Clinton’s ambulance service, AMR, faces severe challenges

By Guest Columnist Steve Peacock

When Clintonians call 911, they expect expert ambulance service to arrive quickly. Ambulance services nationwide are doing their best to meet those expectations, but they are struggling. American Medical Response (AMR) – Clinton’s ambulance service – is no exception. Ambulance services are battling a little-known crisis we want to inform you about.

We are grateful Clinton’s fire-rescue department provides excellent paramedics and EMTs for emergency medical first response. The City’s paramedics and EMTs initiate patient care on-scene, team with AMR’s transport crews and return to their CFO station, ready for the next call in town. AMR’s crew continues patient care on the way to the hospital. CFD’s EMS caregivers are invaluable in helping AMR cope with numerous challenges.

Rest assured, even in the face of the daunting obstacles below, the paramedics and EMTs staffing AMR’s ambulances remain deeply committed to providing quick, safe, medically sound and compassionate care. We’re still on the job, around the clock, and you can count on us to serve Clinton at the highest level circumstances allow. We’re not overwhelmed, and we’re not on life support; but, without certain forms of support, the strains impeding AMR will intensify.

The COVID-19 pandemic is but one challenge ambulance services are grappling with. Other challenges pre-date the pandemic, and the pandemic has made them worse. We’re working hard to overcome (1) a huge shortage in paramedics and EMTs, (2) hospital overcrowding (which delays ambulance crews from transferring care to the facility’s staff) and (3) inadequate funding. The pandemic has made it clear: healthcare resources are finite; those resources can be exhausted. Prior to COVID-19, hospitals, nursing homes and other parts of the U.S. healthcare system were already at or near a breaking point. Ambulance services are one of those “other parts” of healthcare.

Workforce shortage: A shortage of trained personnel has plagued ambulance services for many years. Now, the shortage is historically high. For a variety of reasons, too few people enter our field. Many career opportunities with ambulance services, including AMR serving Clinton, go unfilled. We’ve adopted numerous steps to reduce the shortage, but the pandemic has impaired our recruiting. We even run EMT courses in-house and pay the students to take the course. A fulltime entry-level job awaits our students who become EMTs. Anyone interested in a fulfilling career helping people with urgent medical needs should contact us at 601 -368-2301.

Time lost in overcrowded ERs: Multiple times every day, for an hour and sometimes much more, our ambulance crews must wait in local ERs or in their ambulances with their patient on their stretcher – because the hospital has no bed available. During the wait, the ambulance crew keeps the patient stable. Every minute a crew is held up in the ER is a minute the crew isn’t available for the next 911 medical call. The hospitals team with us to reduce the wait, but ER overcrowding is a difficult issue.

Rising costs, inadequate reimbursement: For many years, hospitals and other providers of healthcare have seen their operating costs escalate. The pandemic has accelerated some of those expenses. For example, ambulance services now spend much more on personal protective gear and decontamination.

Ambulance services are often reimbursed at amounts significantly below their costs. Insurance companies, Medicare and Medicaid set the rates they will pay for ambulance service. Reimbursement is not keeping up with cost increases.

Unlike most healthcare providers, ambulance services treat everyone – whether they have insurance or not. Every day, we treat and transport patients who are unable to pay. We’re paid nothing extra for standing in an ER or sitting in a hospital parking lot for hours, waiting to transfer our patient to facility staff. During the wait, our costs continue, but there is no compensation. In addition, we’ve seen a substantial rise in this scenario: We respond to a 911 patient, treat the patient and recommend transport to a hospital – but the patient decides to forgo the trip. During the pandemic, patient refusals have been all the more frequent, since patients are afraid to go to a hospital. Presently, Medicare, Medicaid and private insurance pay ambulance services only if the patient is transported.

Direct federal support lags behind other healthcare providers: The federal government has sent badly needed funds directly to other parts of the healthcare industry, helping those caregivers remain in operation during the pandemic. By contrast, ambulance services have not received similar levels of direct federal support. Mississippi lawmakers did share some of the first round of COVID-19 relief dollars with our state’s ambulance services. We’re grateful for that funding, but it helped cover a small portion of the financial strains resulting from the pandemic. Without more direct support from elected officials, the gap between ambulance services’ costs and revenue will only widen.

Ways you can help: (a) Contact your state and federal legislators and ask them to do more to help ambulance services with the issues above; (b) Don’t call 911 for minor illness or injury. Use 911 when the victim is having trouble breathing, has chest pain or other signs of heart attack, is losing blood extensively, has a rapid change in consciousness or exhibits signs of stroke such as sudden difficulty speaking or inability to move one side of the body. But, if you’re not sure whether you should call 911 for an ambulance, call 911 immediately; and (c) Encourage people you know who are job hunting or looking for a career change to contact us at AMR to learn about coming in the medical transport field. Call 601-368- 2301.
Please bear in mind the difficulties facing the team at AMR, your community’s ambulance service. Our paramedics and EMTs put their own lives in danger every day, out of love for their fellow human beings.

We are doing everything we can to deliver consistently superior 911 ambulance service, but we are sounding the alarm. We hope state and federal officials will respond accordingly.

EDITOR’S NOTE: Steve Peacock is operations manager for AMR Central Mississippi, the ambulance service for all of Hinds County, including Clinton.