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What MGH didn't plan for was the fact that I had anticipated this move by them.
Probably before they even thought of it, and I was ready. Without going into great
detail, let's just suffice it to say, this stunt backfired on MGH. MediRide's call volume
actually increased by approximately 15 percent!
Then, I got a call from Al Hendra. I was asked to meet, "out of town" with him and
Venetia Bryers. They wanted to meet for lunch in Escanaba. Now, I know that
Escanaba was Venetia's home-turf, so I declined, but offered to allow them to buy me
lunch in Munising. They agreed, and the three of us met for lunch at Sydney's
Restaurant. This was in late May or early June of 2006, a mere 4-5 months after they
insisted on "complying with the Marquette County Medical Control Plan," and
"adhering to the spirit of the Emergency Telephone Service Enabling Act (9-1-1 Act).
Remember Mr. Hendra's letter to Joe VanOosterhout? I told you it would be important.
At this "out-of-town" lunch meeting, Mr. Hendra and Ms. Bryers told me that they'd like it
if I "would agree to return to the alternating" method of dispatching. You know, the one
they backed out of just 6 months earlier. I told them both, in no uncertain terms that I
was not interested in returning to the agreement. I recall saying, "look, if you're asking
me to do it, I know it won't benefit me any. You're in this for you." You see, i didn't just
fall off the turnip truck. MediRide's volume was up, and their call volume was down. It
didn't take a rocket scientist to figure out why they wanted to go back. What happened
to "adhering to the spirit of the ETSC Act, Al?
We ended the lunch (had I known Venetia was paying, I would've ordered more...), and
went our separate ways. I figured that was the end of it. Now, it was my turn to be
wrong.
On June 15th of 2006, less than one month after my Munising luncheon with MGH
administration, I happened to accompany Mike Farmer, from the Powell Township Fire
Department to the meeting of the Marquette County Central Dispatch Policy Board.
Before the meeting got underway, I glanced at a copy of the agenda that was laying out
on the table. I was surprised to notice that there was an item listed on the agenda that
referenced MGH / MediRide Dispatching. What? The Marquette County Central
Dispatch Policy Board was planning on discussing the dispatch arrangement that
would directly effect my business, and I knew nothing about it? I got no letter, no
phone call, no emails...nothing. Apparently the input from the two MGH employees on
the Board, Dan Wolf and Alyson Sundberg, was all Mr. VanOosterhout thought the rest
of the Board needed to know.
I waited anxiously for this item to come up for discussion. Turns out, Marquette
County Central Dispatch got it in their minds to change the dispatching of MGH and
MediRide EMS ambulances back to the alternating arrangement and leave forget the
dispatching laws. I wasn't permitted to speak on the agenda item, until public
comment. Too bad public comment was at the end of the meeting, after the decision
had been made. It was unanimous...Dan Wolf abstained from voting. How noble.
Is it just me, or does anyone else find it strange that less than one month after my
secret, out-of-town lunch with MGH administration, a lunch in which they virtually
begged me to agree to return to the alternating dispatch method, this item was
coming up at the Central Dispatch Policy Board meeting, and I wasn't told a thing
about it. If I didn't just coincidentally attend this meeting, to discuss another topic, I
wouldn't have even known this was going on. Strange, very strange.
So, the alternating dispatch method was back in play...with a new addition. Now
patients could "request" a specific ambulance when dialing 9-1-1. Here's the EMS
Dispatch Policy that was voted in at the June 15, 2006 meeting.
This "Request" caveat was new to the policy, but Marquette General had tried to force
its employees to "request" an MGH ambulance when the original MOU was in place.
They sent out scary memos to their employees, telling them that if they had an
emergency and MediRide EMS treated them, their insurance wouldn't pay. Well, let's
roll back in time here, for just a bit. It seems as though there was some confusion on
the part of Marquette General as to whether or not their employee insurance would, or
wouldn't pay for services provided by MediRide, Inc. EMS.
On June 28, 2005, MGH Assistant Administrator Al Hendra put out a memo to all
employees, and oddly enough, mailed to us here at MediRide, Inc. This memo
basically stated that MediRide EMS is a competing ambulance service, and that
employees would have to pay a co-insurance amount of 15% if they "use the MediRide
service." What he neglected to mention in this memo, is that MediRide, Inc. EMS has
always waived the MGH employee co-insurance, meaning in essence, MGH staff
would NOT be required to pay MediRide the 15% co-insurance. Take note, however, it
wasn't until August 9th of 2005 that they stated in a letter to employees from MGH CEO
Bill Nemacheck that services provided by MediRide, Inc. EMS and other area
caregivers would not be covered.
