No action taken at Bethel Twp. special meeting on ambulance response times

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Following resident and fire company concerns about delayed ambulance responses, the Bethel Township Board of Supervisors held a special meeting Wednesday morning to discuss emergency services. No action was taken.

As previously reported by LebTown, Mount Zion Community Fire Chief Carl Sensenig posted to the company’s Facebook page April 2 about an incident in which a motorcycle crash left the rider on a tar and chip road, 250 feet from his vehicle. An ambulance, with an estimated arrival time of 10 minutes, was dispatched but ultimately canceled and replaced with an ambulance over 20 minutes away.

In 2020, Bethel, along with Swatara, East Hanover, Union, and North Annville townships and Jonestown Borough, entered into an agreement with Penn State Health Life Lion for emergency services, for a total of $31,500 per year. The five-year term expired and auto-renewed for another five-year term at the start of 2025.

Solicitor Andrew Morrow outlined the contract during the meeting, noting that it stipulates that if either party violates the contract, the other party should be notified and given a month to resolve the issue, and the contract may be dissolved in that case. Otherwise, either party may terminate the agreement without cause with 90 days notice.

When a municipality designates a primary service, such as Bethel’s selection of Life Lion, that service has the authority to modify the response in real time, such as canceling an automatic response sent by county dispatch to send a different ambulance. The incident described above was an example of this, though Penn State senior director of Life Lion Keith McMinn said Life Lion was unaware of the distance of the closest unit to the scene.

Sensenig said on Facebook the incident was “not an isolated situation,” citing “repeated EMS delays, with response times exceeding 30 minutes by the same department and similar cancellations.” He posted a radio transmission in which he said, “I don’t have time for EMS politics, if there is a closer BLS (basic life support) unit, send them.”

During Wednesday’s meeting, Sensenig accused Life Lion of “cherry-picking” calls to respond to and called past situations “patient neglect” and “abandonment,” descriptions that were critiqued by McMinn.

“You made the right decision requesting that closer unit for the motorcycle accident which has been subject to this, we’re not questioning that, you made the right decision,” said McMinn. “You have used words like ‘abandonment’ and ‘neglect,’ which have specific legal meanings that we’re very familiar with and all of our agencies are. I will tell you, none of the situations that you have forwarded come close to the legal definitions of abandonment and neglect.

“We support continued dialogues amongst the agencies. Ultimately, the decision-makers are the township supervisors on how we frame this moving forward along with the 911 center, and I think that is the appropriate way to have these discussions moving forward. I think some of the social media things have just not been appropriate, that’s not the way to handle that.”

For Class One and Echo response calls (which often indicate cardiac arrest), Penn State EMS medical director Dr. Chadd Nesbit said, seconds matter and the closest ambulance is dispatched. For other calls, he said, other metrics are more important than response times.

“Overall, we can do much better than simply measuring response times. Doesn’t matter if you have an EMS agency that’s there in four minutes or five minutes if the care that they deliver isn’t high-quality patient-centered care,” said Nesbit, adding that Life Lion is always working to improve service.

Representatives of Swatara Township, Union Township, Jonestown Borough, and East Hanover Township were present and expressed support for Life Lion, and said they received few if any resident complaints.

“I’ve been doing this for all but 40 years as an EMT, over 40 years as a firefighter, and I gotta say, nothing against First Aid or Myerstown, but I think of all the ones that I ran with over the years that Penn State is, no doubt, the most professional and courteous company I ever ran with,” said Swatara Township supervisor and Bunker Hill fire chief Rick Kreitzer.

Life Lion ambulances are stored at Ono Fire Hall in East Hanover Township, which can lead to long response times. Chairman Richard Rudy explained that, as Bethel is the longest township in Lebanon County, this can exacerbate delays in response times to areas like Mount Zion, despite closer proximity to other EMS units.

“I’d just like to say, this is a very, very, very difficult decision to make. We have 5,132 residents in Bethel Township, and our township is the longest as far as mileage-wise in the county. We’re kind of narrow, so not a one-size fits all,” said Rudy, noting Sensenig’s concerns about Mount Zion and his own concerns about the area above Interstate 81. “It’s a difficult thing to make happen when we are striving and felt we hit a home run when we got in these contracts with Life Lion. I believe we did … there’s probably only 1 or 2% of these calls that happened in these outlying areas and we’re all here trying to do the same thing: make it just a little bit better for the next victim.”

Bob Dowd, director of the Lebanon County Emergency Management Agency, said there are many rules and regulations that govern emergency response, as he explained in a LebTown feature earlier this week. He said he would be willing to give the board sample resolutions regarding potential dispatch models (such as requiring that high priority calls receive the closest ambulance and lower priority calls are “stacked”), which could be implemented without altering the contract with Life Lion.

In public comment, the board heard the following feedback (non-exhaustive list):

• Faith Seiverling described an incident in September 2021 in which her husband had a breathing problem and waited 20 minutes for an ambulance to arrive. She said blood pressure machines on the ambulance were not working at the time, and they later learned that a blood clot had traveled from his leg to his only lung, and he could have died. “After that, we found out that that was when First Aid and Safety Patrol was still being stationed up in Mount Zion Fire Company, and they were a block away from us. Why couldn’t the closest ambulance be dispatched to us?”
• Mike Noll, former Lebanon County dispatcher and Bethel resident with ALS, said if he is having a medical emergency, seconds count. “Frankly, I don’t care who’s primary, whatever. I want the closest ambulance. … If I’m having breathing problems, I need somebody there quick, because that could very well kill me.”
• Larry Minnich of Cleona Borough Council and Central Medical said the unit is cancelled while on route to calls around 40 times each month. “I think the biggest thing that concerns me is the fact that, you get dispatched and you’re partially on your way to a call, and you’re only minutes away, and you get canceled by a unit that’s much further away.” He said that in Lebanon, municipalities have a primary responder and that his issue is “when the system breaks down.”
• Gregg Smith of First Aid and Safety Patrol described the costs of EMS services, noting that a Basic Life Support unit costs $640,767.18 per year. He spoke in favor of “home rule,” saying that guaranteed projected revenue is needed to maintain operations, though he said safeguards should be in place to prevent unnecessary delays for Echo and Class One calls. He asked Dowd about response times in Lebanon compared to the rest of the state, and Dowd confirmed that Lebanon County has lower response times than many areas, some of which wait for an hour or longer.
• Barry Rhoads, 44-year EMT and retired military medic, said residents do not care about the business side of things and said some calls do not receive a dispatcher for 30 minutes or longer. He said, just this week, the township needed six or seven ambulance responses in two days, and noted that more people drive through Bethel Township than live there.
• Duane Good, Mount Zion Fire Company volunteer, said, “the biggest concern I have for township residents is when units are canceling other responding units that are closer. I think that’s more the issue that I see and has less to do with who we’re contracted with and more to do with maybe how things are being run day-to-day.”