicles would be staffed by firefighter/paramedics who would provide advanced life support. The fire department has paramedics who could provide their expertise for these engines.
The problem is the two physicians who have controlled ambulances in Peoria for the last two decades don't support the fire department's advancing from basic life support service to advanced life support. Unfortunately, Peoria firefighter/paramedics are not allowed to use their paramedic skills at emergencies.
Matrix noted the fire department has applied to the physician in charge of ambulances to outfit its only engine with various basic and advanced life support medications and equipment. That request was denied.
The boards of directors of our local "health-care industry," and the doctors who have been responsible for ambulances in Peoria, need to disclose their private interests and explain why selling the one and only fire department ambulance is beneficial to sick and injured pre-hospital patients in Peoria.
Dr. John Carroll
Peoria
My Comments in 2021--
So what happened with the fire engine that the PFD bought? It sat unused in a garage and so the PFD sold it on eBay. It was never used for the people of Peoria. I offered to buy the engine and donate it back to the City of Peoria if the Project Medical Director (Rick Miller) would agree and release the health care statistics in Peoria regarding how prehospital patients have done for the past decade in Peoria. I never received an answer from the Project Medical Director regarding my offer.
Conflict of interest in Peoria was and is a serious issue. The public deserve to know which physicians and which politicians have their finger in the pie. Financial gain for individuals should not override public health.
-----
What will the city do with the one Peoria Fire Department ambulance that sits alone and unused? Will it be sold for something more important than saving people's lives?
In September, the Matrix Consulting Group evaluated Peoria's emergency medical services. Matrix reported that the fire department's average response time to life-threatening emergencies was almost two minutes faster than Advanced Medical Transport's. Since the fire department can only provide basic life support, patients frequently wait until AMT arrives for paramedic intervention.
One plan formulated by the consulting firm to improve service was to target certain areas with four non-transport fire department engines. These vehicles would be staffed by firefighter/paramedics who would provide advanced life support. The fire department has paramedics who could provide their expertise for these engines.
The problem is the two physicians who have controlled ambulances in Peoria for the last two decades don't support the fire department's advancing from basic life support service to advanced life support. Unfortunately, Peoria firefighter/paramedics are not allowed to use their paramedic skills at emergencies.
Matrix noted the fire department has applied to the physician in charge of ambulances to outfit its only engine with various basic and advanced life support medications and equipment. That request was denied.
The boards of directors of our local "health-care industry," and the doctors who have been responsible for ambulances in Peoria, need to disclose their private interests and explain why selling the one and only fire department ambulance is beneficial to sick and injured pre-hospital patients in Peoria.
Dr. John Carroll
Peoria
My Comments in 2021--
So what happened with the fire engine that the PFD bought? It sat unused in a garage and so the PFD sold it on eBay. It was never used for the people of Peoria. I offered to buy the engine and donate it back to the City of Peoria if the Project Medical Director (Rick Miller) would agree and release the health care statistics in Peoria regarding how prehospital patients have done for the past decade in Peoria. I never received an answer from the Project Medical Director regarding my offer.
Conflict of interest in Peoria was and is a serious issue. The public deserve to know which physicians and which politicians have their finger in the pie. Financial gain for individuals should not override public health.
-----
Let Peoria Fire Department operate its own ambulance
On Feb. 1 the Peoria City Council voted to sell the only Peoria Fire Department ambulance, which has been sitting idle in a garage. It was never allowed to respond to 911 calls. Numerous firefighters who are certified paramedics are not allowed to use their skills. They have been wasted.
To help rectify this situation, I will purchase the PFD's ambulance at its present market value and donate it back to the PFD if these conditions are met:
1. This ambulance will be used for sick or injured Peorians and staffed by PFD firefighters/paramedics allowed to use their advanced life support skills in Peoria.
