Norton Sound proposes to take over ambulance service
Norton Sound Health Corporation is in talks with the City of Nome to take over the city’s volunteer ambulance service and bring it under the health corporation’s umbrella.
The City of Nome has provided the ambulance service staffed by volunteers and a limited number of paid EMT employees. After repeated complaints by the public that the ambulance either doesn’t show up or arrives late, the council has called for a work session on the topic and discussed last Monday. City Manager Glenn Steckman said that the expectations of the public are high. “Can the Volunteer Ambulance Department provide that?”
Steckman met with NSHC’s CEO Angie Gorn, the head of Medical Services Dr. Mark Peterson and NSHC’s attorney. “We are close to having an agreement, if the council wishes to go with the hospital,” Steckman reported. In broad strokes, the agreement would look like this: the city gives up their state-issued license to provide ambulance services – but regaining the license could be done easily via an informal request to the Dept. of Health, he said. The hospital proposes to provide a 24/7 service and the city would facilitate the dispatch services. A 911 call for help would be relayed to the hospital’s ER where a medical provider takes the call and could dispatch an ambulance immediately.
Steckman said the ambulance vehicles were bought with grants and the city needs to check with the grantors if it would be permissible to sell them to NSHC.
The hospital would accept Medicaid, Medicare and private insurance for billing. The city, under its current policy, does not bill the balance to the patient. “We’re still working on what their rates would be,” said Steckman. “If I had private insurance, and they provided $400 in reimbursement for ambulance service, and the hospital chose to bill $1,000, potentially I could be liable for that difference,” he said.
Angie Gorn attended the meeting virtually and added that NSHC started suggesting almost four years ago to become the ambulance provider. In negotiations with the Indian Health Services’ compact agreement, NSHC added ambulance services. “We now have coverage to be able to provide this service,” Gorn said. She said that NSHC would pay employees to work shifts and have two employees for each 12-hour shift. “We would have a first responder team that’s always scheduled, we would have one individual always in-house at the ER, ready to take calls. And to get the ambulance running, it’d be ideal to have both individuals right there for the entire 12- hour shift.” She said they would have a second team scheduled, mirroring their medivac services. “The benefit that we have at Norton Sound is a much greater, qualified bench of individuals that we can put on call,” she said.
Regarding the question if and how far outside of city limits the NSHC-run ambulance would respond, she said that they need to hear more about the current level of service and what is needed to mirror Nome Volunteer Ambulance Department’s current service and “that we’re covering the needs.”
As many calls involve intoxicated people needing assistance, NSHC proposes “prevention rounds” downtown. In addition to the ambulance services, NSHC would develop a prevention team in order to proactively look for people who may be down and who “we can get to sooner before an ambulance is even called,” she said.
As for pricing, Gorn said their rates would be posted. “It’s 100 percent transparency. To stay in compliance, we have that posted online. So all of our charges for all of our services are available to the public. So, it would be the same for ambulance services.”
Danielle Slingsby, a member of NVAD for 15 years, called in and questioned why the specter of NSHC taking over was always presented to her as a “threat.” “Why haven’t we gathered to have an open discussion with EMS and with the hospital to problem solve first?” she asked. Sharing her perspective as a volunteer she said, “I’ve seen the ambulance service very strong. And I’ve also seen it suffer. And it waxes and wanes based on leadership, based on volunteers, based on alcohol-related call volume, and based on staff.” She commended Jim West Jr. for stepping up and filling the role of ambulance and fire department chief, when it should be two people. She said volunteerism is down nationwide and “many locals that I’ve talked to try to encourage to join didn’t want to step up and do ambulance service because of the volume for alcohol related calls.” She outlined a lack of support. “We never had a group come in to help do an audit on the department, to help see how we can get stronger,” Slingsby said. “And these are just some examples of how a lack of support and a lack of commitment and a lack of open discussion for the department and supportive discussion with the department has made it so that there is no success. There is only limping along.” She didn’t oppose the hospital taking over the service but did raise the subject of staffing and NSHC’s reliance on out-of-town medical professionals. Dr. Mark Peterson responded to that concern saying, “Our current staff at the hospital are excited about training and having these jobs. And our expectation is to fill these jobs with our local staff who live here, work here are committed here.”
The council didn’t want to make a decision on the spot and requested more information. Another work session was scheduled for December 11.