Alle-Kiski Valley ambulance companies struggle to keep up with call volume, community need
Share this post:
The patient was cold and shaking, so the paramedic clutched her hands in his, warming them as they rode in an ambulance to Forbes Hospital in Monroeville.
Her hands were limp and icy. She had just suffered a stroke.
Hayden Geisweidt loves being a paramedic. He enjoys taking care of patients, rescuing them, making them feel safe during a bumpy ambulance ride.
But even as he sat with the stroke patient, he was listening to more calls flood the scanner.
Pretty soon, every truck in the Alle-Kiski Valley was out.
There weren’t enough ambulances to respond to all the calls.
“It’s definitely a delicate EMS structure here, for sure,” said Geisweidt, who works at Vandergrift/Oklahoma Borough EMS. “It keeps us busy, and it keeps the entire region busy.”
In the past 10 years, the number of emergency medical technicians in Pennsylvania dropped by 16%, from more than 34,000 to just over 29,000, according to the state Department of Health. Paramedics have fared even worse. In 2009, Pennsylvania had nearly 12,000 of them. Last year, there were just under 6,700, a drop of 44%.
The dwindling workforce puts a greater burden on the state’s emergency medical services. Understaffed companies are covering several municipalities at once and often venturing outside their coverage areas to respond to incidents, leading to longer response times.
Last year, the Vandergrift/Oklahoma EMS, already stretched thin, received 3,034 calls for service — 438 of which were outside its coverage area, Chief Jim Caporali said. As a result, the truck’s response time could be pushed upwards of 22 minutes, creating potentially dangerous scenarios for patients in need.
Operating with a shoestring budget and skeleton crews, many companies — including several in Western Pennsylvania — have no choice but to consolidate or shut down altogether.
In the Alle-Kiski Valley alone, EMS agencies for Springdale, Avonmore, Arnold and East Deer have shut down in recent years. Statewide, 220 agencies closed between 2009 and 2019.
“In three years, we may not have a service,” Caporali said.
Shrinking benefits, shrinking pay, shrinking staff
After transporting the stroke victim, Geisweidt and his partner responded to an incident in Murrysville, because all three crews belonging to Murrysville Medic One were already responding elsewhere.
Vandergrift and Oklahoma Borough, about 15 miles away, were left unattended for hours.
“We’re always in each other’s territory,” Geisweidt said.
[gps-image name=”2354125_web1_VND-Ambulance2-022020.jpg”]
This happens every day, Caporali said. It’s like dominoes falling, one after another. There just isn’t enough manpower to cover the region’s call volume.
For Geisweidt and other EMS employees, the workload can be draining, especially considering the meager wages. Several area ambulance chiefs say EMS employees in Pennsylvania earn a wage that isn’t commensurate with skill or experience.
The cost of taking an EMT course can be up to $1,000, but wages only hit $13 to $15 an hour.
“Why not spend a couple extra dollars and become a nurse?” said Gary Cockroft, chief of the Lower Kiski EMS.
Addie Birch, chief of New Kensington EMS, said the quality of work now expected of EMS workers has also skyrocketed.
They’re putting tubes into lungs, drilling into bones, administering medication, all while in a moving ambulance. On certain high-risk calls, Birch said, EMTs and paramedics have to wear bulletproof vests. Sometimes, patients physically attack them.
And yet, they could make more money working at the local Sheetz, he said.
“We cannot pay EMTs what they’re worth,” Birch said. “It’s a completely different world from when I started.”
Birch said only two of his 35 employees work there full time. At Lower Kiski EMS, with around 10 full-time employees, Cockroft said he is lucky if he’s able to scrape together two full crews. At least three of Cockroft’s employees won’t even be around much longer.
They’re headed to nursing school.
The shrinking workforce, along with budget constraints, has brought on downsizing. Lower Kiski used to have four ambulances, said Cockroft, but now there’s only three.
Most of the region’s EMS workers work concurrently at different agencies, just to make ends meet. Cockroft and Birch share many employees.
“We’ve all come to the conclusion that we have to work together or we’re not going to survive,” Cockroft said.
