CitizensVoice.com
LEHMAN TOWNSHIP, Pa. — Joe Schneiderite sat in his recliner, watching the news in his Lehman Township home, when his wife called out for him from the kitchen sink. He stood up, took a few steps and then collapsed, striking his head on the kitchen floor.
Schneiderite — a survivor of four heart attacks — lay there for 20 minutes, drifting in and out of consciousness as he and terrified family members waited for an ambulance to arrive from Luzerne, more than 8 miles away.
Unbeknownst to them, another ambulance sat staffed and ready to go 4 miles and nearly 10 minutes closer in Dallas Township, but an arrangement that put local preference over patient safety blocked dispatchers from sending it.
Schneiderite survived the March ordeal, but his long wait for help underscored a lurking problem in the Luzerne County emergency management system. In an industry where seconds can mean the difference between life and death, municipalities do not always use the closest possible ambulance when disaster hits.
Reasons for the problem are numerous, many in the industry say - a lack of oversight from municipal governments, the strength of the good ol’ boy network among ambulance companies, and grudges over territory and payment.
Whatever the reason, it created serious trouble for the 75-year-old Schneiderite.
“That is my father-in-law. I sat here on the floor with that man dying in my arms,” Nathan Mutchler, 45, said. “He’s not a pawn in a chess game. He’s a father, a husband, a grandfather.”
‘It’s life-threatening’
When an emergency hits a community, dispatchers usually send two types of ambulance to the scene - one often staffed with local volunteers who can handle basic medical situations, and a second unit carrying a paramedic for more serious circumstances.
While most municipalities have their own basic-life-support ambulance, only a handful of advanced-life-support units are available throughout the county because of huge costs for start up - at least $250,000, according to one local chief - and maintenance.
Most communities must make agreements with outside providers for advanced-life-support service. And many borough and township governments simply leave those decisions to their local ambulance companies.
In fact, some government officials believe they don’t even have the authority to tell their ambulance company who it should call for more serious emergencies. That’s what Lehman Township Supervisor Chairman David Sutton said when a reporter asked him why the ambulance from Luzerne trumps the much closer one in nearby Dallas Township in a portion of the township.
But in 2008, the state amended the borough and township codes, clearly specifying that the municipalities “shall be responsible for ensuring that fire and emergency medical services are provided.” That law ties the hands of Luzerne County 911 to obey the call orders given to them by the municipalities.
Yet many ambulance companies have remained in control. And while many responsibly choose the closest option, some don’t seem to have residents’ best interests in mind.
“To me, it’s life-threatening,” said Frank Guido, chief of the regionalized Kingston/Forty Fort Fire Department. The department operates its own advanced-life-support ambulance. “I don’t approve of it; I don’t think it’s right.”
The findings of a Citizens’ Voice investigation published March 10, weeks before the Schneiderites’ March 30 scare, revealed several areas of the county, including the portion of Lehman Township where they live, that did not utilize closer ambulance options.
Since the story appeared, some of those municipalities, such as Dallas Township, have made changes.
Many have not.
Distant connections
The Schneiderite home is tucked in a forest of evergreens in a section of Lehman Township covered by Lake Silkworth EMS, a company comprised mainly of part-time and volunteer employees. While nearly all of the township depends upon the advanced ambulances from the recently formed and nearby Back Mountain Regional Fire and EMS, Lake Silkworth EMS continues to use units from Luzerne-based, for-profit Trans-Med Ambulance, Inc., to serve its territory.
That’s fine if the first choice is available. Trans-Med often keeps an ambulance in the Back Mountain, which many companies and communities use in an emergency, including Lake Silkworth. But when it is tied up on another call, as it was the day of Schneiderite’s fall, a truck from Luzerne is next in-line.
Carol White, the ambulance captain for Lake Silkworth EMS, said she has discussed a change with Back Mountain Regional - whose ambulance in Dallas Township was available when Schneiderite needed it - but was told the company did not want more territory. Chris Good, regional EMS chief of Back Mountain Regional, said that while the company is not looking to expand, it will respond as needed.
“I have told everyone that we will go if called,” Good said in a text message.
White, a former full-time employee of Trans-Med, also said she no longer works there, but Phillip Hamilton, the company’s director of operations, said she remains a part-time employee. White denied her connection with Trans-Med influenced her decision to use it over trucks from Back Mountain Regional.
Whether a miscommunication or something more disturbing, the fact remains that if Schneiderite were to have another heart attack and the first-choice Trans-Med ambulance was again occupied in one of the many Back Mountain communities it also serves, 911 must dispatch the unit in Luzerne over the much closer one in Dallas Township.
Hatfields and McCoys
Now a second closer option is available on the Back Mountain, yet Lake Silkworth’s territory remains the last place in the area that continues to use the ambulances from Luzerne.
