The Gazette covers City Hall, now a flood-damaged icon on May's Island in the Cedar River

Ambulances and fire trucks both are coming to help: Is that the ideal approach?

In City Hall, Viewpoint on March 24, 2008 at 1:31 am

 Look for a community discussion in the coming months about the way emergency medical services are provided here.

The Area Ambulance Service isn’t particularly happy about such a discussion, it has said in recent months, because it is one had and thought put to rest just a few years ago. Back then, the cities of Cedar Rapids and Marion and others signed on to support the ambulance service.

In something of revolt, though, the city of Hiawatha, unhappy with what it said was marginal service, decided it would run its own ambulance service with its own ambulances and its own firefighters.

In the intervening few years, the city of Cedar Rapids hired its first city manager. And in the last several months, he, Jim Prosser, has suggested that he’d like to see a discussion about how the city’s firefighters, who answer all medical calls, and the Area Ambulance Service, which answers them, too, might better cooperate.

As it stands, Cedar Rapids can be a pretty good place to have a heart attack or any other medical emergency that prompts a call for 911 medical services. On most of those calls, the citizen will see firefighters, ambulance personnel and a police officer, all at the ready with defibrillators and more.

This, of course, is an entangled, complicated matter to explore and one that surely will invite debate if not the defense of individual empires.

In part, this is so because skill sets of at the ambulance service and the Fire Department differ; and because money is involved. Private insurance, Medicaid and Medicare pay the non-profit ambulance service – though many of the uninsured don’t — while the city gets nothing for its firefighters.

Former Marion Mayor John Nieland has said that the city of Marion looked at using its own firefighters for ambulance service a few years ago, but decided that firefighters would end up spending too much time in hospital emergency rooms once they got a patient there.

A first hint of the potential for debate came a few months ago when the Area Ambulance Service’s board announced it was conducting a new study, and asked Cedar Rapids City Hall to contribute. City Hall dragged its feet.

Then on Thursday, the ambulance service convened an event for “stakeholders” at the Marriott Hotel on Collins Road NE replete with a speaker and a light dinner.

Keith Rippey, executive director of the ambulance service, said the intent of the program was to provide the community with an update on national trends in emergency medical services.

The speaker, Jerry Overton, director of the Richmond, Va., Ambulance Authority, painted a tough picture of the future. He noted that too many patients either don’t have insurance or they have insurance via Medicaid or Medicare that does not cover the cost of the service.

Overton suggested that the federal government had to pay more, and that ambulance services needed to see if they could figure out which of its customers did not necessarily need to be taken to an expensive emergency room.

An early point in Overton’s 40-minute presentation had to do with turf battles. Providers needed to set aside turf battles and get down to providing service, he said.

He did not, though, say anything about the turf issues that might exist here in Cedar Rapids.

Asked after his speech, he acknowledged that the city of Richmond’s firefighters, too, answer medical calls. But he said their focus is public safety, not medical service.

The person conducting the study for the Area Ambulance Service also was at the service’s Thursday gathering. Among those in attendance were Cedar Rapids Fire Chief Steve Havlik and the city’s finance director, Casey Drew.

Rippey said the report commissioned by ambulance service’s board should be out in May.

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