Ambulance issues: Mercy plans to halt emergency service by March 30

Tuesday, February 16, 2016
Mercy Hospital of Berryville has informed Carroll County officials that it will stop providing emergency ambulance service in the county by March 30. (Photo by David Bell/Carroll County News)

Mercy Hospital of Berryville intends to stop providing emergency ambulance service in Carroll County by March 30, according to a letter presented last week to County Judge Sam Barr.

"Please accept this letter as formal notification of Mercy's decision to end emergency ambulance service coverage to Eastern Carroll County, including the communities of Green Forest and Berryville, by March 30, 2016," says the letter, which is signed by Robert "Bob" Patterson, executive director of emergency medical services for the Mercy healthcare system. "This decision comes with heavy hearts and after much reflection around mounting financial losses.

"We will work collaboratively with the EMS provider selected by the court to take over responsibility for emergency ambulance services and will be ready to cease operations at any date you request on or before March 30. Mercy will continue to station an ambulance on the campus of Mercy Hospital Berryville to handle patient transports originating from our hospital after the transition of emergency coverage is complete."

The letter, which is dated Feb. 12 and was hand-delivered to Barr that afternoon, comes more than a year after Barr authorized a second ambulance service to begin operating in the eastern half of the county.

Officials from Mercy, which previously had been the exclusive provider of ambulance services east of the Kings River, met with Barr in December 2014 and presented him with a document indicating that Mercy had lost more than $2 million over a six-year period, including more than $500,000 in 2014 alone.

Barr then authorized Ozark EMS to begin accepting calls on an alternating basis with Mercy, saying he believed that would alleviate Mercy's financial losses. Mercy officials said the move had the opposite effect, cutting its revenue in half without a significant impact on fixed expenses.

"That has increased the operating loss for Mercy," the letter says. "We made the difficult decision at that time to reduce service from three ambulances to two and have since operated in an environment where EMS coverage has not been well-coordinated, leading to confusion, and in some cases the closest ambulance not being dispatched to medical emergencies.

"It has been our privilege to provide EMS services for the citizens and visitors of Carroll County since 2000, when the ambulance service in Green Forest decided it could not continue to provide service. In 2001, we expanded coverage to Berryville when another ambulance service found it no longer financially feasible to continue operations. We have provided services at a financial loss every year since, and the current level is no longer sustainable."

Patterson said by phone Monday that no Mercy employees will lose their jobs as a result of the decision. He indicated that some might be offered positions elsewhere in the Mercy system.

"We intend to take care of our co-workers," he said.

Patterson also said that Mercy's financial losses from the local ambulance service had grown even more than anticipated.

Monday's meeting

However, Patterson did say in his letter to Barr that if the county proceeds with the creation of an ambulance service district, an idea supported by some members of the quorum court, "we would welcome the opportunity to participate in that process to provide emergency medical services to the county."

At Monday night's meeting of the quorum court, Justices of the Peace voted 10-0 to amend a previous ordinance that created a Citizens Advisory Board to study options for ambulance service in the eastern portion of the county. The amended ordinance, which was read three times and approved with an emergency clause at Monday's meeting, authorizes the board to develop a Request For Proposal that it can then distribute to potential ambulance service providers.

Doing so, explained JP John Reeve, would allow the county to get an idea of what public subsidies might be necessary to support an ambulance district in the eastern half of the county.

Any millage levied to support an ambulance district would have to be approved by voters in each precinct included within the district.

Reeve had previously sponsored an ordinance that would create an ambulance service district but would not provide a funding mechanism for it. That ordinance has since been tabled while county officials wait for an attorney general's opinion on whether the quorum court has the authority to create the ambulance district.

Green Forest Mayor Charles Reece, who is chairman of the Citizens Advisory Board and is unopposed as a Republican candidate for county judge in the March 1 preferential primary, said in an email on Saturday that he is "not a happy camper."

"I stand by my initial statement 'someone is going to die as a result of the decision made by the county,' " Reece said in his email.

Ozark EMS confirmed in December that it is no longer taking calls in Green Forest or east of there to the county line, unless Mercy doesn't have an ambulance available. It's unclear how Mercy's announcement will affect that, but Reece said at Monday's quorum court meeting that Mercy's decision will leave Green Forest without service.

Barr, who is seeking re-election and is unopposed in the Democratic primary, addressed the issue only briefly at Monday's meeting.