2. Doctors George Hevesey and Rick Miller have been directors of the Emergency Department at OSF for the past 15 years. They have controlled all ambulances in the area. Both physicians need to publicly declare any fees, stipends, salaries or other benefits they've received from their relationship with Advanced Medical Transport, the only company allowed to operate in Peoria.
3. OSF's Emergency Medical Services Department needs to provide health-care data for the past decade to the city manager and City Council revealing how Peoria's pre-hospital patients did when cared for and transported by AMT. This data was conspicuously absent in the 149-page consultant's report that evaluated fire and emergency medical services in Peoria last year.
The medical ambulance debacle in Peoria, plagued by conflicts of interest, confusion and corporate greed for many years, needs to end.
Dr. John Carroll
Peoria
My Comments in 2021--
In point number 3 above, I was referring to the Matrix study done in 2004. When I spoke with the RN who was keeping the Peoria Area EMS (PAEMS) data, she stated that Matrix never asked her for the healthcare data regarding EMS calls and interventions. And she told me that if they had asked, PAEMS had no aggregate data to share. Would AMT have the data? For example, how many of Peoria's pre-hospital cardiac arrests survived to be hospitalized and how many survived to hospital discharge with good neurologic outcomes? If this data were found, could we even believe it? And when I asked the City of Peoria for this data in the late 2010s, they stated that they did not have the data either. And when I called AMT, they stated that they would not share this data.
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-----
On Feb. 1 the Peoria City Council voted to sell the only Peoria Fire Department ambulance, which has been sitting idle in a garage. It was never allowed to respond to 911 calls. Numerous firefighters who are certified paramedics are not allowed to use their skills. They have been wasted.
To help rectify this situation, I will purchase the PFD's ambulance at its present market value and donate it back to the PFD if these conditions are met:
1. This ambulance will be used for sick or injured Peorians and staffed by PFD firefighters/paramedics allowed to use their advanced life support skills in Peoria.
2. Doctors George Hevesey and Rick Miller have been directors of the Emergency Department at OSF for the past 15 years. They have controlled all ambulances in the area. Both physicians need to publicly declare any fees, stipends, salaries or other benefits they've received from their relationship with Advanced Medical Transport, the only company allowed to operate in Peoria.
3. OSF's Emergency Medical Services Department needs to provide health-care data for the past decade to the city manager and City Council revealing how Peoria's pre-hospital patients did when cared for and transported by AMT. This data was conspicuously absent in the 149-page consultant's report that evaluated fire and emergency medical services in Peoria last year.
The medical ambulance debacle in Peoria, plagued by conflicts of interest, confusion and corporate greed for many years, needs to end.
Dr. John Carroll
Peoria
My Comments in 2021--
In point number 3 above, I was referring to the Matrix study done in 2004. When I spoke with the RN who was keeping the Peoria Area EMS (PAEMS) data, she stated that Matrix never asked her for the healthcare data regarding EMS calls and interventions. And she told me that if they had asked, PAEMS had no aggregate data to share. Would AMT have the data? For example, how many of Peoria's pre-hospital cardiac arrests survived to be hospitalized and how many survived to hospital discharge with good neurologic outcomes? If this data were found, could we even believe it? And when I asked the City of Peoria for this data in the late 2010s, they stated that they did not have the data either. And when I called AMT, they stated that they would not share this data.
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Peoria emergency response system model for nation
Re. Feb. 23 Forum letter by Dr. John Carroll, "Let Peoria Fire Department operate its own ambulance":
Doesn't Dr. Carroll get tired of beating a drum nobody is listening to? How does it benefit the citizens of Peoria to have the Peoria Fire Department (PFD) operate its own ambulance? The cost associated with its operation and maintenance would have to be passed on to taxpayers in the form of higher taxes. The tiered response system that Peoria enjoys does not cost the taxpayer a penny because it is operated outside of a governmental agency.
