Response times steadily increasing in Hartford, dispatch data shows

Kavsuvb

Kavsuvb

Forum Captain
Messages
337
Reaction score
52
Points
28
 
Here's more to this story
 
Talk about crappy reporting and ignoring the underlying causes... it's like the reporters found a story, and forgot to do any actual analysis for why it was occurring....

Here are my questions and comments:

1) how many EMS units does the city pay for? Is this a zero bid contract, or does the city pay for X # of ambulances, and if the call volume exceeds X ambulances, what is the city's mutual aid policy? Note: I didn't say AMR's policy, what was the city's policy, as they are the AHJ, and they should be the ones who set the M/A policy for how calls are handled in their city.

1a) how many other EMS runs were be handled by AMR at the time of this tragic call? Need more context. as well as some analysis for why there were no units available.

2) if call volumes are increasing, and the city doesn't provide funding for more ambulances, the responsibility falls on the city.

This has been occurring over the past 25+ years... call volumes have been going up. taxpayer expectations have been going up (a paramedic on every ambulance), and the funding from the AHJ hasn't always increased. And it's not just in Hartford; many cities in the north east and midatlantic states have been having their run volumes increase significantly month over month and year over year. BTW, the city has 11 engine companies and 5 truck companies... if the city has been paying for less than 11 ambulances, than I think we have identified the root cause....

3) AMR and AETNA don't know how long it takes for dispatch to take and process the call. so you can't penalize AMR and AETNA for dispatch delays. they can only provide information that they have. similarly, you can't penalize an agency for picking up a mutual aid call, because it's not the their fault no units were available.

I'm going to assume that AMR is a self sufficient completed isolated EMS system, where they have their own supervisors, run sheets, policies, without direction communication to the city's 911 dispatch center. and the city's 911 dispatchers either soft transfer all medical calls to AMR for medical processing, or the city's dispatcher's receive a call, and then another dispatcher calls AMR with details.

As a former dispatcher, the call timer should start when the EMS dispatchers receive the call. Ideally, the city's CAD and AMR's CAD should be linked, where a medical call automatically populates from the city's CAD to AMR's CAD. Also, AMR should be required to provide a report to the city for any time a call came in and they had no units available, or they had to utilize (or look for) mutual aid to handle the call

4) Sen Anwar is right... you can't expect medicaid to cover the cost of ambulances. if municipalities want a better ems system, they need to pay for it. And no, having the fire department staff a few ambulances won't solve the issue, because firefighters are typically much more expensive than EMTs and Paramedics, and it's an expensive (and inefficient) short term fix to a much larger problem.
 
DrParasite said:
Talk about crappy reporting and ignoring the underlying causes... it's like the reporters found a story, and forgot to do any actual analysis for why it was occurring....

Here are my questions and comments:

1) how many EMS units does the city pay for? Is this a zero bid contract, or does the city pay for X # of ambulances, and if the call volume exceeds X ambulances, what is the city's mutual aid policy? Note: I didn't say AMR's policy, what was the city's policy, as they are the AHJ, and they should be the ones who set the M/A policy for how calls are handled in their city.

1a) how many other EMS runs were be handled by AMR at the time of this tragic call? Need more context. as well as some analysis for why there were no units available.

2) if call volumes are increasing, and the city doesn't provide funding for more ambulances, the responsibility falls on the city.

This has been occurring over the past 25+ years... call volumes have been going up. taxpayer expectations have been going up (a paramedic on every ambulance), and the funding from the AHJ hasn't always increased. And it's not just in Hartford; many cities in the north east and midatlantic states have been having their run volumes increase significantly month over month and year over year. BTW, the city has 11 engine companies and 5 truck companies... if the city has been paying for less than 11 ambulances, than I think we have identified the root cause....

3) AMR and AETNA don't know how long it takes for dispatch to take and process the call. so you can't penalize AMR and AETNA for dispatch delays. they can only provide information that they have. similarly, you can't penalize an agency for picking up a mutual aid call, because it's not the their fault no units were available.

I'm going to assume that AMR is a self sufficient completed isolated EMS system, where they have their own supervisors, run sheets, policies, without direction communication to the city's 911 dispatch center. and the city's 911 dispatchers either soft transfer all medical calls to AMR for medical processing, or the city's dispatcher's receive a call, and then another dispatcher calls AMR with details.

As a former dispatcher, the call timer should start when the EMS dispatchers receive the call. Ideally, the city's CAD and AMR's CAD should be linked, where a medical call automatically populates from the city's CAD to AMR's CAD. Also, AMR should be required to provide a report to the city for any time a call came in and they had no units available, or they had to utilize (or look for) mutual aid to handle the call

4) Sen Anwar is right... you can't expect medicaid to cover the cost of ambulances. if municipalities want a better ems system, they need to pay for it. And no, having the fire department staff a few ambulances won't solve the issue, because firefighters are typically much more expensive than EMTs and Paramedics, and it's an expensive (and inefficient) short term fix to a much larger problem.
Click to expand...
In Hartford, Ct EMS is split between AMR and Aetna. AMR covers the North end of Hartford while AETNA covers the South end of Hartford including Wethersfield and Rocky Hill, Ct.

I know in Ct not many fire dept's have their own EMS.

Connecticut use to have EMT-I's before the hospitals and states abolished them mainly cause the state was flooded with Paramedics in the cities but not in the suburbs or Rural communities.
 
Kavsuvb said:
In Hartford, Ct EMS is split between AMR and Aetna. AMR covers the North end of Hartford while AETNA covers the South end of Hartford including Wethersfield and Rocky Hill, Ct.
Click to expand...
sure, but how many ambulances does Hartford pay both AMR and Aetna to provide? The city is the AHJ, so they need to fund the appropriate level of service. They should pay for a set number of ambulances, and if the city needs more the city needs to pay for more ambulances. it is a contract requirement.
Kavsuvb said:
Connecticut use to have EMT-I's before the hospitals and states abolished them mainly cause the state was flooded with Paramedics in the cities but not in the suburbs or Rural communities.
Click to expand...
Sounds like the suburbs and rural communities need to increase the funding they provide to their EMS systems to hire more paramedics in non-urban areas.
 
DrParasite said:
sure, but how many ambulances does Hartford pay both AMR and Aetna to provide? The city is the AHJ, so they need to fund the appropriate level of service. They should pay for a set number of ambulances, and if the city needs more the city needs to pay for more ambulances. it is a contract requirement.

Sounds like the suburbs and rural communities need to increase the funding they provide to their EMS systems to hire more paramedics in non-urban areas.
Click to expand...
We use to have EMT-I's in Connecticut when we were short on Paramedics. The state has so many paramedics in the cities and suburbs that in the rural communities they don't have paramedics.

DrParasite said:
might not be common in CT, but it happens more than you would believe
Click to expand...
In Connecticut, not many Fire depts have their own BLS ambulance but that may change in the near future.
 
You must log in or register to reply here.
Back
Top