I guess that MGH assumed that their employees wouldn't realize that Blue Cross Blue
Shield of Michigan could not deny payment for services to participating Blue Cross
Blue Shield providers like MediRide EMS, Bell Hospital, etc. MediRide, Inc. EMS has
treated hundreds of MGH employees, billed their hospital-provided health insurance,
and not a single claim has been denied. All of them have been paid. Even though
employees were told that they wouldn't be paid.
I found that policy to be reprehensible! After that letter was put out, some MGH
employees were experiencing real emergencies, dialed 9-1-1 for help, and when
MediRide EMS responded, they refused to allow us to treat them because "their
insurance wouldn't pay for it." That's crazy! Our staff tried to assure them that it would
be paid for, but they were so afraid because of the threats by MGH administration, they
would rather delay emergency medical care, and risk their own lives. I ask you, how
caring do you think those "hands" are, and what do they really "care" about?
Marquette General has taken the "request" policy from Marquette County Central
Dispatch, and used it, in my opinion in ways that could be construed as very
dangerous to the public. Let me give you some examples.
MGH holds the local Phillips Lifeline franchise. Think "I've fallen, and I can't get up."
Lifeline users push a button on a pendant and the Lifeline service center calls
Marquette County 9-1-1 and sends an ambulance to the patient. If you or your family
member has a Lifeline in and around Marquette, when you push the button for
help...you are automatically sent a Marquette General ambulance. Pay no mind that
the Marquette General ambulance may not be the one located close to you. Nope.
The MGH ambulance might even be busy with another patient at the time and a
MediRide ambulance is available, ready to respond to your call for help. Too bad. I've
asked a few Lifeline patients that I know if they've directed MGH Lifeline to specifically
request a MGH ambulance for them. They promptly replied that the did not. That
leads me to believe that Marquette General is making important, life-or-death
decisions for it's Lifeline customers, without even consulting those patients. Again,
denying the patient a choice in the services he or she could receive. Sounds just like
how they denied patients the choice for non-emergency transports too. Notice a
pattern developing here?
In addition, all Marquette General physician offices, home health nurses, and outlying
campus locations have been instructed that if a patient requires an ambulance, the
MGH staff must dial 9-1-1 and specifically request a Marquette General ambulance. Is
that a patient request? I doubt it. Why? Well for one reason that we've heard over the
dispatch radios Marquette General ambulances being "requested" to respond to MGH
physician offices to transport patients that are "unresponsive," or who are having "CPR
performed" on them. Now, you tell me. How is it that a person who is unresponsive is
"requesting" anything. They're not even conscious. It doesn't make sense.
I strongly believe that this is very dangerous. It sounds to me like MGH is willing to put
revenue above a patient's welfare. I could be wrong, but I'll give you an example, and
let you decide for yourself.
In order to protect the confidentiality of the patient, I won't divulge dates and times of
this incident, but if you'd like to verify my story, you may request, under the Freedom of
Information Act, the meeting minutes of the Marquette County Central Dispatch policy
Board where I brought it to the members' attention.
A elderly MGH Lifeline patient pushed her HELP button. The Lifeline call center
attempted to reach the patient, but was unable to. The patient did not respond. As is
MGH Lifeline policy, the call center operator called Marquette County Central Dispatch
and "requested" a MGH ambulance respond to this patient. The MCCD dispatcher did
her job, and paged the MGH unit. Unfortunately, this MGH ambulance was busy
treating another patient on the other side of town. The MGH crew told the dispatcher
that they would expedite their current call, and to "send city fire" over to the
unresponsive patient to hold down the scene. Now, the guys at the Marquette City Fire
Department are unquestionably some of the finest people around. They do incredible
work, but, their agency is only licensed at the Basic Life Support level. MGH and
MediRide EMS are Advanced Life Support providers. The highest level of care
available. In a situation where a patient is "unresponsive," Marquette County protocols
demand that patient receives Advanced Life Support care. After nearly 15 minutes, the
MGH ambulance finally arrived on the scene. Fifteen minutes! Meanwhile, a
MediRide EMS Advanced Life Support ambulance could have been to that address in
less than 2 minutes. Did that patient, waiting for help, know there were other
ambulances that could help her immediately? Probably not. Did that elderly patient
know that MGH Lifeline had specifically "requested" a MGH ambulance for her?
