December 20, 2014

Elyria
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City memo cites LifeCare response times as barrier to eliminating Elyria Fire’s medical role

ELYRIA — Pulling back from the Elyria Fire Department running as first responders to emergency medical calls will not come easily as data collection from LifeCare Ambulance Inc., shows response times that can sometimes run as high as 10 minutes a call, said city officials.

In an internal memo written a week ago by Bruce Shade, assistant safety service director, it is recommended that the city keep the Fire Department’s first responder program as it is the best way to ensure basic care arrives within six minutes and more advanced care is on scene within eight minutes 90 percent of the time. Shade said it’s a national standard that LifeCare is not fulfilling.

Shade brought copies of the memo with him Tuesday when he accompanied Mayor Holly Brinda and other city leaders for a discussion with The Chronicle-Telegram’s editorial board regarding Issue 5, the city’s 0.5 percent temporary income tax that will be on the ballot in November.

LifeCare had an average response time of five minutes and 39 seconds for July and five minutes and 47 seconds in August, the memo said. The memo called the average within acceptable standards.

However, response times were greater than 10 minutes 22 times in July and another 13 times in August.

“LifeCare Ambulance was able to arrive on scene of EMS calls within six minutes only 60 percent of the time during July and 56 percent of the time during August,” Shade wrote. “Their arrival within eight minutes occurred only 85 percent of the time during July and 84 percent of the time during August.”

LifeCare President Pete de la Porte said he received a copy of the memo late Tuesday and said the document is not as clear on his company’s response times as it appears.

“At one point, we are called acceptable and then said we are not,” he said. “I stand behind the response times we have because five minutes is not just acceptable, it is pretty great.”

With months of conversations and requests for information already shaping the atmosphere concerning emergency medicine in Elyria, de la Porte said he knows the city is concentrating on the preservation of the role of the Fire Department, which will be in a funding peril once a federal grant runs out next year.

“They are stating without the city first responder program we are not as good as we say we are,” he said. “But where are the Fire Department’s response times or number of calls the department runs each year? That document is pretty one-sided.”

The city requested information from LifeCare in its pursuit of reviewing the 17-year-old contract it has with the city’s sole ambulance providers in July. Brinda said Tuesday that her intention then, as now, is to renegotiate a contract with LifeCare that allows the city to pull the Fire Department away from medical calls — a function that costs the city upwards of $200,000 a year.

However, Brinda said that she couldn’t in good faith pull city paramedics out of the field just to save money because the city has received the limited information thus far — city officials requested data going back to January, but were told the data were not accurate for the first six months of the year.

“LifeCare has been very cooperative and has said why the information is not available, but finding incidences where response times have been more than 10 minutes leaves us with more questions than answers,” Brinda said. “We don’t have all of the information right now, but we are working diligently with our partner — that’s what LifeCare has always been in this city — to reach a conclusion that is best for the city.”

Shade said the city has received information related to the date and time of EMS calls in the city — 479 such calls in July and 463 calls in August — but does not know the medical nature of any of the calls to determine if the long wait times occurred during life-or-death situations.

Shade said most of the calls with long response times, 42 percent in July and 39 percent in August, occurred from 11 p.m. to 7 a.m. and believes it may be due to reduced overnight staffing at LifeCare.

“As a cost-saving measure, private ambulance companies typically reduce the number of crews working during less busy periods, such as at night, when there are fewer inter-facility transfers,” he said. He doesn’t know if that generalization fits LifeCare’s business model.

De la Porte said LifeCare’s business model of dynamically deploying vehicles around the area it covers based on constant evaluation of call volume and leaning toward anticipating when and where emergency will occur works well.

“Every year, we get better and better at aligning our company with all the changes that happen in health care and the city,” he said. “Our business plan works and has been proven to work well for the past 27 years. We are absolutely willing to change our business plan, but for an outsider to say we should would also require a conversation of how they would fund such changes”

Brinda said she absolutely believes the fact finding her administration continues to pursue falls well within the direction set forth by City Council, which backs renegotiating the LifeCare contract but not using the old contract as an end run toward the Fire Department taking over medical transports.

“I think they want us to take our time and come up with the best contract possible,” said Safety Service Director Mary Siwierka. “We have kept them informed along the way that the goal is a new and better contract with LifeCare that reflects the dynamics of patient care and the city over the last 17 years of change.”

City Councilman Mark Craig, I-4th Ward, has been leading the charge on Council to keep the mayor’s administration focused solely on renegotiating a contract.

“I don’t want a conversation about response times to turn into why it would be better for the Fire Department to run transports when we have specifically said that is not what we want,” he said.

Contact Lisa Roberson at 329-7121 or lroberson@chroniclet.com.