Response times are at an all-time high and life-support services are being performed by a highly accredited, non-profit transporting agency. The PFD and Advanced Medical Transport (AMT) work very efficiently together with highly trained, skilled personnel on both sides. To tamper with a system that is so effective merely to satisfy some political agenda that Carroll and other Peoria officials have is unjustified and irresponsible. Doctors George Hevesey and Rick Miller are exceptional leaders and physicians. Peoria's EMS system is being used as a model for other systems around the nation. Peoria must be doing something right.
Dr. Carroll should stop wasting his time and energy and quit trying to mask the issue with hints of misappropriations, unethical management and unprofessional conduct. He also should save his money regarding the ambulance: Peorians pay too much tax as it is.
Troy Stephens
Florence, Ky.
Formerly of Peoria
Re. Feb. 23 Forum letter by Dr. John Carroll, "Let Peoria Fire Department operate its own ambulance":
Doesn't Dr. Carroll get tired of beating a drum nobody is listening to? How does it benefit the citizens of Peoria to have the Peoria Fire Department (PFD) operate its own ambulance? The cost associated with its operation and maintenance would have to be passed on to taxpayers in the form of higher taxes. The tiered response system that Peoria enjoys does not cost the taxpayer a penny because it is operated outside of a governmental agency.
Response times are at an all-time high and life-support services are being performed by a highly accredited, non-profit transporting agency. The PFD and Advanced Medical Transport (AMT) work very efficiently together with highly trained, skilled personnel on both sides. To tamper with a system that is so effective merely to satisfy some political agenda that Carroll and other Peoria officials have is unjustified and irresponsible. Doctors George Hevesey and Rick Miller are exceptional leaders and physicians. Peoria's EMS system is being used as a model for other systems around the nation. Peoria must be doing something right.
Dr. Carroll should stop wasting his time and energy and quit trying to mask the issue with hints of misappropriations, unethical management and unprofessional conduct. He also should save his money regarding the ambulance: Peorians pay too much tax as it is.
Troy Stephens
Florence, Ky.
Formerly of Peoria
End false allegations about Peoria's ambulance service
Re. Feb. 23 Forum letter by Dr. John Carroll, "Let Peoria Fire Department operate its ambulance:"
Dr. Carroll's letter is filled with misleading statements.
First, the ambulance owned by the Peoria Fire Department never had a license or a staffing pattern to be placed into use. All pre-hospital services that provide ambulance transport are strictly governed by the Illinois Department of Public Health. The fire department does an excellent job as a basic life support, non-transporting agency.
Second, Emergency Medical Services (EMS) for Peoria have markedly advanced in the past 20 years through a commitment by the Peoria area hospitals to support a single quality agency. This agency pioneered throughout central Illinois the first critical care curriculum for paramedics and transport and has been accredited, receiving an outstanding score. Dr. Carroll's attempt to paint a picture of negligence and poor care is absolutely erroneous and inflammatory.
Third, emergency rooms at St. Francis, Methodist and Proctor receive traffic from up to 80 different ambulance agencies. The quality of care of each patient transported is of great importance.
Protocols have been developed for quality patient care to be delivered. In the last five years, the system has continued improvement by the addition of medications for all in the system. Physicians who monitor patient care and work to improve EMS protocols are provided a stipend for their services.
Dr. Carroll continues to create, by innuendo, a sense that the system he knows little about is not meeting the needs of Peoria. It is a shame that this continued dialogue may confuse some people regarding emergency care for the city.
Dr. Rick Miller
Medical Director
Peoria Area Emergency Medical System
Comments in 2021--
Dr. Miller was getting nervous.
After the man died in the restaurant in 2005, Miller changed the rules which allowed the PFD Paramedics to function as Paramedics after AMT arrived on scene. This was significant and not reported in the Journal Star. -----
Dr. Carroll's letter is filled with misleading statements.
First, the ambulance owned by the Peoria Fire Department never had a license or a staffing pattern to be placed into use. All pre-hospital services that provide ambulance transport are strictly governed by the Illinois Department of Public Health. The fire department does an excellent job as a basic life support, non-transporting agency.
