Milwaukee ambulance system under strain as private enterprise leaves


A private ambulance company that the city of Milwaukee says did not follow up on his 911 calls on the northwest side of Milwaukee has announced that it plans to stop working with the city.

The Midwest Medical Transport Co. advisory comes as the Milwaukee Fire Department, which handles the most critical calls, comes under increasing pressure to respond to lower-level medical incidents that under the city’s system , should be handled by private paramedics.

“I lead the last line of defense for the people of Milwaukee when something is beyond their capabilities, which is what we do here,” Acting Fire Chief Aaron Lipski said. “And frankly, the people we largely represent are already the most underserved and disadvantaged communities in the state, and leaving them in the lurch is something that I probably shouldn’t take personally, but I do. .”

The city’s entire emergency medical response system is at a crossroads, he said.

The fire department currently responds to about 1,000 lower-level calls per month, Lipski said.

This can make fire department paramedics unavailable to respond to high-level calls or force a fire truck or ladder truck that responded first to wait with the patient for long periods of time, it said. he told the Common Council’s Safety and Public Health Committee last week.

The biggest impact, he said, is on the person who calls 911 because they want to get to the hospital after breaking their foot or cutting their hand.

The wait can drag on because even though a fire truck may be on the scene, the department has limited capacity to provide transport to the hospital. Private companies would traditionally carry lower level calls.

For various reasons, Lipski said, it has become much less lucrative to participate in the 911 system as a private provider.

In an April 12 letter to Lipski, Midwest Medical chief executive Jeff Shullaw wrote that the company intended to terminate its agreement with the city and would be willing to complete that process as early as April 30.

The Omaha, Nebraska-based company did not respond to interview requests on Friday.

Midwest Medical attorney Brian Randall, who is based in Milwaukee, told the Ambulance Service Board earlier this month that staffing and funding were a challenge.

“On behalf of Midwest Medical, the decision has been made that it is in everyone’s best interest to issue the Notice of Intent and let the city focus on remedial action that can improve the system in its together,” he said.

The intention, he said, was not to leave the city stranded. There is a 180-day “exit period”, he said, but the company could exit the deal earlier “if necessary and necessary”.

Ambulance officer: the system is down

At one time, there were four private companies taking less serious calls in Milwaukee, each assigned to its own area of ​​the city. The departure of Midwest Medical would bring that number down to two.

Paratech Ambulance Service basically bought a small ambulance company and then was bought by Midwest Medical late last year, Ald said. Mark Borkowski, who also chairs the Ambulance Service Board.

It became clear early this year, he said, that Midwest Medical was unable to handle the workload.

“Obviously they either had no idea what they were getting into or they didn’t like what they found, but it put the city in a huge bind,” he said. he told the Milwaukee Journal Sentinel.

Of the city’s three private ambulance companies, Midwest Medical was unable to handle the largest percentage of calls and transferred the most calls to the fire department, department data shows. ‘fire.

The percentage of calls the company was unable to respond to rose to 65.5% in February, according to firefighters.

Curtis Ambulance Service, another of the three private companies, was at 33.5% in February, while Bell Ambulance was at 1.2%.

The goal is to keep that figure below 4%, Deputy Fire Chief Joshua Parish told the Ambulance Service Board earlier this month.

“A percentage only tells half the story, while call volume tells a much bigger story,” said Parish, who leads the office of EMS, training and education at the fire department.

The fire department also handled the most calls from the area of ​​the city in which Midwest Medical is tasked to respond. That number jumped to 877 calls in February, compared to 246 in the Curtis neighborhood and 19 in the Bell neighborhood.

Lipski told the Journal Sentinel that more lower-level calls are coming back to the fire department because private ambulance companies as a whole aren’t putting enough ambulances on the streets.

This is happening, he said, because it is expensive to train emergency medical technicians and staff ambulances, and COVID-19 testing and vaccination efforts have drawn in workers who had been in ambulances.

On a deeper level, he said, low Medicaid reimbursement rates present financial challenges for ambulance services.

This issue was the subject of a letter sent by Bell Ambulance Vice President and Chief Operating Officer Wayne Jurecki, in which he wrote that “the City of Milwaukee’s EMS system in its current form is in breakdown”.

The costs of providing emergency medical services have risen dramatically while reimbursement from government and third-party payers has stayed the same or fallen, he wrote.

Last year, financial challenges increased due to higher costs associated with the coronavirus pandemic, he said.

“Bell’s size and available resources have allowed us to absorb the losses associated with providing services to the EMS system, but we find it simply untenable to continue to subsidize the EMS system,” Jurecki wrote.

His demands to the city included implementing a $125 response fee for each EMS system response a provider makes.

The fees “would help solidify the continued viability of providers and stabilize the inequitable EMS system,” he wrote.

Contact Alison Dirr at 414-224-2383 or Follow her on Twitter @AlisonDirr.

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