Kingfisher fire chief responds to recent EMS concerns
[ Ed. Note: In recent weeks, Kingfisher Fire Department and EMS has come under fire for not taking calls to transfer patients from Mercy Hospital Kingfisher to other hospital facilities in nonemergency situations. Kingfisher Fire Chief Tony Stewart submitted the following response explaining the city’s reasoning.]
In October 1969, the citizens of this community voted to take over the ambulance service from the local funeral home.
With this endeavor, the community voted in a non-earmarked, one-cent sales tax to support an emergency ambulance service. This service would be in addition to our firefighting duties.
As well as covering approximately 507 square miles for the EMS, our assumed fire district outside the city is approximately 157 square miles. All of this is in addition to the fire protection of each structure within our city limits, which includes all residences, businesses, churches, schools, day cares, and many out buildings.
We provide mutual aid to the county volunteer departments and they us. We have a wonderful relationship with our volunteer departments and they assist our EMS crew when we are called to their communities.
Fire prevention along with life safety inspections are among the many requests we provide.
Over time with many more rules, regulations, protocols and statutes, from OSDH, NFPA, ODOT, State of Oklahoma and others, we have been torn by what we are mandated to do against the non mandated.
Obviously if we don’t follow the mandates, penalties such as fines, loss of license or incarceration could occur and nobody wants that.
So another question to answer is, if we took all of the calls before why aren’t we taking them now? The answer to that is our call volume has grown tremendously over the years to the point that EMS calls are almost all we get done.
We are much more than an ambulance service.
This is our call volume for the last 10 years;
2009 – 716 calls, this is over double from 10 years previous.
2010 – 769, an increase of 53.
2011 – 827, increase of 58.
2012 – 863, increase of 36.
2013 – 922, increase of 59.
2014 – 1,099, increase of 177.
2015 – 1,109, increase of 10.
2016 – 1,161, increase of 52.
2017 – 1,303, increase of 142.
2018 – 1,487, increase of 184, over doubled again in 10 years.
Can you see the concern on our part of wanting to keep the ambulances in our area for the people that will need it? It’s not a matter of if; it’s a matter of when.
All of these numbers represent a life and when you ask us to ignore the law and send an emergency ambulance on a non-emergency interfacility transfer anyway, you are asking us to put someone’s loved one’s life in danger. Do we really want to do that?
This is what the law states:
“There is a required duty to act within the licensed service area upon acceptance of an ambulance service license. All licensed ambulance services shall respond appropriately; consistent with the level of licensure when called for emergency service, regardless of the patient’s ability to pay. Non-emergency interfacility transfers are exempt from the statutory duty to act.”
This brings us to the issue at hand. It is true that the city has an agreement with the 522 District and it does talk about emergency and routine transfers.
There are two distinctions that need to be drawn. First, concerning the 522, we currently perform the emergency and nonemergency and routine transfers within the district.
A transfer as defined in our profession is moving a patient from one place to another by ambulance. Second, a 522 contract does not overturn or supersede any state laws as previously described above.
One of the primary reasons for this is to not take an emergency ambulance out of service in case they are needed for an emergency in their respective area.
Please understand that we realize life is precious and even more so when it’s your family. We have family here, also. We see this and live this almost every time we respond to a call.
This is why the city believes that by taking an emergency ambulance out of service to provide a routine/nonemergency transfer is asking us to overlook the law and take a chance that your loved ones won’t have a life-saving emergency ambulance if it is needed.
Let’s use the most recent example, when Mr. Townsend was at the latest council meeting he was asked by the mayor if his mother-in-law was OK because the mayor had heard that she had a heart attack.
Mr. Townsend spoke of this openly and publicly at a meeting so I am not divulging anything he didn’t say. She did have a heart attack and the FD took her to Oklahoma City.
Obviously he didn’t share the whole story so feel free to ask him or his family how the call originated (911 emergent or non-emergent call) and how well it turned out because we weren’t out on a routine or nonemergency interfacility transfer. The paramedic immediately could see it was far worse than what it was called in as.
There are those who are quick to say let’s take all of the routine and nonemergency transfers from one hospital to another. That is the sole responsibility of the transferring hospital and not the local ambulance service.
If we had been on one of those calls it could have cost the life of Mr. Townsend’s mother-in-law.
For many years the Fire Department has had a very wonderful working relationship with Kingfisher Regional. After the hospital relocated and Mercy took over, a change occurred.
It was as if “we demand you so serve our ER regardless of the consequences outside of our back door.”
They have used examples like “if you don’t go by ambulance then the test we have just run on you won’t be covered by your insurance,” or “I’m sorry to tell you this but Kingfisher Ambulance service doesn’t do any transfers on the weekends.” These are actual statements told to me by patients of the Kingfisher ER.
When the Kingfisher ER wants to send a non-emergency patient to another hospital some of the reasons they give are “the patient is sick and needs to go to a hospital” or the one that is given almost every time is “if they don’t go by ambulance they will die.”
We take many patients to the ER that are not dying so an excuse like this is totally used to turn a nonemergency call into an emergency call or to keep them from going to OKC by their personal vehicle.
If they don’t go by ambulance then the hospital will take responsibility for the discharge but if another hospital discharges them Kingfisher has no liability. I think it’s all about liability.
It has gotten to the point now that when the ER calls for a transfer, they will ask us to tell them if the patient is an emergency or nonemergency patient. How would we know? That’s not our job that is the job of the ER staff. Things need to change; that I do agree with Mr. Townsend.
The city is very close to working out an agreement with Miller EMS to cover the nonemergency transfers from the Kingfisher hospital.
For over two years of Mercy suggesting that they are taking care of this issue, the city has decided to find a solution because we value the needs of our citizens as well as those in the surrounding areas that we serve.
This is not our responsibility but it appears that the hospital is fine with pressuring us into these transfers and in some cases misleading the patients and or family into a smear campaign.
In closing let me share with you that when it comes to my men doing their job they are as professional, kind, tender, knowledgeable, sacrificing, humble and devoted as they come.
And if you feel like you need to attack their character or make accusation toward them, then you haven’t had the chance to get to know them. They love what they do and how they get to help people, especially in their time of need. It is tough showing up on scene and seeing people at one of the worst times of their lives but my men signed up for this.
They love this community and the people within it.