County continues to discuss ambulance transfers

The Marion County Board of Commissioners continued their discussion from last week’s meeting regarding when Commissioner Kent Becker asked to revisit the conversation after speaking more with St. Luke CEO Jeremy Ensey as well as receiving a phone call from a local physician.

“His concern was that the attending physician and the receiving hospital emergency room should always have the priority, meaning if there is an ambulance in Marion County, it needs to transfer. My own personal belief is I don’t want there to be a patient in need of immediate care at the next location that has to wait four or five hours if we have an ambulance that is available and a paramedic that would be on call. I just thought we needed a little further discussion. It’s no put down on our EMS or any of that. I think we all need to be on the same page,” said Becker.

Chair Dave Mueller said that he had EMS Director Travis Parmley explain things to him and it was really helpful so he would like to have him explain it more to the board. Parmley moved to the mic while thanking Mueller for the chance to explain things. Becker agreed that Parmley should speak, but also explained that he had several people express frustration including upset family members and a doctor. All agreed the topic was emotional.

“I think what we need is a little clarity,” said Mueller.

“I’m not a doctor, right? But the reality is what I deem a critical transfer I will send every ambulance I have, and I will sleep good at night. What I don’t want to do is send out a possible UTI and not have an ambulance. It’s never been my intention to not send a critically ill patient, within our policy, where they need to go,” said Parmley. “If they are going for an immediate intervention, I have no problems with that. But if it’s something that can wait, then I will send one at a time.”

“I just think it’s something we all need to be on the same page,” said Becker.

“Yes, that’s in the policy that if it’s necessary I will send all five units out. If you are questioning my ability to determine if it’s necessary, we can work on that,” said Parmley.

“I would guess working with the hospitals, they know when they call you for a transfer if someone can wait or when someone needs to go right away,” said Becker. “When an attending physician says they gotta go and a receiving hospital says you gotta get them there, you need to do that.”

“Sure,” said Parmley. “I’ve got 51 examples of transfers to a certain facility. Out of that 5 have been actual emergencies. Otherwise we got there in a timely manner. We are human. I can make a mistake like anyone else. I try to use my experience and education to make a decision. I take critical patients. I’ve taken 104 this year. I understand it’s an emotional issue especially for family members.”

Becker continued to press Parmley and state the need to follow what attending physicians and receiving hospitals are saying since they are the experts.

Parmley brought up expenses and costs to his department for transports.

“Commissioner Dallke brought up the unpaid bills for transports. The reality is for insurance to pay for an ambulance, the terminology has to cover that your life has to be threatened and can only be covered by being taken in an ambulance.

“After listening to everybody and listening to the professionals, I just don’t want a patient laying up here in Hillsboro or wherever that needed to be in Wichita or wherever they were supposed to go two hours ago…”said Becker.

“Sure, I want to help people. That’s what I do,” said Parmley. “I only have a certain amount of facilities and resources and when those resources are tapped out, they’re tapped out. People have to wait. That’s the reality.

Commissioner Randy Dallke brought up the need to support Parmley when hearing people complain. Becker replied that it is imported to support Parmley but also to be on the same page and make sure that physicians are being heard and patients are being transported when they need to be. No decisions were made.

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