"I regret that they choose the option to do that, but that's their option," he said of Mercy's decision. "We appreciate the service they've provided."

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  • Doesnt Barr have a county road he needs to go work on?!? Sad news for the people of Carroll County. Nothing will be done until some "good ole boy" dies at the hands of an "incompetent ambulance service" or the lack of a service at all. Move along Barr. You knew what you were doing when you moved Ozark in.

    -- Posted by concernedcitizen31 on Tue, Feb 16, 2016, at 3:11 PM
  • The Eastern District will be much better off now that the Citizens Advisory Board is taking over the leadership roll of creating something similar to what the WCCAD has. Mr. Reece has a good plan, and has some very knowledgeable people on his board. Additionally, Reece will no doubt tap into the knowledge and expertise of the leadership at the Eureka Springs Fire/EMS department for guidance. The WCCAD is a very well managed organization. I believe I can speak for others in saying we are well pleased with our system.

    -- Posted by rockpilefarmer on Tue, Feb 16, 2016, at 9:10 PM
  • Sounds like Sam Barr really screwed up......

    -- Posted by beachdrifter on Tue, Feb 16, 2016, at 9:42 PM
  • I think Barr's screw up will turn out to be a blessing in the long run. For years, people in the eastern half (actually, more than half) of Carroll County have had hap-hazard EMS. There has never been any consistency. With Reece heading up the citizens advisory board, and input from the people who run the WCCAD, this can only be a win-win situation. Not only for the Eastern District, but also for the Western District. Uniformity and cooperation among other EMS agencies are the essence of a good system. Besides, Ozark EMS hires local paramedics and EMTs. Mercy imports from elsewhere.

    -- Posted by rockpilefarmer on Wed, Feb 17, 2016, at 9:04 AM
  • Before you are so quick to judge "Judge Barr", you might want to know the real story. There has been many times Mercy ambulances have all been busy with "transfers" and left the county without service. They also would trump Air Ambulances for their own helicopter even if it meant bringing it in from much longer distances. They also required their dispatches to run through Springfield MO. They could not talk directly with the first responders. I think Mercy has great employees, but understand the corporate decision makers were trying to put the screw to Carroll County. Judge Barr stood up to them. If they were actually losing money, they would not even offer to be involved in the new ambulance district. It is time Carroll County took control of our ambulance service and stop relying on people elsewhere who care only about profit.

    -- Posted by Carroll Cty Citizen on Wed, Feb 17, 2016, at 10:34 AM
  • Speaking of profit, the only way to run a business is to make a profit, or you fail. There are other ways to have a good EMS system. You could pressure your fire departments to begin an EMS program like Eureka Springs has. I doubt that would ever happen. That means work. Work is a four letter work for all too many people.

    -- Posted by Gearhead on Wed, Feb 17, 2016, at 4:24 PM
  • Some Fire Departments in the county do not have a tax to support them, so how would you expect them to start an EMS Service? Maybe you should talk to them about their needs and experiences with the past EMS companies. Try being on scene needing an ambulance and not having one, or having to wait a long time for one to respond. Also, some of the volunteer fire fighters/ responders are the hardest workers in the county.

    -- Posted by Carroll Cty Citizen on Wed, Feb 17, 2016, at 5:03 PM
  • Some fire departments. Not Berryville and Green Forest. They are tax supported. And there is grant money available. Eureka Springs just got an $800,000 state of the art Pierce ladder truck. $750,000 was from a grant Nick Samac applied for. To date, Nick has about 2 million dollars in awarded grants under his belt. Not bad, huh? There are plenty of start up funds to be had. And, like Eureka Springs, you bill for services. This is really not rocket science.

    -- Posted by Gearhead on Wed, Feb 17, 2016, at 6:14 PM
  • Billing for Services is easy. Collecting is not. Reimbursement has sank to an all time low. ESFD are well trained ems providers. Wow they are tax supported. My understanding is that is what Mercy was asking ( was there a way the East side of carroll county could do that.) Nick Samac I believe is the COUNTY OEM director he should probably be helping the other FD's as much as his own.

