Kan. county starts pilot program to boost response times
The county revised its contract with AMR to temporarily waive the requirement to have paramedics on scenes at all calls within a specific time frame
By Tim Hrenchir
The Topeka Capital-Journal, Kan.
SHAWNEE COUNTY, Kan. — A pilot program Shawnee County commissioners established Monday will enable ambulances in some circumstances to not carry paramedics, thus helping bring a quicker overall response to calls, an official with the county's ambulance service provider said.
"I guarantee you we will see improvement in response times," said Jon Antrim, regional director for Kansas for Colorado-based American Medical Response.
Commissioners Bob Archer, Bill Riphahn and Kevin Cook voted 3-0 Monday to revise the county's contract with AMR to temporarily waive — for six months, from Sept. 1 through Feb. 29 — the requirement that AMR gets a paramedic to the scenes of all its calls within specific amounts of time spelled out in its contract.
The arrangement that has been in place doesn't "stop the clock" until a paramedic arrives at the scene, said Nelson Casteel, the county's ambulance compliance officer.
The setup approved Monday stops the clock on certain specific, low-severity calls once AMR gets an emergency medical technician to the scene, he said.
Antrim said AMR has as many as eight ambulances available at a time to respond to calls in Shawnee County, with each being staffed by a paramedic and an EMT.
Still, about 84% of AMR's calls in Shawnee County are to provide only basic life support and consequently require only an EMT, Casteel said.
Those calls involve such things as transferring a patient whose condition isn't serious from a nursing home to a hospital, or going to help someone who has fallen and can't get up, he said.
Antrim said AMR will now begin for 24 hours a day to maintain a single basic life support ambulance staffed by EMTs, who will respond only to low-severity calls on which the clock will stop once they arrive.
The move approved Monday will "be the first step of many to bring innovation to the Shawnee County Emergency Medical Services System," Casteel told commissioners in a memo dated July 1, which was part of the agenda packet for Monday's meeting.
AMR remains in substantial compliance with its existing contract with the county, having been fined for being late on 2.7 percent of its calls in 2017 and 3.5 percent in 2018, Casteel said.
Still, he said, the number of calls AMR receives — and correspondingly, the number of fines it ends up paying — are increasing.
AMR received 24,883 calls in 2018, a 10% increase over the 22,684 received in 2017, Casteel said.
Shawnee County fined AMR $13,281 for 433 violations in 2017 and $40,760 for 819 violations in 2018.
"It is the opinion of AMR and the Shawnee County Compliance Officer that the Shawnee County Emergency Medical Services System continues to grow in volume and based on the trends being seen there will be an increasing number of calls/runs each month going forward," Casteel said.
AMR has also seen a significant rise in its number of calls in which it is asked to provide assistance of a non-medical nature, such as helping to lift someone, he said.
The pilot program is not a way to make AMR's contract easier to meet and or to help it to "beat the clock," make more profit and reduce its number of ambulances on the street, Casteel said.
In fact, Antrim said, the company anticipates having more ambulances on the street.
The new arrangement focuses on seeing that AMR gets "the appropriate resources to the appropriate patients," he said.
To ensure patient care isn't compromised, local fire chiefs, the county's Ambulance Advisory Board and the AMR-Topeka-Shawnee County Protocol Working Group will be asked to increase their oversight of the situation, Casteel said.
©2019 The Topeka Capital-Journal, Kan.