Probably not. If that was your mother, or grandmother that needed help, right now, but
was forced to wait for nearly 15 minutes for help, what would you want done? (LISTEN
to audio tape of this call).
This isn't the only type of incident like this. It happens all the time, and the general
public has no idea! They're relying on public agencies like Marquette County Central
Dispatch and its policy board to protect them against things like this. Sadly, small
town politics, and greed rule the roost in Marquette County. I've tried, hard, to get
Central to see the error here, but for some reason they refuse. I've tried to show them
that they are required by law to dispatch the closest available ambulance. Still, they
refuse. Take a moment to review this letter to the Dispatch Policy Board dated March
13, 2008. I lay out and explain the law, in pretty clear terms. What do you think?
Probably before they even thought of it, and I was ready. Without going into great
detail, let's just suffice it to say, this stunt backfired on MGH. MediRide's call volume
actually increased by approximately 15 percent!
Then, I got a call from Al Hendra. I was asked to meet, "out of town" with him and
Venetia Bryers. They wanted to meet for lunch in Escanaba. Now, I know that
Escanaba was Venetia's home-turf, so I declined, but offered to allow them to buy me
lunch in Munising. They agreed, and the three of us met for lunch at Sydney's
Restaurant. This was in late May or early June of 2006, a mere 4-5 months after they
insisted on "complying with the Marquette County Medical Control Plan," and
"adhering to the spirit of the Emergency Telephone Service Enabling Act (9-1-1 Act).
Remember Mr. Hendra's letter to Joe VanOosterhout? I told you it would be important.
At this "out-of-town" lunch meeting, Mr. Hendra and Ms. Bryers told me that they'd like it
if I "would agree to return to the alternating" method of dispatching. You know, the one
they backed out of just 6 months earlier. I told them both, in no uncertain terms that I
was not interested in returning to the agreement. I recall saying, "look, if you're asking
me to do it, I know it won't benefit me any. You're in this for you." You see, i didn't just
fall off the turnip truck. MediRide's volume was up, and their call volume was down. It
didn't take a rocket scientist to figure out why they wanted to go back. What happened
to "adhering to the spirit of the ETSC Act, Al?
We ended the lunch (had I known Venetia was paying, I would've ordered more...), and
went our separate ways. I figured that was the end of it. Now, it was my turn to be
wrong.
On June 15th of 2006, less than one month after my Munising luncheon with MGH
administration, I happened to accompany Mike Farmer, from the Powell Township Fire
Department to the meeting of the Marquette County Central Dispatch Policy Board.
Before the meeting got underway, I glanced at a copy of the agenda that was laying out
on the table. I was surprised to notice that there was an item listed on the agenda that
referenced MGH / MediRide Dispatching. What? The Marquette County Central
Dispatch Policy Board was planning on discussing the dispatch arrangement that
would directly effect my business, and I knew nothing about it? I got no letter, no
phone call, no emails...nothing. Apparently the input from the two MGH employees on
the Board, Dan Wolf and Alyson Sundberg, was all Mr. VanOosterhout thought the rest
of the Board needed to know.
I waited anxiously for this item to come up for discussion. Turns out, Marquette
County Central Dispatch got it in their minds to change the dispatching of MGH and
MediRide EMS ambulances back to the alternating arrangement and leave forget the
dispatching laws. I wasn't permitted to speak on the agenda item, until public
comment. Too bad public comment was at the end of the meeting, after the decision
had been made. It was unanimous...Dan Wolf abstained from voting. How noble.
Is it just me, or does anyone else find it strange that less than one month after my
secret, out-of-town lunch with MGH administration, a lunch in which they virtually
begged me to agree to return to the alternating dispatch method, this item was
coming up at the Central Dispatch Policy Board meeting, and I wasn't told a thing
about it. If I didn't just coincidentally attend this meeting, to discuss another topic, I
wouldn't have even known this was going on. Strange, very strange.
So, the alternating dispatch method was back in play...with a new addition. Now
patients could "request" a specific ambulance when dialing 9-1-1. Here's the EMS
Dispatch Policy that was voted in at the June 15, 2006 meeting.
This "Request" caveat was new to the policy, but Marquette General had tried to force
its employees to "request" an MGH ambulance when the original MOU was in place.
They sent out scary memos to their employees, telling them that if they had an
emergency and MediRide EMS treated them, their insurance wouldn't pay. Well, let's
roll back in time here, for just a bit. It seems as though there was some confusion on
the part of Marquette General as to whether or not their employee insurance would, or
wouldn't pay for services provided by MediRide, Inc. EMS.
