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FCH discusses future of ambulance service

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By Dave Bell

The Fayette County Hospital Board on Monday heard a presentation from the owner of an Effingham County ambulance service who plans to launch an ambulance operation in Fayette County this spring.

Terry White, chief executive officer of Altamont Ambulance Service, told the board that he’d like to work with the hospital, but would go ahead with his plans even if the board decided to keep the FCH ambulance operation going. If both are in operation, the county’s emergency dispatchers are required to alternate between the two ambulance services when emergency calls are received.

White, a licensed EMS instructor who has been in the ambulance business since 1994, told the board that he has been studying the situation here for the past six months. He has located a building near the intersection of Eighth and Randolph streets to serve as his center of operations. He said that the building would have three ambulance bays and sleeping room for six people.

The building – and the ambulance service – will be “ready to go in 90 days or less,” he said. “We would like to come in with your blessings, in a partnership with you. We might be the fit you’re looking for. And we will sign a commitment.”

He said that his ambulances would have a six- to eight-minute response time within the city of Vandalia.

Currently, FCH has one ambulance crew on duty at all times, and must call in a second crew if additional calls come in or if a patient needs to be transported to another health care facility.

In a letter of intent from White to FCH Chief Executive Officer Greg Starnes, White said that he will provide 24-hour ambulance service, staffed by paramedics.

“It is our intent to initially staff a minimum of two advanced life support units, with an additional ALS unit as back-up provided by available staff members. Mutual aid agreements will be maintained with all surrounding ambulance services to insure adequate response during a major emergency.”

He also said that his agency “maintains a working relationship with both Air Evac and Arch helicopter service for both on-scene and hospital response requests.”

Further, the letter said that he monitors the in-house training of his staff. Most vehicle maintenance is done in by three staff mechanics, which he said is a major cost-saving factor.

In a letter to the board, Starnes outlined the hospital’s current situation regarding its ambulance service.

“The hospital loses money on the ambulance service,” Starnes said. “The hospitals in Effingham, Hillsboro and Pana do not provide ambulance service. Independent companies provide the service….If we at the hospital continue to provide ambulance service, it is my understanding that emergency calls would be alternated between Altamont Ambulance Service and us. That would reduce our runs by approximately 50 percent.

“We did 1,200 runs in 2009 and had gross revenues (charges) of $1.456 million. Before overhead allocations, we lost $18,000, and with overhead expenses applied, the loss totaled $187,000. If the runs were reduced by 50 percent, our anticipated loss before overhead allocation could be close to $267,000.”

Starnes concluded his letter by recommending that the board no longer require the hospital operator, Heartland Health System, to provide ambulance services and that the district sell the ambulances it now owns.

Though the board took no action on Monday, several members expressed support for the idea of the hospital getting out of the ambulance business – as long as they could be assured that Altamont Ambulance Service would maintain the service at a high level of quality.

Board member Norris Price said that the hospital should “suspend the service – not terminate it,” in case the need ever arises for the hospital to get back in the business.

Charlie Barenfanger, another member of the board, said that he’d done some research on what area hospitals are doing relative to ambulance services, and he found that “ambulance services are run independent of most hospitals around here.”

Board member Jim Lay said that he’d like to get a commitment from Heartland Health System “that whatever they save (by getting out of the ambulance business) that they’d reinvest it in equipment in the hospital.”

Under the current system at FCH, the EMTs split their time between ambulance runs and work in the emergency room. Starnes said that if the hospital no longer had ambulance personnel, “we’d have to add staff in the ER.”

 “Let’s think about it for a month,” said Delbert Miller, district board president.

The board agreed to put the issue on next month’s meeting agenda.

•      •      •

In other action at Monday’s meeting:

• The board heard an update from Mark Ritter and Scott Hunter of Hurst-Rosche Engineers Inc. of Hillsboro on the work being done on the hospital’s window replacement project, as well as improvements to the heating and air-conditioning system.

Ritter also provided the board with blueprint drawings of planned improvements to the hospital’s special care unit. After reviewing the drawings, the board voted to have Hurst-Roche submit them to the Illinois Department of Public Health for approval.

• In the medical staff report, Dr. Brent Schwarm said that a stroke protocol is being developed for the emergency room – a program that will create specific procedures for treating stroke patients who come to the FCH emergency room. The stroke protocol is modeled after the Stat Heart program that the hospital developed with Prairie Cardiovascular of Springfield.

• After putting significant cost-cutting measures in place last fall, the hospital had a good January – recording net income of $166,663. That compares with a $285,000 loss last January.

Starnes said that he was very pleased with the turnaround, and pledged to keep employees “apprised of the impact of the sacrifices they’ve made. These things have really made an impact.”

Starnes said that the new digital mobile MRI unit is providing good images for patients. It is brought to FCH three days per week.

He also said that the hospital is looking at providing mammography services through the use of a similar mobile unit.