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Pa. paramedic interceptor program sends EMS beyond its primary service area

Shippensburg Area EMS uses a paramedic interceptor model to provide ALS across a wider area, but officials say the program creates reimbursement and funding challenges

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Shippensburg Area EMS/Facebook

By Maddie Seiler
The Sentinel

SHIPPENSBURG, Pa. — Shippensburg and Newville have their own emergency medical service agencies and first-due service areas, but sometimes, Shippensburg vehicles respond to Newville calls.

So why the overlap? Local first responders weigh in.

EMTs vs. paramedic

While most EMS agencies have emergency medical technicians, or EMTs, not all of them have paramedics - and there is a difference.

EMTs provide basic life support, or BLS. According to Shippensburg Area EMS Chief Shawn Hartsock, that can include splinting, oxygen, bleeding control, automatic external defibrillators, breathing treatments and basic medications.

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Paramedics provide advanced life support, including cardiac monitoring, advanced airways and advanced medications, he said.

“EMTs only have a really small amount of medications, where paramedics have a whole drug box and toolbox of medications and advanced airways, IV access, things like that,” Shippensburg Area EMS Capt. Heather Franzoni said.

She said a lot of smaller EMS agencies in the area, like Newville, only provide basic life support, relying on paramedics to respond from places like Shippensburg or Carlisle.

The Bright Side: Local EMS agencies push prevention tactics

With the cost of equipment - and most everything else - on the rise, local EMS agencies are thinking outside the ambulance to prevent people from needing to call 911 in the first place.

Additionally, without a Shippensburg hospital, ambulances typically transport patients to Carlisle or Chambersburg.

“By the time you get to the scene, provide on scene care, get to the hospital [and] clean up, you’re looking at a good hour before you turn that ALS provider around,” Franzoni said.

But not every call requires a paramedic.

That’s why the agency uses a paramedic interceptor model to respond to calls. Instead of riding in an ambulance, paramedics usually drive a separate vehicle.

If they arrive at the scene and determine that advanced life support isn’t needed, the paramedic can leave and go back in service while EMTs transport the patient to the hospital, Franzoni said.

Franzoni said there are about half as many paramedics as EMTs at Shippensburg Area EMS, so the paramedic interceptor model helps ensure that the right responders are available when they’re needed.

“We ... believe in putting the right resources on the right call,” she said. “A paramedic does not need to be on every call, so you leave them in service for those higher-level calls when you can.”

Program costs

According to Hartsock, one of the challenges of the paramedic interceptor model is the cost.

“Paramedic interceptors are not reimbursed,” he said. “So the insurance companies only pay for the transporting ambulance service.”

While Shippensburg has an agreement with Newville to split the revenue if a paramedic gets on an ambulance, it doesn’t account for all the other calls, Hartsock said.

He estimated that Shippensburg Area EMS could receive about $140 to $300 per interceptor call.

“If you look at the amount of basic equipment that we use, if we use cardiac monitoring, we start an IV, we do a first round of drug, we put pads on people, we put an airway in, we’re topping $400 or $500 just in basic equipment, not including the fuel, the salary for the person to come out, the liability insurance and everything else,” Hartsock said.

As for capital costs, he said a cardiac monitor costs about $60,000 and an ambulance is about $400,000.

Hartsock said the agency is considering options to help fund the interceptor program, including solicitations from municipalities that receive the service or a possible fee per call to offset costs.

“We would be willing to explore it, willing to look at it, but it’s definitely in infancy stages, and we are definitely not looking at costing any municipality any money without some sort of further discussion,” Franzoni said.

Newville’s EMS agency did not return a request for comment.

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