On June 28, 2005, MGH Assistant Administrator Al Hendra put out a memo to all
employees, and oddly enough, mailed to us here at MediRide, Inc. This memo
basically stated that MediRide EMS is a competing ambulance service, and that
employees would have to pay a co-insurance amount of 15% if they "use the MediRide
service." What he neglected to mention in this memo, is that MediRide, Inc. EMS has
always waived the MGH employee co-insurance, meaning in essence, MGH staff
would NOT be required to pay MediRide the 15% co-insurance. Take note, however, it
wasn't until August 9th of 2005 that they stated in a letter to employees from MGH CEO
Bill Nemacheck that services provided by MediRide, Inc. EMS and other area
caregivers would not be covered.
I guess that MGH assumed that their employees wouldn't realize that Blue Cross Blue
Shield of Michigan could not deny payment for services to participating Blue Cross
Blue Shield providers like MediRide EMS, Bell Hospital, etc. MediRide, Inc. EMS has
treated hundreds of MGH employees, billed their hospital-provided health insurance,
and not a single claim has been denied. All of them have been paid. Even though
employees were told that they wouldn't be paid.
I found that policy to be reprehensible! After that letter was put out, some MGH
employees were experiencing real emergencies, dialed 9-1-1 for help, and when
MediRide EMS responded, they refused to allow us to treat them because "their
insurance wouldn't pay for it." That's crazy! Our staff tried to assure them that it would
be paid for, but they were so afraid because of the threats by MGH administration, they
would rather delay emergency medical care, and risk their own lives. I ask you, how
caring do you think those "hands" are, and what do they really "care" about?
Marquette General has taken the "request" policy from Marquette County Central
Dispatch, and used it, in my opinion in ways that could be construed as very
dangerous to the public. Let me give you some examples.
MGH holds the local Phillips Lifeline franchise. Think "I've fallen, and I can't get up."
Lifeline users push a button on a pendant and the Lifeline service center calls
Marquette County 9-1-1 and sends an ambulance to the patient. If you or your family
member has a Lifeline in and around Marquette, when you push the button for
help...you are automatically sent a Marquette General ambulance. Pay no mind that
the Marquette General ambulance may not be the one located close to you. Nope.
The MGH ambulance might even be busy with another patient at the time and a
MediRide ambulance is available, ready to respond to your call for help. Too bad. I've
asked a few Lifeline patients that I know if they've directed MGH Lifeline to specifically
request a MGH ambulance for them. They promptly replied that the did not. That
leads me to believe that Marquette General is making important, life-or-death
decisions for it's Lifeline customers, without even consulting those patients. Again,
denying the patient a choice in the services he or she could receive. Sounds just like
how they denied patients the choice for non-emergency transports too. Notice a
pattern developing here?
In addition, all Marquette General physician offices, home health nurses, and outlying
campus locations have been instructed that if a patient requires an ambulance, the
MGH staff must dial 9-1-1 and specifically request a Marquette General ambulance. Is
that a patient request? I doubt it. Why? Well for one reason that we've heard over the
dispatch radios Marquette General ambulances being "requested" to respond to MGH
physician offices to transport patients that are "unresponsive," or who are having "CPR
performed" on them. Now, you tell me. How is it that a person who is unresponsive is
"requesting" anything. They're not even conscious. It doesn't make sense.
I strongly believe that this is very dangerous. It sounds to me like MGH is willing to put
revenue above a patient's welfare. I could be wrong, but I'll give you an example, and
let you decide for yourself.
In order to protect the confidentiality of the patient, I won't divulge dates and times of
this incident, but if you'd like to verify my story, you may request, under the Freedom of
Information Act, the meeting minutes of the Marquette County Central Dispatch policy
Board where I brought it to the members' attention.