The Kunkle Fire and Ambulance Company, a paid and volunteer hybrid covering half of Dallas Township, started its own advanced ambulance last month. The unit now covers much of the Back Mountain, including Kunkle’s own territory, Harveys Lake and Monroe Township in Wyoming County. Those three had all used trucks out of Luzerne ahead of the miles-closer Back Mountain Regional before The Citizens’ Voice pointed it out.
Several sources in the ambulance industry, speaking under the condition of anonymity, criticized Kunkle Chief Jack Dodson and others for not working more closely with Back Mountain Regional. Some local fire and EMS departments, many of which are volunteer, resent the larger Back Mountain Regional, which includes full-time paid staff and was created in a merger between departments in Dallas and Lehman Townships. The local companies consider regionalization a threat to their autonomy and that general feeling is a deterrent to needed mergers all across the county, the sources said.
Dodson denied animosity between his company and the neighboring regionalized force, which covers the other half of Dallas Township, calling those accusations “nonsense.” He noted that Back Mountain Regional’s advanced ambulance now serves as the backup in Kunkle’s territory. His company previously had used Trans-Med in Luzerne as its second choice over its neighbor, then changed after The Citizens’ Voice questioned the practice.
The “Hatfield and McCoy mentality,” as one describes it, would seem to encourage more involvement from elected officials, yet Dallas Township Supervisor Elizabeth Martin, one of the politicians who oversees emergency services, hung up on a reporter when asked about the township board’s involvement in ambulance call orders.
Harveys Lake Fire Chief David Davis also denied any resentment between companies, saying he used the Trans-Med ambulances from Luzerne for his community instead of the closer Back Mountain units because he didn’t want to deprive half of Dallas Township of its ambulances. But Davis has no problem using those from Kunkle’s territory.
He switched to that company’s advanced-life-support ambulance when it went into service last month.
Bypassing closer options
Luzerne County’s ambulance problem extends beyond the Back Mountain.
Larksville, Edwardsville and Courtdale, all of which have a mutual response agreement with their fire and police departments, also aid each other when it comes to basic ambulance service. But for more serious emergencies, the trio of municipalities calls an advanced unit from across the river in Plains Township despite a closer option: Trans-Med in Luzerne. Bypassing those ambulances adds, at minimum, an additional 2.4 miles and a bridge for an ambulance from Plains Township racing to an emergency in those communities.
The local ambulance providers have clashed with the for-profit ambulance company in recent years over payment, culminating in Trans-Med suing the Edwardsville Ambulance Association for $7,600 last year in magisterial district court. The Edwardsville Ambulance Association is appealed the lawsuit to the Court of Common Pleas.
Edwardsville Councilman John Sedeski, who has tried to mediate the disagreement, said it had become “extremely touchy.” Not wanting to see it politicized, the Edwardsville council put the issue aside until after the May 21 primary election, he said. Sedeski, whose brother-in-law is an ambulance driver for Trans-Med, said the council would likely revisit the issue at its meetings this month.
Mike Lehman, the head of the Edwardsville Ambulance Association, did not return a message seeking comment.
Courtdale, which doesn’t have its own ambulance service, recently voted to make Trans-Med its first responder for advanced emergencies, but the borough council shelved that plan after Larksville EMS objected, Courtdale Mayor Dorothy Duesler said. The borough will hold two public town-hall meetings in the fall before the council makes a final decision.
Hughestown switched its basic ambulance back-up from Old Forge EMS in Lackawanna County to the closer Avoca EMS after The Citizens’ Voice story appeared, but continues to use the same advanced unit from Plains despite closer options.
Ending ‘Ambulance Wars’
Until 2000, when it outfitted every advanced ambulance with a global-positioning device, allowing it to dispatch the closest possible unit, Lackawanna County had its own “ambulance wars,” David Hahn, the county’s emergency services director said. Crews wanting the business would race each other to accident scenes, pulling resources away from other areas.
Luzerne County has considered its own system, but because the county does not have the authority to mandate it, municipalities and ambulance companies would have to come to an agreement, Fred Rosencrans, the interim executive director of Luzerne 911 said. That could make the proposition as difficult as the slow-moving regionalization efforts in the county.
But without some changes and more active municipal governments, favoritism and territorial jockeying could cause more damage than just bruised egos.
Just ask the Schneiderites
“If those people could feel what we felt that day, I think it would change all their minds and attitudes about what’s going on,” said Mutchler, Schneiderite’s son-in-law and next-door neighbor.
Eventually, the ambulance from Luzerne and another from neighboring Ross Township arrived. Despite lingering headaches, Schneiderite has mostly healed from the bleeding on the brain suffered from his concussion. He did not endure another cardiac episode while waiting for help.
But his experience, a stark reminder of what could happen if changes aren’t made, left his family furiously asking what needs to happen for some ambulance companies to do what’s right.
“You know what it’s going to take?” Joe’s wife Gladys Scheiderite, said. “Somebody’s going to lose their husband or one of their loved ones, and it’s too late then.”
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