More wildlife. Less pollution. More quality time. There exists undeniable signs that mitigation and sheltering are working, in the fight against the coronavirus—and that we’re even experiencing some unintended positive side effects.
Another one of those positive signs locally is a decreased need for ambulance and emergency services. But the catch-22 for county ambulance providers is that their revenues are directly linked to the number of patients they serve.
Schaefferstown Emergency Medical Services and Central Medical Ambulance Service are a pair of first-responding units which serve two different geographical ends of Lebanon County: Schaefferstown EMS operates on the dedication of 25 volunteers, while Central Medical is a business enterprise that employs as many as 30 part-time and about a dozen full-time paramedics and EMTs.
“I think it’s a good thing in a lot of ways,” said Larry Minnich, Central Medical’s operations manager, of the fewer call his business is seeing. “To have no calls ever, would be the best thing ever, but from a business standpoint, it’s not. It’s 50-50 if you have to concern yourself with patient care and revenue.”
If you have to worry about revenue to pay your employees, Minnich said, more calls is better than fewer calls.
“I think there’s a mixed feeling,” said Loren Miller, Schaefferstown EMS’s director of operations. “On the one hand, it’s good to see less people in need of medical care. But some people might not be seeking the care they need. We’re kind of fearful of what the call volume will be when restrictions are lifted. But with fewer calls, we get less income from people’s insurance. It’s a little bit of hit-or-miss, from all angles.”
Since the outbreak of the coronavirus and Pennsylvania Gov. Tom Wolf’s subsequent mitigation measures five weeks ago, both Central Medical and Schaefferstown EMS have seen significant drops in the need for their ambulance services.
According to Minnich, the need for emergency services in Lebanon County is down by as much as 40 percent. Miller said that through the first three weeks of April, Schaefferstown EMS calls were down about 65 percent.
“As far as call volumes go, we have not seen an uptrend,” said Miller. “We have seen the exact opposite since the stay-at-home order came into place. A lot of other local services are seeing the same trend. Our assumption is that people are heeding the warnings to stay home.”
That means fewer emergencies such as car accidents.
“Generally speaking, numbers are down because people are shut in. Most of our revenue comes from contracted services. We do dozens of different varieties of contracted services,” said Minnich. “A big part of our business is staffing sporting events and special events, and none of those are taking place. If we were just in the 911 business, we wouldn’t be in business.”
Schaefferstown EMS and Central Medical have seen varying amounts of patients afflicted with COVID-19. While paramedics and EMTs have never experienced anything quite like the coronavirus, their jobs require them to be prepared for any medical possibility.
“We’ve transported numerous people who have tested positive for the coronavirus or who have symptoms,” said Minnich. “But if someone has symptoms of the coronavirus, they’ll be noted. Typically, you’ve got five to seven minutes to get ready for what you’re going to encounter. I think the technology and communications you get before you actually touch patients has improved.”
When LebTown spoke with Miller late last month, he said Schaefferstown EMS had yet to treat anyone who has tested positive, but staff is still taking necessary precautions.
“The coronavirus has transformed everything we do, in some way, shape or form. Within our typical day-to-day operations outside the coronavirus, we didn’t have to take a bunch of precautions,” Miller said. “Now, with every single call, our providers are required to wear surgical masks.”
Central Medical and Schaefferstown EMS are first-responder enterprises funded in two totally different ways. One thing they have in common is that they’re both facing the same financial difficulties all local businesses are struggling with right now.
Schaefferstown EMS’ funding primarily relies on patients’ insurance, but the enterprise also organizes fundraising efforts and counts on donations from the community.
“Without community support, we’d be in a terrible place,” Miller said. “Our fund drives have been amazing. Every year, the cost of doing business goes up. Every year, our call volume goes up. But every year, our community has been there 110 percent.”
Minnich said there’s a “fine balance” that needs to be struck between “where you put your people and where you put your finances.” The coronavirus has made that balance harder to strike than ever.
“With everybody you talk to, the business model is going to be different from here on out,” Minnich said. “It’s very expensive to be in the ambulance business. We don’t get money from municipalities.”
One of the things that the pandemic has forced all of us to do is weigh the importance of humanity against the importance of financial security. That is especially true for local ambulance services, just in a totally different way.
“To me, the scariest part is that if someone would get exposed to it, its effects aren’t consistent among people,” said Minnich. “My biggest concern is the uncertainty of the virus. I’m afraid for my people, that anything could happen if they were exposed.”
“I can’t thank our volunteers enough, with what they’ve been working with,” said Miller. “Just how it’s transformed into something we’ve never seen before, and that they’re asked to do it for free. We’ve had a couple of providers who have stepped down, for an array of circumstances.”
That uncertainty has become our future and new normal. But there are few locals more equipped to handle the unknown than paramedics, EMTS and first-responders.
“I think every single human being on the face of the earth is looking forward to the end of this,” said Miller. “I think that’s especially true for us. The way we carry on with a call isn’t anywhere close to how we carried on a call before. Every single call we go on is an unknown. There’s an element of surprise that always exists.”
“We’re going to adapt to anything thrown at us,” said Minnich. “Some people are compliant and some people aren’t compliant. I think this is a good eye-opener. People need to be aware and be participants in this. There needs to be more education. I’m just overwhelmed by how fast we’ve gone from Point A to Point B with this thing. A lot of positive things have gone away.”
But a lot of positives still remain.
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An earlier version of this article used “ambulatory” in some spots instead of “ambulance.” Ambulatory care in fact refers to rehabilitation medicine and we have corrected the post accordingly. Thanks to the LebTown reader who pointed this out for us!