News From Terre Haute, Indiana

December 5, 2012

County hears ambulance contract proposals

Three volunteer fire departments want language changed to increase paramedic service

Howard Greninger
The Tribune-Star

TERRE HAUTE — Representatives of three Vigo County fire departments want to change language in a contract before any company is selected as the county’s 911 emergency care provider.

Darrick Scott, chief of the Sugar Creek Fire Department, addressed the Vigo County Board of Commissioners Tuesday on behalf of that department as well as the Honey Creek Fire Department and Riley Fire Department.

“We are asking, as three volunteer fire departments, for checks and balance,” Scott said. “When we ask for a paramedic service, we need a paramedic service. I don’t care who it is.”

Scott said he would like commissioners to add contract language to dictate that any ambulance service that receives a call for a paramedic and “cannot respond immediately, transfer the call to somebody else.” Paramedics are able to administer narcotics.

Scott said in many instances, a basic life support (BLS) ambulance is sent to a patient, then three to five minutes later a unit with a paramedic will arrive. Scott said the first ambulance is no better than fire department units already at the scene.

“I don’t want to hear and I am sure some of the other fire chiefs don’t want to hear, ‘Well, we are just getting ready to leave the nursing home, so we did not transfer the call.’ I am not talking about any [individual company]. It has happened with all the services in this county. That has got to stop,” Scott said.

“I don’t care who gets the call, I really don’t. I will be blunt. I don’t care if it is CARE [Ambulance] or TransCare [Ambulance]. I don’t care. I just want the proper medical treatment to happen in a timely fashion,” Scott said.

TransCare Inc. and CARE Ambulance each submitted proposals Tuesday to commissioners for emergency medical service.

A two-year contract with TransCare Ambulance expires Dec. 31. State law declares that emergency medical service is an essential purpose of county and city government. The law seeks to promote the establishment and maintenance of an effective system of emergency medical service, including the necessary equipment, personnel and facilities to ensure that all emergency patients receive prompt and adequate medical care.

Scott said the county should review dispatching of ambulances.

“I don’t care if it is [Terre Haute] city fire that responds. If there are three paramedic units in any of the EMS agencies and one will take 5 minutes, but there is a closer unit, that can be there in 2 minutes, what are we doing? It doesn’t make sense to me,” Scott said of dispatching ambulances.

Scott said he does not support having a BLS unit transport a person to meet up with another unit with a paramedic. “Why! Why? When there are other units that could be there in a timely fashion. It has happened with every [EMS] service here,” he said.

Scott recommended that commissioners establish a board, composed of fire department members and emergency professionals, that can immediately review runs made for emergency services. Scott said he would like that board empowered to take immediate action, instead of having to give a 180-day notice that the county would reopen its contract.

Dr. Dorene Hojnicki, who serves as an unpaid medical director for Sugar Creek, Honey Creek, Riley and three other county fire departments, said the county “has to have eyes on the patient. It is not acceptable to hold dispatch calls” even for 1 or 2 minutes while waiting on an ambulance unit to be available, she said.

Hojnicki suggested the proposed review board, recommended by Scott, be able to levy a significant penalty against the contracted service provider when it does not consistently respond in a immediate and timely fashion.

Contract proposals

TransCare has had a county service contract for the past 12 years, including the two-year contract expiring at the end of the year. TransCare CEO Russell G. Ferrell requested a five-year contract, as it allows the company to better spread out costs of new equipment.

The company would provide the service for $60,000 annually, an amount that has not changed for the past 12 years, Ferrell said. The company would provide two ambulance stations — one on the north and one on the south portion of the county.

The company has 31 full- and part-time paramedics, 49 emergency medical technicians and 22 EMT advanced technicians.

Care Ambulance also seeks a five-year contract, with an initial two-year contract, then three one-year renewable contracts. The company’s first contract would “have no direct costs” to the county, said Steven Coston, president of Procarent, parent company of CARE Ambulance.

In its proposal, CARE said it “will implement a revenue recovery program to offset expenses related to the provision of service. This program will be conducted in accordance with Medicare, Medicaid and insurance regulations.”

The company estimates it would provide nine paramedic transports per day. If the need is higher, it would renegotiate a contract. The company would keep ambulance units in the north, south, east and west sections of the county, with one in reserve in the central part of the county, providing five advanced and four basic life support units.

CARE, which established a Terre Haute presence in 2008, has 11 full-time paramedics and eight part-time paramedics. It would increase to 16 full-time paramedics if it obtains the county contract, adding two paramedic-equipped units to its fleet. The company has 27 full-time and 12 part-time emergency medical technicians. The company has 12 advanced life support trucks for Terre Haute.

CARE currently serves as a back-up provider to TransCare and the city of Terre Haute.

Commissioners Tuesday took the ambulance service proposals under advisement.

Reporter Howard Greninger can be reached at 812-231-4204 or