Geisweidt had once balanced his time working at multiple agencies in the Alle-Kiski Valley, but he decided to scale back so he could return to school. He is next for a career change.
Even though he loves the work, Geisweidt doesn’t know how much longer he can maintain the momentum. Working overtime is a financial necessity, Geisweidt said. The job takes over your life. Relationships are impossible to maintain.
“I love what I do, but it’s hard to make a living,” Geisweidt said. “I don’t want to go back to working two to three jobs, because what kind of living is that?”
[gps-image name=”2354125_web1_VND-Ambulance4-022020.jpg”]
The waiting
The call came in at 6 a.m. Jim Dunmire remembers glancing over at the clock as he slowly came out of sleep. He answered.
Through the receiver, he heard the voice of his brother-in-law, Richard Young. He was talking fast, panicked, saying “I need your help,” again and again.
Young had been awakened early in the morning to learn that his grandson, Zecchariah, wasn’t breathing. The child was only a month old.
Already out of bed and gathering his things, Dunmire, a Vandergrift resident, asked if the parents had called 911. They had. He climbed into his truck and sped into the December night. He remembers his heart sinking when he rounded the bend to his nephew’s house. There was no one there.
No police lights.
No ambulance.
Dunmire bounded up two flights of steps in the house where the parents met him. He began CPR immediately, still perched on the staircase.
Vandergrift/Oklahoma EMS arrived moments later, eight minutes after receiving the 911 call, a fast response time considering the ambulance headquarters was located nearly three miles away in Oklahoma.
The EMTs administered more CPR for about five minutes, before loading the infant into the ambulance and speeding off to the hospital.
Zecchariah died that morning, Dec. 9.
“Instead of us planning for his first Christmas, we had to plan his funeral,” Dunmire said.
Dunmire doesn’t blame the ambulance agency for those eight, long minutes. After Zecchariah’s death, he hopped back into his truck and drove the route himself, and it took him the same amount of time to get from the ambulance base to his nephew’s house.
But he wonders if his nephew’s fate would have been different if the company had been based in Vandergrift, as it once was, instead of in Oklahoma Borough.
He brought the issue to a Vandergrift Council meeting in January, pleading with council members to search for a solution — funding, educational outreach, anything.
“They need help,” he said at the meeting.
The council members listened to Dunmire’s speech, but nothing was resolved.
Caporali said it’s unlikely a faster response time could have saved the infant.
But for Dunmire, it is another unknown factor that might have made the difference. The family still does not know the official cause of death.
“The waiting and waiting is terrible,” he said.
In search of solutions
Darrick Gerano, chief of Murrysville Medic One, fears no one is listening. As president of the EMS Council of Westmoreland County, he’s been warning community members about the impending crisis for years. At meetings with board members and local elected officials, he pleaded for more state or county funding and oversight.
Everyone who heard him was concerned, Gerano said.
But as soon as the meeting is over and the lights go out, that’s the last of it.
[gps-image name=”2354125_web1_VND-Ambulance3-022020.jpg”]
EMS chiefs in the Alle-Kiski Valley agree: Funding is the most immediate need.
Small town agencies largely rely on membership fees, insurance fees and donations.
Most agencies in the Alle-Kiski Valley receive no funding from the municipalities they serve. Some send out annual subscription forms to community members, asking residents to donate a small fee to support services, but the response is dismal — less than 30% in New Kensington, for instance.
And with soaring deductibles, the agencies have stopped expecting patients to respond when they’re billed after an incident. Vandergrift/Oklahoma EMS has about $173,000 in outstanding debt from 2019 patients.
“No matter how much we send a bill for, that’s not the amount we get,” Caporali said.
Most smaller agencies don’t even have the funds to pay for state-mandated improvements, like the recent requirement that each ambulance come equipped with new, $40,000 cardiac monitors.
Consolidating does not bring the costs down. The agencies still have the same expenses, the same call volume and the same staff.
The only difference is that service and care is delayed.
If something doesn’t change soon, Caporali doesn’t know how the region’s ambulance services can survive.
“If the general public understood what we have to go through every day,” he said, “They would be very alarmed.”