December 04, 2013 - If there's an emergency medical call just over the Genesee County line, don't look for Brandon Fire Department to respond.
A request earlier this fall by Atlas Township Fire Chief Fred Forys for Emergency Medical Service (EMS) mutual aid using Brandon Fire Department has been denied by the Professional Standards Review Organization (PSRO), the factfinding board for the Genesee County Medical Control Authority (CCMCA).
The GCMCA is the oversight for the EMS system in Genesee County and is administered by Genesys Regional Medical Center, Hurley Medical Center, McLaren Regional Medical Center and the Genesee County Board of Commissioners. Due to low call volume, Goodrich and Atlas Township are not covered by an EMS, rather depend on nearby ambulance services from Grand Blanc, Davison and Groveland Township in case of emergency. As a result, response times have been a concern for township officials.
However, to fill the void in Atlas Township EMS, neighboring Brandon Fire Department, with four ambulance units including two at station one in downtown Ortonville, about two miles south of of the county line, offered to provide assistance.
In a letter to Forys from Bruce Trevithick, GCMCA executive director, several factors were considered in the decision.
"Currently Brandon Fire is not licensed in Genesee County and therefore there is no quality oversight of incidents they would respond to in this county," he wrote. "Further, mutual aid is a system that is used between like services, and in this case does not apply when your fire or mobile fire rescue agency requests Brandon Fire as a transporting Basic Life Support or Advanced Life Support services."
Trevithick added it's very complex.
"I understand that Brandon does not want to be licensed in Genesee County and bear the costs associated. We are bound by state law and are required to oversee EMS in Genesee County," he said. "Currently, Brandon has no requirement to us to oversee their work. As a citizen I understand the desire Brandon Fire Department has to send an EMS as a good neighbor, but there's more behind the scene issues."
Trevithick said the Commission on Accreditation of Ambulance Services (CAAS) requirement in Genesee County, not required in Oakland County, is due to the large volume of private EMS agencies located in the area.
"CAAS meets the basic standards and we feel more comfortable with that," he said. "Conversely, Oakland County has more municipalites that have built in standards. They have a different mechanism for oversight."
"Atlas Township residents should also see an improvement with the new Automatic Vehicle Location Systems (AVL) to determine the closest EMS unit to the request for emergency medical care that went into effect in October in Genesee County. The average response time went from over 12 minutes to less than 10 minutes. That time will only improve even more. We also have competition for EMS calls—companies want that business."
Brandon Fire Chief David Kwapis suggests the GCMCA reconsider their decision.
"Genesee County (EMS) has the same drug box as Oakland County," said Kwapis, referring to the in-vehicle drug kit or paramedic box carried by EMS. "The state procedures in both counties are the same. It would cost the Brandon Fire Department $30,000 to $40,000 to meet all the criteria and have AVLs and CAAS. We could be in Atlas Township fast—we're only about a mile or so from the county line from Ortonville. If we would run a call to (Genesee County) it would be only if another EMS was not available. It's not about the money, it's about people in need especially on busy M-15."
Some of the additional costs required by Genesee County to Brandon Fire Department includes AVL to determine the closest unit to the request for emergency medical care and CAAS, not required by Oakland County EMS.
"Right now we have no problem going to Lapeer County, we have mutual aid with them no problem—if they don't have any others (EMS) to respond they call us. We need to set boundaries where we could go in Genesee County—covering the entire area is not our objective here, rather providing support for each other's community when necessary. Other fire departments—Groveland, Atlas, Lapeer—come over and support us if the need is there through mutual aid. Prior to 2009 we could make those runs to Genesee County."
"Do the right thing and assist any resident out regardless of where they live," said Kwapis. "We need the ability to go (into Atlas Township) when the EMS units are not available to cover."
Kwapis emphasizes that trips into Genesee County were only about seven or eight times per year back in 2009 before the restriction was put in place.
"The need for EMS is rising," added Kwapis. "Consider in 1987 Brandon EMS responded to 314 calls. Last year we went out on 1,140 calls. Residents are living longer and there's a lot of traffic on M-15. The need is there. The GCMCA needs to do the right thing."
Atlas Township officials have considered a private EMS stationed in the community.
In December 2012 representatives from Regional Emergency Medical Services (REMS) attended the Atlas Township meeting to discuss locating a facility in the community. REMS is a joint-venture partnership between Flint-based hospital McLaren Health System, and Southfield-based Community EMS, Inc. (CEMS), a non-profit ambulance service. After first opening in January 1996, REMS serves Lansing, Fenton, Flint, Flushing, and Genesee and Mundy townships. The company employs about 300 with 75 vehicles. However, even after township officials offered to provide use of the south bay in the township garage to house the ambulance and develop some kind of base or post in the township, the plan was dumped due to a lack of projected 9-1-1 calls to be profitable.
Atlas Township Supervisor Shirley Kautman-Jones said it's a matter of common sense.
"Our township is not going to be a parasite off other communities," she said. "Nor are we trying to circumvent any regulations or authorities. Rather, we are just looking for mutual aid only in the case of extreme emergency. The problem is the amount of time it takes to respond to the southeast section of the county."
Jones said it's a matter of arriving at the scene of an emergency more efficiently.
Furthermore, Jones referenced the Sept. 30, 2011 Goodrich homecoming game against Lake Fenton. With the Martians up 14-0 and 6:09 left in the second quarter, Lake Fenton defensive back Matt Hommer had head-to-head contact with a Goodrich player. Following the collision, Hommer, a junior, laid on the field in rainy, cool conditions for more than 30 minutes while coaches and trainers attended to his injuries. Genesee County Sheriff paramedics were called and arrived just prior to the arrival of a Swartz Ambulance. Hommer was stabilized and taken off the field on a stretcher. He was transported to Genesys Regional Medical Center for treatment and later released.
The incident sparked a debate over just how long it took for an ambulance to respond from Grand Blanc. One account was about 12 minutes others ranged to almost 30 minutes before EMS arrived to assist the player. Hommer was not seriously injured in the collision.
"I get it," added Jones. "It seems longer than we realize when it's an emergency. That young man laid on the field for a long time, more than the 12 minute response time reported. In the case of Brandon assisting when necessary we need to look at the geographics and logistics—if our neighbors need help we need to be there."
Groveland Township currently has six EMS trucks in operation, with an additional truck in Holly. Calls to Atlas Township come from the Grange Hall Road Fire Station One—located about a mile from M-15.
"On occasion we go into Atlas Township," said Groveland Township Fire Chief Steve McGee. "It's difficult with borders—I understand it's not fair for one community to subsidize another with regard to EMS. However, there's a moral line there. If the nearest EMS is a half-hour away and another is only a few minutes (away) I would not have a problem with that. Still we put our residents first, but if we can make it work we do—it needs to be a win-win situation. We just can't do it at the expense of our own residents."
"Operation of an EMS is expensive," he added. "By incorporating Genesee County we can have more business and that helps everyone."