A elderly MGH Lifeline patient pushed her HELP button. The Lifeline call center
attempted to reach the patient, but was unable to. The patient did not respond. As is
MGH Lifeline policy, the call center operator called Marquette County Central Dispatch
and "requested" a MGH ambulance respond to this patient. The MCCD dispatcher did
her job, and paged the MGH unit. Unfortunately, this MGH ambulance was busy
treating another patient on the other side of town. The MGH crew told the dispatcher
that they would expedite their current call, and to "send city fire" over to the
unresponsive patient to hold down the scene. Now, the guys at the Marquette City Fire
Department are unquestionably some of the finest people around. They do incredible
work, but, their agency is only licensed at the Basic Life Support level. MGH and
MediRide EMS are Advanced Life Support providers. The highest level of care
available. In a situation where a patient is "unresponsive," Marquette County protocols
demand that patient receives Advanced Life Support care. After nearly 15 minutes, the
MGH ambulance finally arrived on the scene. Fifteen minutes! Meanwhile, a
MediRide EMS Advanced Life Support ambulance could have been to that address in
less than 2 minutes. Did that patient, waiting for help, know there were other
ambulances that could help her immediately? Probably not. Did that elderly patient
know that MGH Lifeline had specifically "requested" a MGH ambulance for her?
Probably not. If that was your mother, or grandmother that needed help, right now, but
was forced to wait for nearly 15 minutes for help, what would you want done? (LISTEN
to audio tape of this call).
This isn't the only type of incident like this. It happens all the time, and the general
public has no idea! They're relying on public agencies like Marquette County Central
Dispatch and its policy board to protect them against things like this. Sadly, small
town politics, and greed rule the roost in Marquette County. I've tried, hard, to get
Central to see the error here, but for some reason they refuse. I've tried to show them
that they are required by law to dispatch the closest available ambulance. Still, they
refuse. Take a moment to review this letter to the Dispatch Policy Board dated March
13, 2008. I lay out and explain the law, in pretty clear terms. What do you think?
| AUDIO EXTRA! Names / Phone numbers of private citizens or patients have been edited out to protect privacy. |
Cut # 1 - Sheila Peters "Requests MGH EMS For
Pt. With "Decreased Level of Consciousness
Here is tape of Deputy Sheila Peters, from the Alger
County Sheriff's Office calling Marquette County and
making a "request" for Marquette General EMS to
respond to a woman with a "decreased level of
consciousness." Question 1, why would someone
in Alger County, dialing 9-1-1, request an
ambulance from Marquette when they would be
expecting an Alger County ambulance? Question 2,
how does someone with a decreased level of
consciousness think to "request" a specific
ambulance at all?
Deputy Peters consistently "requested" Marquette
General ambulances on behalf of 9-1-1 callers in
Alger County. Additional audio to follow.
Pt. With "Decreased Level of Consciousness
Here is tape of Deputy Sheila Peters, from the Alger
County Sheriff's Office calling Marquette County and
making a "request" for Marquette General EMS to
respond to a woman with a "decreased level of
consciousness." Question 1, why would someone
in Alger County, dialing 9-1-1, request an
ambulance from Marquette when they would be
expecting an Alger County ambulance? Question 2,
how does someone with a decreased level of
consciousness think to "request" a specific
ambulance at all?
Deputy Peters consistently "requested" Marquette
General ambulances on behalf of 9-1-1 callers in
Alger County. Additional audio to follow.
Asks Patient If He Wants MGH
Here is another recording of Deputy Sheila Peters
of the Alger County Sheriff's Office. In this call,
Deputy Peters tells dispatcher in Marquette that the
patient is requesting a Marquette General
ambulance. At 0:38 into the recording, you'll then
actually hear Deputy Peters ask her caller if they
wanted a MGH ambulance. I wonder, how did she
know they wanted an MGH ambulance BEFORE
she asked them? The other question again, is, why
would someone dialing 9-1-1 in Alger County
automatically "request" an ambulance from
Marquette County, when they're expecting an Alger
County rig to respond? It doesn't make any sense.
Something is clearly wrong here. The system to
allow "requests" is clearly open for cronyism and
foul-play. It allows people in power to make
choices for unsuspecting patients. Who do you
want making YOUR health care decisions?
Here is another recording of Deputy Sheila Peters
of the Alger County Sheriff's Office. In this call,
Deputy Peters tells dispatcher in Marquette that the
patient is requesting a Marquette General
ambulance. At 0:38 into the recording, you'll then
actually hear Deputy Peters ask her caller if they
wanted a MGH ambulance. I wonder, how did she
know they wanted an MGH ambulance BEFORE
she asked them? The other question again, is, why
would someone dialing 9-1-1 in Alger County
automatically "request" an ambulance from
Marquette County, when they're expecting an Alger
County rig to respond? It doesn't make any sense.
Something is clearly wrong here. The system to
allow "requests" is clearly open for cronyism and
foul-play. It allows people in power to make
choices for unsuspecting patients. Who do you
want making YOUR health care decisions?
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