Missing drugs, bad records were among squad’s problems before it closed, records show.
By Patrick Lester
Morning Call (Allentown, Pennsylvania)
Copyright 2007 The Morning Call, Inc.
All Rights Reserved
In the years leading to its closure, Perkasie Community Ambulance had problems keeping tabs on its narcotics, was accused of misrepresenting its amount of time on duty and continually did not meet county and state staffing requirements, records show.
And while Bucks County officials repeatedly urged the squad to operate as a basic life support unit, management insisted it could run an advanced life support unit.
If a new board of directors returns a Perkasie-based ambulance to the road by next month as proposed, it will have to repair a host of problems as well as serious financial woes that led to a planned government seizure of the nonprofit’s property, repossession of a vehicle and a frozen fuel account.
The organization, which operated on an annual $250,000 budget, owes more than $90,000 to the Internal Revenue Service and was operating without workers’ compensation insurance from July 2006 until it closed earlier this month.
The state’s Emergency Medical Services director said the future of the Perkasie organization, which operated less than two miles from Grand View Hospital’s ambulance company in West Rockhill Township and fewer than five miles from two other squads, will be dictated by demand.
“It’s a community partnership between the ambulance and community, and they’ll determine the level [of service], " Joseph Schmider said.
Financial struggles aren’t unique to the Perkasie squad.
Ambulance leaders across the region and state have said they’re having a difficult time making ends meet, partly because payments from patients’ insurance providers aren’t covering expenses.
An expert on ambulance services soon will shed some light on the need for a Perkasie-based operation when an study of ambulance services in Upper Bucks is released. Everitt Binns of Binns and Associates, a health care and public safety consulting firm conducting the study, said he expects to reveal the recommendations in mid-April.
In the meantime, Perkasie Community Ambulance’s board of directors is hopeful it can reopen by April 12 and serve the borough in addition to parts of East Rockhill, Hilltown and West Rockhill townships and Silverdale borough.
Secure medications
The squad’s problems began in 1999 when former President Wheeland Hill embezzled more than $200,000.
Hill pleaded guilty to the crime. And while the organization for years pointed to the theft as the reason for its financial problems, the nonprofit recouped much of that money from its insurance provider.
Other problems surfaced years later, according to papers filed with the state Department of Health, whose Emergency Medical Services office regulates and oversees ambulance companies.
County officials learned in 2003 a drug cabinet at the squad’s headquarters wasn’t double-locked and a drug-use log wasn’t being filled out daily as required by federal law.
Ray Leet, the county’s former Emergency Medical Services director, wrote in a 2003 letter to the state that “we have documented serious issues involving their narcotics accountability and drug box expiration dates.” In addition, he said a Doylestown Hospital pharmacist was “very concernedabout drug boxes and narcotics being trusted to Perkasie Ambulance.”
Last year, a locked box holding 10 vials of morphine, Valium and other sedatives was reported missing from the back of a Perkasie ambulance. Borough Police Chief Joseph Gura said the investigation is inactive and the drug box was never found. Jeryl DeGideo, director of Bucks County Emergency Health Services, wouldn’t comment specifically on the drug allegations, saying she wanted to avoid speaking about the negative issues surrounding the group. But she said those problems “absolutely” did not compromise patient care.
Former squad Chief Michelle Erdman, who didn’t return a phone call for this story, confirmed in a December 2003 memo that the drug log was not being signed. She also said in letters to the county that her organization was “being singled out” and was long a victim of “political games” orchestrated by other companies.
Staffing discrepancies
The company also was at least three weeks behind in turning over reports to the county that detailed its emergency calls and patients treated. County records indicate the ambulance squad may have artificially inflated the number of hours it had a paramedic on duty while operating as an advanced life support unit.
Advanced care ambulance services, which carry more-specialized equipment and offer more services than a basic unit with an emergency medical technician, are required to have a paramedic on duty around the clock.
In a December 2003 memo to the state, Jason Diefenderfer, a county emergency services field representative, wrote that his office “strongly” believed “the service is intentionally failing to log offcausing a perceived increase in documented in-service times.” He said a member of the crew confirmed the practice and said it continued even after management was confronted.
Perkasie ambulance had trouble meeting its around-the-clock requirement since it began offering advanced services in 1999.
In its first six years, it had a paramedic on duty slightly more than 16 hours per day, but the state continued to issue the service temporary licenses in an effort to get the squad to address its problems.
County officials continually recommended Perkasie remain a basic medical unit -- that type of service isn’t required to have 24-hour staffing and isn’t permitted to use medications -- but the organization insisted on being an advanced unit.
“It’s a pretty strong crew, and they’ve got this pride thing going,” DeGideo said last week.
Emergency calls
Meanwhile, in order for a new Perkasie ambulance service to survive, it may have to find ways to get more business. Last year, it went on 673 calls, down 16 percent from the previous year.
Emergency services officials say an ambulance squad of that size would have to respond to 800 to 1,000 billable calls to stay afloat. Others said the squad would be able to do well with fewer than 800 calls if it were able to raise money in other ways, including payments from people who subscribe to the ambulance service.
When revoking its license for closing down, the state issued a terse letter to Chief Lori Wychakinas, calling the closure “irresponsible” because Perkasie ambulance did not provide a state-mandated 90-day warning before shutting down.
Before a new operating license would be issued, Perkasie’s new board of directors would have to pass criminal background checks, DeGideo said, and the organization’s vehicles and equipment would have to pass inspections.