    -- Posted by plasma on Thu, Feb 18, 2016, at 12:46 PM
  • It has been over a year now, and the QC has been pleading for citizens in the ED to step forward and help head off a potential disaster. Almost nobody did until word of Mercy pulling out got their attention. I don't believe that writing grant proposals for every FD in the county is in Nick's job description. Each and every fire department is responsible for writing their own grant proposals. They can learn to do it themselves just like other FDs do, or they can hire a professional to do it for them. Grassy Knob, Inspiration Point, and Holiday Island all write their own grant proposals as does Eureka Springs.

    -- Posted by Gearhead on Thu, Feb 18, 2016, at 3:52 PM
  • I don't know about the other departments in the WCCAD, but Grassy Knob has a dedicated group of citizens that have a grant writing committee that meets once a month. To date, I believe they have written more than a dozen grant requests. They have been awarded a number of grants over the years.

    -- Posted by rockpilefarmer on Fri, Feb 19, 2016, at 11:30 AM
  • Grants are easy to write and I know the other depts. in the county write them as well. As far as Mercy trumping other aircraft? Other aircraft at times to not have the ability to lift off with a heavier patient. Also who knows if a person in an accident, or is unresponsive is a member of another service? Not everyone puts stickers on their vehicles, front doors or on them . And transfers are a way of life and a matter of fact for EMS. Think for a minute, if your family member needed to be TRANSFERRED for a life saving advanced facility wouldn't you want them transferred asap. ALL EMS services in Carroll County take transfers except ESFD and they are subsidized.

    -- Posted by plasma on Fri, Feb 19, 2016, at 12:33 PM
  • Bottom line, Western District has an ambulance district. It is time for the Eastern 2/3 to have one as well. Perhaps a sales tax would be more palatable???????????

    -- Posted by plasma on Fri, Feb 19, 2016, at 12:35 PM
  • Actually plasma, Eureka is NOT subsidized. Eureka is contracted. There is a difference. Eureka Springs Fire/EMS was only obligated to cover their own area. That would be within the city limits and their fire district for which dues are paid. When Eureka got more and more busy, they were not really able to guarantee that they could supply the other areas, Holiday Island, Inspiration Point, and Grassy Knob with an ambulance. That is when negotiations took place and a contract was drawn up. They have certain obligations that must be followed such as guaranteed response time, and other services such as teaching the First Responder and EMT classes to WCCAD members annually. Additionally, a good chunk of the funds go to the first responders in each fire department in the form of safety gear, AEDs for EMTs, an EMS duty bags with oxygen, and all the first aid items one would need. This is pretty expensive stuff. Additionally, extra money is strategically returned as money to assist in EMS like rescue trucks, high and low angle rescue equipment, and other things that aid all involved. The money that Eureka gets through WCCAD also help to pay salaries as there is 24/7 coverage with two staffed ambulances, insurance, and 4 WD ambulances. We think it is all well worth it. But the ED will be a different animal since they will be contracting to a private service. That is more like a subsidy as you mention.

    -- Posted by rockpilefarmer on Sat, Feb 20, 2016, at 11:45 PM
  • WCCAD is tax supported. That is a subsidy. I do not recall having said it is not worth it.

    -- Posted by plasma on Sun, Feb 21, 2016, at 9:30 AM
  • ESFD would not exist as a paid FD w/o the (Non) subsidy.

    -- Posted by plasma on Mon, Feb 22, 2016, at 8:46 AM
  • con·tract

    noun

    ˈkäntrakt/

    1.

    a written or spoken agreement, especially one concerning employment, sales, or tenancy, that is intended to be enforceable by law.

    "both parties must sign employment contracts"

    Subsidy

    noun (plural subsidies)

    1A sum of money granted by the government or a public body to assist an industry or business so that the price of a commodity or service may remain low or competitive:

    a farm subsidy

    they disdain government subsidy

    WCCAD has a contract. We do not subsidize. BIG difference.

    -- Posted by rockpilefarmer on Mon, Feb 22, 2016, at 9:42 AM
  • I'm constantly flabbergasted by the lack of interest on the part of the eastern side residents. This is literally life and death! Why are there so few taking an interest in seeking a long term, quality solution?

    -- Posted by standard_bearer on Mon, Feb 22, 2016, at 9:26 PM
  • OZARKEMS came over to the eastern district when Mercy said they needed 400,000 to stay. The long term goal definitely needs to be met,but it's not going to be in a month or two. Until something is achieved, we have a company that taking care of the eastern district and willing to add a additional Unit in Green Forest.

    -- Posted by ems4life on Fri, Feb 26, 2016, at 7:44 PM
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