Kansas EMS providers say county leaders ignored their warnings
Officials seek to make changes to correct "hemorrhaging" staffing levels among Sedgwick County first responders
This is part of a series from The Wichita Eagle about what it calls "a broken emergency medical system that's growing worse by the day." Check out additional coverage of this ongoing story:
By Chance Swaim and Michael Stavola
The Wichita Eagle
SEDGWICK COUNTY, Kan. — Depending on who you talk to in Sedgwick County government, troubles within EMS are either ominous or overblown.
Multiple EMS employees have warned county leaders that Dr. John Gallagher is driving away paramedics and putting lives at risk. The majority of county commissioners aren't convinced and say they are waiting for the findings of an outside law firm's audit before deciding whether he should stay as the director.
Commissioner Jim Howell said they already have enough information to place Gallagher on administrative leave until all of the investigations are completed.
Besides the outside law firm's review, Gallagher is at the center of two other potential investigations, one with the Kansas Board of EMS and one with the Kansas Board of Healing Arts, related to his handling of a suicide call in 2019.
"Every day that we wait, we're losing more paramedics," Howell said.
"This appears to be Sedgwick County leaders digging-in against overwhelming data," Howell said of suffering response times and a department in disarray. "It feels more political than data-driven. I think anybody would look at this data, and they would make a pretty common sense conclusion."
The Wichita Eagle found Sedgwick County leaders have bungled attempts to reconcile conflicts within the EMS department, allowing an interdepartmental squabble to turn into a public health crisis.
A county commissioner reportedly threw away an employee petition. Another commissioner refused to listen to an audio record of their concerns. County management didn't inform commissioners of the potential gravity of Gallagher's decision to deny a suicidal man an ambulance before they approved a 5-year contract with him.
The contract was approved on the consent agenda without public comment or debate by commissioners, fueling mistrust. And when the county moved to review problems within EMS, it initially chose an auditing firm with loose ties to two county officials, a move that inflamed county employees.
"The onus of this failed experiment falls as much on you as it does Dr. Gallagher and his executive staff," EMS Capt. Cole Mitchell told County Manager Tom Stolz and Assistant County Manager Rusty Leeds at a meeting in April.
"The fact is, you guys took factual and credible information given to you, you ignored it, you manipulated it and even borderline intimidated those who brought it forward, all to fit a narrative. You knowingly and willingly made a bad decision."
County commissioners split
Sedgwick County Commissioners don't agree on a solution to the EMS crisis. Political rancor between Howell and Commissioners Pete Meitzner and David Dennis has impeded a civil discussion from the bench.
All commissioners told The Eagle they want EMS worker morale to improve.
Howell said he has a list of "action items" the county should do immediately: separate the EMS from the Office of the Medical Director, name an interim EMS director and an interim medical director, and begin a national search for permanent replacements.
"If we did those things, I think paramedics would come back," Howell said. "We would stop the hemorrhaging immediately."
Howell, whose daughter in-law works for EMS, has consistently pushed for more data on EMS performance under Gallagher, but he said he was dismissed by County Manager Tom Stolz, who called his requests "a witch hunt."
"I believe the county has been dismissive and strangely reluctant to review the decisions made in the past," Howell said.
Howell, a Republican, said it has been difficult to get support from other commissioners for political reasons. The two members of the board in his political party, Meitzner and Dennis, have been the strongest supporters of Gallagher and have each floated privatization as a solution if Sedgwick County EMS continues to struggle, a proposition Howell strongly opposes.
Meitzner and Dennis have doubts that there's any problem with EMS services.
Meitzner said he hasn't heard complaints about EMS from doctors or the general public about response times.
"In city and county government, the citizens are really good at letting you know if there's something wrong," he said. "In this case, the citizens and the doctors I know, the citizens and the doctors are very happy with the service. They don't call up and say I'm happy with the service, but they would sure call up if they were complaining."
When Cara Poole, whose son suffered a seizure and waited 24 minutes for an ambulance, wrote an email to Dennis with concerns about response times, he told her that the slow response to her son's emergency didn't have anything to do with EMS staffing levels.
"This was not an EMS staffing issue although those who want us to fire the current Medical Director (Gallagher), always point to anything they can to bolster their case and discredit EMS," he wrote in a June 17 email.
Meitzner questioned Howell's motives, suggesting he's only interested because he has a family member who works in EMS. "I have no idea if that means anything," Meitzner said.
Troubles with EMS have gotten the attention of the private sector. In late April, a representative from Global Medical Response, parent company of American Medical Response, wrote to Meitzner saying the company had been "following the current issues" and "staffing problems" at Sedgwick County EMS and wanted to share a proposal.
