By Pat Hammert/Staff Writer

Reactions to the announcement that Parkview Hospital will close its ambulance service in four months range from resolve to outrage by city leaders who must find a funding solution to keep it running.

Councilman Tony Maldonado, calling the action by hospital trustees “strong-arm tactics,” has requested Parkview Administrator Lex Smith be available at Tuesday’s City Council meeting to answer some questions.

“This whole action was calculated,” Maldonado said. “Where has the dialogue been between the hospital and this Council. Where has our city manager been with this? It is cruel and callous that they would do that, giving us four months to try to find some answers.”

He said he felt that trustees are “backing us in a corner.”

Making it official

At a hospital trustees meeting last Tuesday, the authority voted 5 to 2 to close its fiscally failing ambulance service. The service will be terminated June 30, placing it in the hands of city leaders since the hospital is municipally owned.

The two Council representatives who serve on the board of trustees — Mayor James Moore and Vice Mayor Debbie Harrison — cast yes votes, along with trustees Dale Bynum, Margaret Mehle and David DeLana. Voting against closing the service were trustees Michael Compton and Willard Holsted.

“This community will not be without an ambulance service on July 1,” Harrison said after the meeting. “The city has a responsibility to provide that service and the Council takes that responsibility seriously.”

She said she will be pushing for “requests for proposals” from private ambulance services in the surrounding area as well as Parkview.

“I’ve discussed this with the hospital and they are amenable to providing a bid. That way, citizens can see the options available to them and what is out there. I think we need a paramedic level service like we’ve had through Parkview because when an ambulance comes to my door to help me or a member of my family, I want the best quality available to me,” she said.

Latest numbers

The financial report for the last six-month period shows at Dec. 31, the El Reno service suffered a $290,000 loss on its annual million-dollar operation.

Adding to the bad news were numbers from Parkview-operated ambulance services at Hinton and Geary, that together over the last six months operated in the red more than $77,000.

Both Hinton and Geary subsidize the services through voter-established EMS-522 districts. An election last May to establish such a district in the El Reno area was unsuccessful. State law allows an EMS-522 to tap property taxes to pay for emergency services.

Public to private

Two years ago, Parkview officials approached the city asking for a subsidy, warning of the critical needs of the service because of Medicare cuts. The Council took no action, with some members urging investigations into privatizing the hospital.

“Right now is a perfect opportunity to privatize the whole operation of the hospital,” Maldonado said. “It’s just that people don’t want anybody in their sandbox, but I’m in the health-care business and I’ve seen hospitals recognize the need for a partner. Take Deaconess (in Oklahoma City) for instance. They went out last year and found a strategic partner, an independent hospital service that could help them out on their bottom line.”
Triad Hospitals Inc. manage dozens of hospitals across the country including Deaconess, Claremore Regional Hospital, SouthCrest Hospital in Tulsa and Woodward Regional Hospital.

Trustee frustration

Last year, Parkview took a $470,000 loss on its ambulance service and in June trustees notified the city that a supplement would be needed. An EMS task force supported a public safety sales tax after studying the issue for several months, but no further action was taken.

At Tuesday’s board meeting, officials showed frustration at their cries for help from the city going unheeded.

“The city was going to go out for proposals for ambulance services, but there has been no effort to do so,” Smith told trustees. Holsted suggested going back to the city before voting to terminate the service, but Bynum said “been there, done that, Willard.”

Holsted told the board he had talked with the city manager who had assured him the city was “working on it.”

Mayor Moore said he’d “carried this through all along and nothing has happened. What can you do, I’m only one vote.”

Councilman Paul Atkins said there has been no public discussion of the ambulance issue since the last meeting of the EMS task force.

“I’m at a loss, I didn’t know the situation had gotten so critical,” he said.

Tuesday’s agenda

After hearing of the hospital’s actions, City Manager Doug Henley said he added an agenda item to Tuesday’s meeting that will allow him to seek bids from Parkview and other ambulance services.

“I knew there were two ways for them to go. Come to the Council and ask for a subsidy or do this. Now that they’ve taken the formal action, we can develop some specifications to go out for bids,” he said.

He said the city’s response to Parkview’s dilemma has not been slow because the city could not proceed until trustees took formal action.

Finding funds

City Councilwoman Julie Rozsypal said “there very well could be funds inside the bud-get” to address the immediate issue to keep the ambulance service running. She said the EMS-522 was an equitable way to shore up the service, but voters decided against that method. She said little has been discussed at meetings about the issue since she was elected last year.

“The ball has been dropped … by city management,” she said. “Part of his job is to keep the Council informed on these issues.”

She said the Council needs to find some answers.

“I’ve always been opposed to raising taxes but that’s what provides the services. There is a critical need here and I’ve always had the feeling that those who receive the benefits must pay the costs.”

Maldonado also said Parkview should cease providing ambulance services to Hinton and Geary and instead concentrate exclusively on El Reno.

Harrison said a voluntary subscription service could provide some funding. A viability report was presented to hospital trustees last week that estimated charging a $60 a year subscription would result in an annual $85,000, at the most.

Cost-cutting

Smith said this week the hospital would “be happy” to provide a bid proposal. He said costs to operate have been reduced.

Emergency Services Director Ray Simpson, in a report to trustees, said he has cut staffing on Parkview’s four ambulances over the past three years while still providing a paramedic-level service.

Moving to 12-hour shifts has caused an unusual turnover of personnel, he said. He said concerns about the future of the service has also caused turnover.

Personnel costs have decreased. Staffing hours — that is hours being paid to personnel — averaged 3,500 in 2002. In 2005, staffing hours averaged 2,700.

Response time remains at six to eight minutes, but patient transfers have to be frequently stacked because of lack of standby crews.

Simpson said supply expense has been cut “drastically” but fuel costs have doubled.

Guarantees

Smith said people should not be concerned about Parkview continuing to provide the same level of ambulance service it has always provided. He expects there to be some concern among ambulance personnel as the announcement was made.

“We hope they will stay, but we can guarantee the people of El Reno that the service will continue to be the outstanding service they’ve all grown accustomed to. Whether we have to recruit and hire new people, it will remain at the paramedic level,” Smith said.

“But after July 1, there are no guarantees. The city must take action to provide those services.”