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Complaints about Groton Ambulance prompt town councilor to investigate

Groton — The chairman of the Groton Town Council's Public Safety Committee said he is investigating complaints that Groton Ambulance Association, Inc. provided no service on seven Sundays in April and May and did not respond to five calls the last week of June.

Councilor Rich Moravsik has requested data for the 45 days that began July 9 and end Aug. 23, including weekly schedules for personnel, the association's standard operation procedures, its employee guidelines, the latest audit report filed with the state, its annual and monthly reports, its charter and a list of its board members.

Moravsik said he would also review incident reports during the period.

He initiated the review after hearing complaints about a decline in service and comments made at the Groton Fire Officers' monthly meeting, he said.

In one instance, a man was injured at a loading dock and the Poquonnock Bridge Fire Department responded to treat him while waiting for an ambulance. But the ambulance never arrived, and the injured man finally drove himself to a local emergency room, according to the draft meeting minutes of the July 15 public safety committee.

Moravsik said he also learned that on seven Sundays, the ambulance did not have adequate staffing — two people on duty at the same time — to allow a crew to go out on calls.

"We have to make sure that the people that sit down in their house feel comfortable that an ambulance will come. That's the bottom line," Moravsik said. "When you get comments like that, you've got to ask, 'What's going on?'"

George Timothy Law, president of Groton Ambulance Association, said the agency had a temporary staffing shortage that has since been addressed. He said he had provided almost all of the documents the town councilor asked for on Tuesday. In the case of the man at the loading dock, Law said the request for an ambulance was canceled.

"I would never dispute that we had a staffing problem," Law said. "The issue is we're an at-will employer, and a large percentage of our staff is per diem, which means as needed, and the staff just has not been available to cover those shifts. Because they're per diem employees, they're not locked into any schedule."

The association has four full-time employees and 26 per diem staff on its roster, Law said. He said the association has since hired two part-time employees assigned to Sundays and two additional per-diem staff, one of whom is in training.

Law said this solved the Sunday problem. He said he could not afford to hire more full-time staff because of the cost of benefits. The association has no contracted service agreement with the town of Groton, although it is required by state law, he said. The two sides have struggled for years over the issue and have not been able to agree, he said.

"The town never wanted to sign a contract that locked them into a monetary compensation for the ambulance service," he said. "But we can't do it with no guarantee of funding."

Groton Ambulance is a private, nonprofit organization, assigned to provide ambulance services to about two-thirds of Groton, including the city of Groton and much of Groton town.

Mystic River Ambulance covers the portion of Groton that includes roughly Noank, Groton Long Point and Mystic, according to Joseph Sastre, director of the Groton Office of Emergency Management. Lawrence + Memorial Hospital provides paramedic services to the region.

The state Department of Health assigns the geographical area that ambulance organizations cover.

The town provides a subsidy of $105,951 to Groton Ambulance and leases the building at 217 Newtown Road to the association for $1, according to the town budget.

The ambulance also bills insurance, Medicare, Medicaid and patients directly for transport services to support itself. Last year, Groton Ambulance received 4,940 calls for service, the town budget showed.

When a person calls 911 with a medical problem, the Groton emergency communications center forwards the call to the ambulance assigned to that area and other responders depending on the nature of the call. If it's a serious emergency, firefighters and possibly paramedics would be dispatched.

If Groton Ambulance cannot respond because its ambulances are taking other patients to the hospital, or it is understaffed, the dispatcher forwards to the next closest ambulance, or Mystic River Ambulance. If that service is also busy, the dispatcher continues forwarding the call to the next closest company, until one responds.

One of the complaints involved a woman in her 70s in the Poquonnock Bridge area who had fallen and needed help.

Groton Ambulance was dispatched but had two crews taking other patients to the hospital, so the call rolled over to Mystic River, Sastre said. But Mystic River was also busy, and ultimately the call went to North Stonington.

The ambulance responded about 40 minutes after the original call, as it drove with regular traffic and no siren, as is done with basic calls, Sastre said.

“We don't run into this a lot. It was almost like the perfect storm,” Sastre said. “Does this happen every night of the week? No. Because every night of the week, Groton Ambulance doesn't have all its ambulances out, nor does Mystic River.”

Law said the Poquonnock Bridge Fire District didn't respond to the call because it was answering only serious emergency calls at that time due to staffing issues. The dispatcher's information didn't indicate the fire department was needed, Law said.  

Sastre said Groton Ambulance responds to serious emergencies within an average of 6 minutes.

“That's not bad,” he said. 

Sastre met with Moravsik and Town Manager Mark Oefinger on July 2 to discuss the concerns, then again as a group and with Law on July 9.

Municipalities set the performance standards for emergency medical groups assigned to their areas by the state Department of Public Health, said Christopher Stan, a health program associate with the state department.

If rules or standards are violated, the commissioner of public health has various remedies ranging from retraining to revoking a certificate or license, Stan said.

A municipality may also petition the state to take over a service area for performance issues.

"The state's (primary service area) process is designed to assure that all Connecticut residents and visitors benefit from timely, coordinated and consistent EMS coverage," said a statement by Raphael M. Barishansky, director of the Department of Public Health's Office of Emergency Medical Services. "The Office of Emergency Medical Services assigns primary service areas, reviews said assignments on a recurring basis and ensures that standards established by local EMS plans are maintained."

Sastre said ambulance associations, like hospitals and other medical agencies, are struggling with lower insurance reimbursements and other payments due to changes brought by the Affordable Care Act. Ambulances also are not paid if they assist a patient but do not transport, Sastre said.

It comes down to money, he said. During budget time, people are so focused on the bottom line that they don't ask basic questions like how an organization is doing, he said.

Ron Yuhas, of the Poquonnock Bridge Fire District board, said it's tough to cover every shift when you only have a handful of paid staff. But at the same time, he said the fire district can't have firefighters and fire trucks tied up waiting for ambulances for 15 minutes.

Poquonnock Bridge Fire Department Chief Joseph Winski said the department is working with the ambulance association.

“We're all on the same page,” he said. “I have to give them credit. They're making attempts to improve. Just like us, we've had our issues and we've made improvements.”

Moravsik said Groton Ambulance provides excellent service when it is available; the issue is how available it is.

People driving down Newtown Road “see four ambulances in front of (the senior housing) Grasso Gardens and they think, 'We've got a good system down there.' But maybe it needs to be looked at,” Moravsik said. “If I'm wrong, that's good. Maybe we can improve it. But if I'm right, maybe we need to shake it up.”

d.straszheim@theday.com

Twitter: @DStraszheim

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