Meitzner and Stolz later held a teleconference with GMR representatives. Both said it was informational in nature and did not involve any negotiations.
"How can we not have a plan B?" Meitzner said in an interview with The Eagle. "That would be irresponsible, unless they can resolve it. I'm hoping they can resolve it, personally. Maybe it can go back to a manager-led department; maybe it's still a medical-led department."
Stolz, in a separate interview, said he would prefer not to privatize EMS.
"I would love to keep the current model that we have and make it work," Stolz said. "But if we just continue to hemorrhage paramedics then we'll have to look at a solution to try to help the people on the street keep their head above water and serve the people."
Meitzner said the staffing crisis in EMS isn't unique, as other county departments struggle to fill positions. He also posited that the pandemic has led to a worsening of the situation.
"You know, with COVID and the money that people are getting for not working, it can put a strain everywhere," he said.
Dennis told The Eagle he's waiting for the law firm's findings to form an opinion on what should change.
"I don't know what it's going to recommend at this point and time," Dennis said. "I can't tell you until I read the audit what my decision is going to be moving forward. It could be anything, from privatizing the whole thing to change of leadership."
The two Democrats on the commission, Lacey Cruse and Sarah Lopez, have signaled that they are also waiting for the investigation findings before deciding whether to push for a leadership change.
In the meantime, Cruse said she's pushing for a pay raise for EMS employees and would like to see more mental health care available to them.
"Right now, our EMS employees have an opportunity to see a counselor three times," Cruse said. "It's free. We pay for the service for all of them, but not all of them use that. And so how can we take those unused visits and give it to the people who are going to see the value in seeing a therapist."
Lopez, who joined the commission in January, said she doesn't know the entire backstory of Gallagher's promotion. But she did attend one of two closed-door staff meetings in late April, along with Howell, where EMS employees called on county leaders to fire Gallagher.
"There's some real problems that need to be addressed and need to be fixed," she said. "But there has to be a process in how we do this. I wish that process would have started and played out before now, but that hasn't been the case. So it's to the point where there is no middle ground that we can get to a compromise. ... We've crossed that line already."
Years of pushback
Sedgwick County EMS employees have told The Eagle they no longer feel comfortable approaching some county commissioners for help.
When paramedics brought a petition signed by nearly half the department to Meitzner, he threw it in the trash, multiple witnesses have said.
The petition questioned Gallagher's honesty, experience, leadership and transparency and asked for an open search to fill the vacancy left open nearly a year after former EMS Director Scott Hadley retired. It had been reportedly signed by more than 100 street-level EMS workers.
"He kind of berated us for being there," EMS Capt. Brendan McGreevy told The Eagle. "He said something along the lines of, he had been in charge of a Fortune 500 company and had never had low-level employees come to him with issues like this.
"That's when he proceeded to say that 'this is why I have the county manager, so I don't have to deal with issues like this,'" McGreevy said.
After an awkward silence, the paramedics got up to leave, McGreevy said. Meitzner followed them out of his office "with the letter in his hand and threw it in the trash in the lobby. And then he went back into his office."
Meitzner said he doesn't recall doing that. "If you hand me something, I'm not a guy that goes — I don't do that."
"In all my years of service, I always respected the departments, the managers, and the employees," Meitzner said.
Former director's warning
Hadley, the former EMS director who worked alongside Gallagher, said he also tried to warn officials against promoting Gallagher when he retired in 2018.
"I told them not to experiment with Sedgwick County EMS and change the current model and ... do not put Dr. John Gallagher in charge of the service," he said. "That was known to many people on many different occasions in discussions that I had. I didn't record those conversations so I can't produce any proof that I had those discussions with anybody. They can all deny that that happened, but it did."
During the April meetings, Stolz denied that Hadley told him not to hire Gallagher. Hadley said that's a lie.
Hadley said, before his retirement in October 2018, he expressed his concerns to then-County Manager Michael Scholes; Stolz, who at the time was a deputy county manager; Leeds, assistant county manager; Commissioner David Dennis; and former Commissioner Michael O'Donnell.
"In my opinion of being in EMS for 30 years and looking at other characteristics of leaders in a department, I believe Dr. John Gallagher ... has a narcissistic leadership style, meaning he is self-serving, he really doesn't have any empathy for others, he likes people around him that agree with him and anybody with a dissenting opinion is either ignored or they have hostility back towards them or some other type of repercussion," Hadley said.
"I believe what you've seen manifest since my departure over the two years that he's been there, you now see a culture that is toxic. You see people leaving at an unprecedented rate. They are losing medics by the day."
Dennis, in a June interview with The Eagle, blamed Hadley for the low morale in the department, even though he's been gone for nearly three years.