Second, Emergency Medical Services (EMS) for Peoria have markedly advanced in the past 20 years through a commitment by the Peoria area hospitals to support a single quality agency. This agency pioneered throughout central Illinois the first critical care curriculum for paramedics and transport and has been accredited, receiving an outstanding score. Dr. Carroll's attempt to paint a picture of negligence and poor care is absolutely erroneous and inflammatory.
Third, emergency rooms at St. Francis, Methodist and Proctor receive traffic from up to 80 different ambulance agencies. The quality of care of each patient transported is of great importance.
Protocols have been developed for quality patient care to be delivered. In the last five years, the system has continued improvement by the addition of medications for all in the system. Physicians who monitor patient care and work to improve EMS protocols are provided a stipend for their services.
Dr. Carroll continues to create, by innuendo, a sense that the system he knows little about is not meeting the needs of Peoria. It is a shame that this continued dialogue may confuse some people regarding emergency care for the city.
Dr. Rick Miller
Medical Director
Peoria Area Emergency Medical System
Ambulance monopoly unhealthy for Peoria
Now I know why I must not have the misfortune of having a heart attack in the city of Peoria.
If the Peoria Fire Department arrives to help me before Advanced Medical Transport (AMT), which they usually do, the firefighters are not permitted to transport me to the hospital. They can do nothing to help me except basic life support, and then they must stand by and wait for AMT to arrive at the scene. Many of the firefighters have advanced level training and are paramedics, but because AMT has a monopoly on patient transport and paramedic care, valuable time is wasted. When every second can be a matter of life and death, the stricken patient pays the price.
Unbelievable, right? Believe it.
In Peoria (as opposed to East Peoria, Morton and Pekin), money is apparently more important than lives. We had better heed Dr. John Carroll's concerns. He's been right all along.
Rose Kelley
Peoria
If the Peoria Fire Department arrives to help me before Advanced Medical Transport (AMT), which they usually do, the firefighters are not permitted to transport me to the hospital. They can do nothing to help me except basic life support, and then they must stand by and wait for AMT to arrive at the scene. Many of the firefighters have advanced level training and are paramedics, but because AMT has a monopoly on patient transport and paramedic care, valuable time is wasted. When every second can be a matter of life and death, the stricken patient pays the price.
Unbelievable, right? Believe it.
In Peoria (as opposed to East Peoria, Morton and Pekin), money is apparently more important than lives. We had better heed Dr. John Carroll's concerns. He's been right all along.
Rose Kelley
Peoria
Rescue services get some criticism - EMTs, firefighters work well together, officials say
July 7, 2005 | Peoria Journal Star, The (IL)
Let Peoria firefighters give enhanced aid at emergencies
Doctors controlling ambulances have conflict
It is interesting that the Dunlap agency was considered for an "emergency field upgrade" to transport Hurricane Katrina victims. Yet the same agency got into serious trouble with Peoria's Emergency Medical Services (EMS) leaders for transporting one of its own firefighters to a local hospital. Does that make any sense?
Last year, the EMS physician in charge of all ambulances in the Peoria area did not support the Peoria Fire Department (PFD) equipping or using the only ambulance it owned. Because it sat unused in a garage, the PFD sold it. Maybe this ambulance could have been used to help the Dunlap firefighter and intercepted the Dunlap vehicle as it headed for Peoria.
The real issue here is being diverted. It should not be about Chief Doering and whether he should lose his emergency medical technician license as he protects his firefighters and the Dunlap area. The issue is whether the Peoria physicians that control EMS are acting in a responsible, moral fashion for the people of central Illinois. I believe they are not.
Until this conflict of interest is exposed and issues made transparent to the public, no changes in EMS will be made and suboptimal patient care will continue.
Heights' EMT vote wisely avoids ambulance service conflicts
Forum: Let firefighters save lives
Forum: Keep improving Fire Department equipment
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