By David Hurst
The Tribune-Democrat
TIRE HILL, Pa. 鈥� Two area ambulance services are joining forces under one name.
The merger will put Windber-based Northern EMS鈥� staff and equipment under Conemaugh Township EMS, ambulance managers from both departments said.
But after the move goes through next month, the same territory will be served 24/7 by the same number of ambulances and teams of paramedics and medical technicians as there are today, said Northern EMS manager Jerry Hileman and Conemaugh Township EMS manager Terry Ruparcic.
The one difference is that the Northern EMS ambulance 鈥� an Advanced Life Support unit that Northern EMS board member Bob Statler called essentially a hospital on wheels 鈥� will be based one mile northwest of its current Somerset Avenue location, a few blocks outside the Windber Borough line.
Northern EMS and Conemaugh Township EMS have a combined territory that includes Conemaugh Township, Benson, Hooversville, Windber, Scalp Level, Ogle Township, Central City, Paint Borough and Paint Township, as well as parts of Jenner, Quemahoning, Shade and Adams townships.
Ambulance services have to pay staff around the clock to ensure a rapid response to calls, whether it鈥檚 a health emergency at home, a highway crash or a fire. That involves thousands of annual response calls.
Continuing that level of response requires 鈥渟trength in numbers鈥� 鈥� something the merger will allow, said Ruparcic.
鈥淲e want to control our own destiny,鈥� he said, adding that both organizations realize their challenges will get more difficult in the coming years.
Changing times
For Northern EMS and Conemaugh Township EMS, which have responded to calls in each other鈥檚 territories for decades, the move was driven by changing realities for ambulance services nationwide.
Annual call volumes and costs are going up, but numbers of staff and new recruits, needed to run ambulances 24/7, are dropping. Ambulance services are finding it harder to staff their stations around the clock.
While the price tags for medical supplies, training and ambulance vehicles have gone up for decades, reimbursement rates from insurance agencies including Medicare have barely budged, said Statler, who was part of the original organization that founded Northern EMS in the 1990s.
Conemaugh Township EMS鈥� 22-employee service is still on solid footing for its current two-ambulance 24/7 operation 鈥� but that鈥檚 after years of downsizing, Ruparcic said.
The situation is more precarious in the Windber area, Statler and Hileman said.
Northern EMS鈥� territory largely serves communities such as Windber, Scalp Level and Central City whose residents are often reliant on Medicaid or Medicare, making the financial hit even more acute, Statler said.
Ambulance services cannot bill for the treatment they provide, only the act of transporting patients. And the companies have to wait for the insurance agencies they bill to decide how much to reimburse and when, officials said.
鈥淭here are definitely times we鈥檝e got more money going out than we do coming in,鈥� Statler said of Northern EMS鈥� current state. 鈥淚f we tried to hold on, three, maybe four years from now, we鈥檇 probably be another Jeannette.鈥�
The city of Jeannette, Westmoreland County, saw its ambulance service close overnight one day last year. The organization declared bankruptcy.
鈥淲e don鈥檛 want to get to the point where, all of a sudden, ambulance service is forced to shut down in our area and people are forced to rely on mutual aid鈥� from another community鈥檚 service, Statler said, citing areas where ambulance calls might require a 45-minute wait.
Closer to home, communities such as Boswell and Patton have seen their organizations fold. Patton Borough was able to turn to Hastings Area Ambulance, which set up a local substation.
Some eastern Pennsylvania ambulance organizations have turned to boroughs and townships to dedicate tax money toward ambulance operations.
In Pennsylvania, ambulance services are separate organizations that aren鈥檛 directly affiliated with borough, township or city governments. So asking elected officials for financial support from municipal coffers is a tough sell, Statler and Ruparcic said. Many often cite their own financial struggles.
鈥楧ollars and cents鈥�
At a time when young jobseekers are often seeking hefty paydays straight out of school, finding new recruits is similarly tough, Hileman said.
鈥淲e used to have 20 applications sitting on our desks. Now, neither of our departments have any,鈥� Ruparcic said.
It comes down to dollars and cents, he said.
EMTs and paramedics provide the same type of care many nurses do for half the hourly wage on average, Conemaugh Township EMS assistant manager John Zellam said. It鈥檚 often the difference between more than $30 an hour and $15 an hour, he said.
Hileman said multiple crews used to be staffed for Windber-area ambulance calls.
This year, Northern EMS鈥� nine full-time employees have been typically able to staff one ambulance. But when an employee is sick or scheduled for time off, it has become a serious issue trying to find someone to fill the slot, he said.
There is an increasingly small number of dedicated EMTs and medics across the region who are often working for two or three different agencies at any given time.
And fewer recruits are joining the ranks.
Adjustments
The merger will keep two staffed Conemaugh Township ambulances and one in the Windber area 24/7.
Windber鈥檚 ambulance will be based at Scalp Level-Paint Volunteer Fire Company through an agreement between that department and the EMS service鈥檚 board.
Windber Fire Department will continue to operate with its apparatus at the Somerset Avenue location, said Statler.
Three Northern EMS board members, meanwhile, will join Conemaugh Township EMS鈥� governing board, increasing the group to 11 voting members.
鈥淲hat it means for the public is that they鈥檒l have the same quality care they have now,鈥� Ruparcic said. 鈥淭he public shouldn鈥檛 notice a change.鈥�
Central City Borough Council members discussed the change Tuesday after signing an agreement modifying their primary ambulance coverage to Conemaugh Township EMS.
鈥淲e鈥檒l see how it works out,鈥� Council President Bob Sanzo said.
Ruparcic foresees more local ambulance services becoming 鈥渞egional鈥� ones in the years ahead. But he and Hileman said that鈥檚 only part of the solution.
If reimbursements don鈥檛 improve, something insurance companies pay teams of lobbyists to control, local communities will one day have to find 鈥渓ocal solutions鈥� to the issue, he said. That could mean forming independent ambulance authorities that could provide service to 鈥渕ember communities鈥� for a set fee.
鈥淓ventually,鈥� Statler said, 鈥渟omething is going to have to change.鈥�
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