"Hadley poisoned the well as he was leaving," Dennis said. "After he left, he even came back and was still poisoning the well here because he didn't like Gallagher and that is carry over from what we are having today."
"He is (still) working with his good old boys down there trying to discredit Dr. Gallagher," Dennis said.
Dennis, who was chairman of the County Commission in 2018 and 2019, said the department had problems with sexual harassment under Hadley.
When asked about specifics, Dennis said, "I don't get into personnel issues."
Hadley said those are wild allegations.
"That is just, wow," he said. "I don't even know what he is talking about."
Stolz, the county manager, said he had received complaints from employees "about some sexual harassment issues going on."
"People were frightened to report it. There was a good old boy system," Stolz said.
Stolz said those complaints factored into the decision to promote Gallagher.
"No sooner did we do that, we had a couple of sexual harassment complaints that actually came up just a few weeks after we did the merger, and we actually took some job actions on people," Stolz said.
Dennis said he's unsure if it's a majority of employees with concerns about Gallagher or just a few.
At the same time, he has refused to listen to a recording of the meetings where dozens of EMS employees laid out their complaints against Gallagher. EMS workers had asked that Dennis, Meitzner, Gallagher and his executive team not be invited to the meeting so they could speak freely.
"If they don't want me involved, then I will stay back out of it," Dennis said. "I know they recorded it, but I didn't go back and listen to the recordings because at that point it appeared that they didn't want me to know anything."
Contract on consent agenda
The Sedgwick County Commission ultimately backed the decision to promote Gallagher at an Aug. 20, 2019, staff meeting.
At that meeting, commissioners Dennis and Cruse framed the EMS employees' complaints about Gallagher as resistance to change, ignoring the petition signed by 104 employees — a majority of the frontline ambulance workers.
"I know change is hard, but it's time to rip this bandage off and make a decision," Dennis said.
Cruse said she believed Gallagher could improve his relationship with employees.
"I did meet with a lot of boots-on-the-ground folks, and I heard some concerns," Cruse said. "And I want to say that those concerns were heard, but ... we do have to move forward. Change is tough."
Commissioners weren't the only ones who dismissed the petition.
In emails to EMS crew leaders, Stolz attempted to discredit the effort — nicknamed " Project Street" by organizers.
Stolz said some employees had told him that they felt coerced into signing the letter, "so that (letter) doesn't hold much water to me," he wrote to paramedic Caleb Yoder. "That is not how we treat employees."
One of the organizers, former paramedic April Calaway, strongly disputes anyone was coerced. She said signing was completely voluntary.
Stolz told The Eagle "a handful of people" complained in 2019 that they were being asked to attend meetings and sign the petition letter. He said he promised them anonymity and would not provide their names.
Although Gallagher took over the role of EMS director in August 2019, it didn't become official until Dec. 4 of that year, when the Sedgwick County Commission unanimously approved a 5-year contract worth more than $1 million, with two 2-year automatic renewals.
Gallagher's contract was buried in the consent agenda and passed without any debate or public comment. It came up for a vote on the same day Howell, the only commissioner to question the promotion, missed his first commission meeting in six years, which he had pre-arranged months earlier.
"I can assure you that had I been there, I would have pulled it off the consent agenda and you better believe I would have had questions," Howell said. "That's an extremely generous contract. I'm not sure we have ever had another county employee contract like that."
Stolz said Gallagher's future at Sedgwick County largely hinges on the audit findings of the outside law firm, which has been interviewing EMS employees since June.
"It's important to me that people feel respected," Stolz said. "And if they're not feeling respected, I need to understand why they're not. And we'll do whatever we have to do to help them feel respected in the workplace."
"A lot of what I hear, I want to validate," Stolz said. "But one of the things I have a hard time reconciling is this guy is not qualified. To me, on paper, he's highly qualified. Now, the question is, does that extrapolate into leadership and human interaction? Well, that's what we're looking into right now."
Gallagher said he welcomes the investigation.
"I think it's incredibly important that we make sure that they (EMS employees) feel heard, and that they feel valued, right," he said. "We've definitely made changes within this timeframe, and that's been hard. We've got some people that want to turn back the clock."
On June 12, Gallagher sent out a warning to Brownlee and two physicians on the Medical Society of Sedgwick County committee that reviewed the suicide case, saying that The Eagle would soon be publishing a story on EMS.
He assured them the current controversy would soon blow over.
"As before, this is an effort spearheaded by a single commissioner and a group of employees who are trying to dismantle our new physician-led model," Gallagher wrote. "Fortunately, the EMS department leadership has excellent support from the county, including the other four commissioners, the county manager's office, the county legal and HR departments ... and we are confident that this too shall pass."
(c)2021 The Wichita Eagle (Wichita, Kan.)