News and Tribune

June 24, 2013

Officials raise concerns over ambulance service

Gahan backs Rural/Metro; Floyd Memorial says issues can be resolved



Though he stressed the issues can be resolved, a local hospital official said there have been some concerns about the service provided by Rural/Metro Ambulance since the company began operating in New Albany. 

Rural/Metro has transported patients to Louisville that could have been treated locally, and there are also concerns about the number of EKG tests being administered by the company, according to Dr. Daniel Eichenberger, the chief medical officer for Floyd Memorial Hospital and Health Services. 

The EKG test — which stands for electrocardiogram — checks for complications with electrical activity in the heart. 

Hospital and city officials said the concern is that Rural/Metro isn’t performing enough EKG tests on patients prior to them arriving in the emergency room.

“We were used to certain things being before,” Eichenberger said. 

Mayor Jeff Gahan allowed Rural/Metro to assume control of ambulance service in place of the New Albany Fire Department in October. 

He said the move would save taxpayers as much as $270,000 annually through reductions in expenses from having firefighters staff an ambulance. 

Gahan also touted that Rural/Metro had more accreditation for levels of service, and could provide three ambulances for the city instead of just one. 

“I’m very pleased with the transition and the service we’re providing the residents of New Albany,” Gahan said Friday. “We’ve been able to expand the services with more ambulances without any additional costs to the taxpayers.”  

Rural/Metro also operates under the management of the NAFD’s administration. 

But there have been issues with Rural/Metro in surrounding communities. 

In March, Rural/Metro terminated its contract with Clark County following complaints by the Clark County Health Department. 

Dr. Kevin Burke, the executive director of the Clark County health department, alleged Rural/Metro failed to stock certain medicines, didn’t obtain mutual-aid agreements with other certified ambulance providers and neglected to maintain a minimum number of ambulance units in the county. 

Rural/Metro claimed Clark County emergency and health officials had been unwilling to meet with them about the concerns, and thus the company elected to voluntarily terminate its contract. 

Dr. Tom Harris is the Floyd County Health Officer and served as the medical director for the NAFD when it operated an ambulance. He was opposed to the city’s contract with Rural/Metro last year, and remains opposed after almost nine months after the company took over the New Albany service. 

“None of the local EMS medicine specialists that are to trained to administer EMS are willing to work with this group, and that should tell you a lot right there,” Harris said. 

The medical director for Rural/Metro practices near Indianapolis. 

Some patients have been transported to Louisville hospitals instead of Floyd Memorial, which is also an issue, Eichenberger and Harris said. 

“I think that’s the expectation of Floyd Memorial and the medical staff,” Eichenberger said. “Our hospital is a well-rounded, full-coverage hospital that can handle virtually anything the ambulances bring in, other than major trauma.” 

Obviously hospitals receive more money for the more patients they treat, but NAFD Fire Chief Matt Juliot said the issue isn’t just tied to money. 

Patients have the right to decide which hospital they are transported to, and when  the city’s service offered only one ambulance, it was difficult to take people to the facility of their choice, Juliot said. 

The one NAFD ambulance had to remain in Floyd County the majority of the time, so if a patient wished to be transported to a Louisville hospital, a private company such as Yellow Ambulance would have to be called in, he explained. 

“None of our medics are trying to talk patients into diverting from Floyd Memorial,” Juliot said. 

He added that more EKG’s will be administered, but also that he has no complaints with how Rural/Metro has performed to date. 

Prior to the privatization of the service, Juliot said he received at least one phone call per week from a patient complaining about the treatment or service they received. 

“Since the program took over in October, I have yet to field one phone call or complaint,” Juliot said. 

Most of the public doesn’t realize there’s even been a switch since Rural Metro employees wear NAFD uniforms and primarily operate ambulances marked with city logos, he continued. 

“We went with what we felt was the best service to the citizens of New Albany, and I feel they’re getting a better service than what the fire department could provide at the time,” Juliot said. 

Though the administration could have likely proceeded with privatizing the service anyway, the New Albany fire union did approve the move in a vote by its members. 

The Medical Executive Committee — a board that represents about 500 physicians at Floyd Memorial — and Eichenberger sent the administration a letter requesting a meeting with Gahan in April. 

Juliot and City Attorney Stan Robison eventually met with some hospital officials, including Eichenberger, this month. 

Harris said Gahan refused to meet with him prior to switching the ambulance service, and added that he should have at least talked with Eichenberger and the other hospital officials about the issues that have been presented. 

“It’s disconcerting to me that the mayor is unwilling to interact with the physicians who have the knowledge of the problems here,” Harris said. 

But Juliot said he felt some of the allegations against Rural/Metro were false. The issues that were unveiled in Clark County aren’t related to the service in Floyd County, Juliot added. 

He said that Floyd Memorial has been encouraged to provide a medical director for Rural/Metro to oversee the protocols and treatment administered if they feel there are any problems.  

Harris conceded there’s no apparent will by the administration or leadership of the NAFD to return the service to the fire department, which he said was a well-run operation. 

Gahan said that based on his conversations with Juliot and Rural Metro, the company is “striving to improve the services any way they can.” 

“They’re committed to providing the absolute best possible care and service,” Gahan said. 

Floyd Memorial desires a “good, collaborative working relationship” with the city, and the issues that have been cited by the hospital aren’t catastrophic, Eichenberger said. 

“I don’t think it’s anything that’s not resolvable,” he said. “As long as the problems are getting resolved, we’re going to be happy.” 

The News and Tribune attempted to contact multiple Rural/Metro representatives for comment for this story. As of press time, messages hadn’t been returned or the officials contacted said they couldn’t speak to the media. 

One representative at Rural/Metro said she hadn’t been informed of any complaints regarding the company’s New Albany service, but referred questions to another official with the company.