LaBELLE — Discussion of Hendry Regional Medical Center’s patient-transport issues got so long and involved at county commissioners’ meeting Dec. 11 that the board chairman couldn’t remember at the end if a motion had been made on the issue.
But the staff recommendation that they negotiate a memorandum of understanding (MOU) with the hospital eventually was approved. County Administrator Jennifer Davis explained, in introducing her report, that two subjects were covered — the HRMC landing zone for transportation of patients via helicopter, and its request for assistance with ground transport of those needing Advanced Life Support rather than just Basic Life Support (BLS) ambulance rides.
She reported that on the first topic, because of a significant increase in copter transports, she’d talked by phone with hospital executives because it was causing “multiple service issues within the county.” “They are in line to handle the landing zones internally within their existing staff as of the first of the year,” Ms. Davis said. “They’re doing training the remaining portion of December, and then the fire departments etc. will not have to respond for the landing zone.”
“Good work,” Commissioner Michael Swindle complimented her. “That’ll take care of it,” said Commissioner Darrell Harris, and Ms. Davis confirmed that it would as of Jan. 1, 2019.
But the second issue prompted some commissioners to raise potential life-safety concerns on behalf of their constituents. It is described in the report as being based on HRMC’s need “to acquire additional transport services” and said that was why landing-zone transports had increased so much, with an additional need for the Hendry County Emergency Medical Service to assist.
What caused the problems is that Positive Mobility about six months ago had backed out of its contract to do HRMC’s inter-facility transports, for when patients were transferred to other facilities for treatment. The report said that “our local fire department has experienced a large number of calls to block off the road at the hospital in order for the helicopters to land,” straining the City of Clewiston’s fire budget as well as the firemen. The county pays for 67 percent of that budget and 100 percent of first responder calls.
The hospital, it said, has “had a difficult time finding sufficient coverage for all of their requests,” and is using several ground transport companies but that Hendry EMS has helped when it can. A shortage in paramedics, though, hinders county EMS response since its first priority is to respond to 911 calls; thus, the board voted in an earlier, separate discussion to add EMTs and make another BLS ambulance available under a stopgap arrangement.
Ms. Davis’s report requested an MOU be established outlining “the various policy guidelines that we feel are necessary to make sure that we are covering the constituents of Hendry County properly from a 9-1-1 perspective.” It also provided a graph of summary data, showing their ground transports had fallen while emergency patients admitted had risen, and said “if the transport is not collectable by traditional methods, the hospital has agreed to pay the Medicare rate.”
Commissioner Karson Turner asked EMS chief Adrian Damms to speak on the issues, questioning whether there had been times when a 911 caller could not get timely service because the ambulances were in use. “We haven’t had that yet, but it’s come very close multiple times. We’ve been lucky,” he replied.
In response to a Turner question about whether mutual aid is available from neighboring counties, Mr. Damms said he has used Glades County EMS but that the Seminole Tribe didn’t have enough units and that he’d never approached Palm Beach County Fire Rescue to inquire about that. Mr. Turner noted South Bay is not far away with its “beautiful new fire rescue station” and suggested “locking ourselves in a room” to discuss it with all those parties. “Who do I have to talk to, what state legislator? Do you want me to talk to (Gov.-elect) Ron DeSantis? We’ll holler at somebody to say, ‘Hey, we need to break down an imaginary line and service a life safety issue’...”
Commissioner Swindle said he thought this was more HRMC’s issue than the county’s, similar to the Good Wheels issue they also dealt with at that meeting, “but now we’ve talked for 15-20 minutes about how are we going to solve their issue. I want to see some sweat equity on the hospital’s part,” he added, noting that county taxpayers are again footing the bill for staff time on a problem faced by another quasi-public entity (HRMC is financed through countywide taxation). “Are they trying to get ambulance services, or why don’t they buy their own? That seems like the simple answer.”
Mr. Turner said, “I’m looking forward to us having a giant sit-down and trying to look at if there are any efficiencies that can be created.”
Chairman Mitchell Wills noted, “Again it comes back to exactly what we said earlier, where’s the facts? Show us the backup.”
HRMC’s chief financial officer, John Beltz, was in the audience and stepped up to answer questions. Commissioners requested that he and HRMC staff put together a report for the county board for further discussion later.
Chairman Wills told him that the sometimes heated discussion “is not an attack against you or the hospital; we’re all accountable to someone. We just need the information in order to make the best decision we can.”