IU Health Lifeline works to improve EMS delivery advocating one dispatch center in Lawrence County

LAWRENCE CO. – IU Health Lifeline notified the Lawrence County 911 board that they will discontinue their 911 dispatch operations at their Bedford location beginning on October 1, 2021.

According to an IU Health spokesperson, “IU Health’s intent is to hold to the Friday, October 1st deadline.”

IU Health Lifeline has released a letter given to the Lawrence County 911 board which is advocating for the improvement of 911 services in keeping track of available ambulances in Lawrence County.

A copy of the letter is listed below:

Guiding Principles for Lawrence County 911 Dispatch Operations

1) Inform: IU Health will discontinue EMS dispatch operations at IU Health Bedford effective October 1st, 2021
2) Inform: IU Health LifeLine has experienced operational efficiency in statewide operations when partnering with communities that offer a unified EMS dispatch center
a. Unified radio communications (singular channel/ center to monitor for new requests and communicate with regarding the status of operations)
b. Unified asset tracking and global awareness of in-service and out-of-service ambulances
c. Single requestor regarding out of county mutual-aid response
d. Mobile data terminal (MDT) implementation to reduce radio traffic and promote real-time awareness

3) IU Health LifeLine would request that the closest appropriate ambulance (to include an appropriate level of care: Advanced Life Support/ALS versus Basic Life Support/BLS) be dispatched on all 911 requests in the City of Bedford and Lawrence County
4) IU Health LifeLine would request that all ambulances supporting 911 operations in Lawrence County be required to clearly communicate when “in” or “out” of service to the unified public safety access point referenced above
a. Ambulances should be mandated to communicate when out of service for 911 operations due to any of the following criteria:
i. Interfacility transports
ii. Out of service for staffing, mechanical, or any additional criteria that would result in the associated ambulance being unavailable to respond to 911 requests
5) IU Health LifeLine would request that all ambulances supporting 911 operations in Lawrence County follows industry-standard naming conventions:
a. “Medic” denotes an Advanced Life Support (ALS) ambulance- paramedic staffing on unit
b. “Ambulance” denotes a Basic Life Support (BLS) ambulance- no paramedic staffing on unit

6) IU Health LifeLine would request that all incidents involving an ambulance out of service for more than 6 hours be reported and reviewed at the monthly 911 board to promote transparency and collect information to aid in improving ambulance coverage within Lawrence County

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Lawrence County currently has three dispatch centers, which serve two private ambulance companies which include IU Health Lifeline and Seals Ambulance also known as Priority Ambulance Service. The three emergency dispatch centers include Lawrence County Central Dispatch, Bedford Police Department 911 Dispatch, and IU Lifeline Ambulance Service which operates out of IU Health Bedford Hospital.

There will be five IU Health employees which will be affected by the changes, three of which are also switchboard operators for the hospital.

“Unified radio communications on a singular channel/center to monitor for new requests and communicate with regarding the status of operations is important. At the present time the 911 system in Lawrence County is too fragmented, ” said Cory Hall Statewide Director of IU Health Lifeline.

The use of a mobile data terminal implementation will also help reduce radio traffic and promote real-time awareness of where all the ambulances are located within the county.

IU Health Lifeline Ambulance in Lawrence County operates out of one location in the City of Bedford, located on Clinic Drive. Seals Ambulance Service operates out of two locations which include the Mitchell Volunteer Fire Department on Doc Hamilton Boulevard and Oolitic Volunteer Fire Department located on Hoosier Avenue.

Calls for ambulances in the City of Bedford are first answered by the Bedford 911 dispatch center and then transferred to the IU Health Lifeline dispatch center to dispatch an ambulance. Following the closing of the ambulance dispatch, emergency calls will be handled by the local 911 dispatch center, and inter-facility transfer calls will be handled out of the Indianapolis dispatch office, according to Hall.

Calls for ambulances in Lawrence County are transferred based on the location of the call, and availability of an ambulance. Should ambulance service not be available in Lawrence County, IU Health Lifeline dispatchers would contact surrounding counties for ambulance coverage.

Following October 1st the plan is to have one dispatch center coordinate needed commuication to counties for ambulance coverage.

IU Health Lifeline operates two ambulances and one supervisor vehicle to respond to emergency calls, and Seals Ambulance service operates two ambulances within Lawrence County. On many occasions, both ambulance companies are out of service executing inter-facility transfers between IU Health Bedford Hospital, and St. Vincent Ascension Hospital to other hospitals located as far away as Indianapolis or Lousiville, Kentucky.

Due to the inter-facility transfers, this leaves the county without an available ambulance which requires other counties to provide 911 ambulance coverage to Lawrence County. According to Hall having one communication center would allow one dispatcher to request mutual aid.

The lack of ambulance coverage in Lawrence County has been a major concern since 2020.

During a Lawrence County 911 meeting in 2020, it was noted there was an increase in cases where ambulance services were not available to respond to calls.

  • On one specific day both hospitals had up to 6 patients that needed to be transferred. However, no ambulance was available. These included a head bleed and several vented patients.
  • Chest pain patients near Spring Mill State Park had to have Orange County Ambulance cover the call.
  • Two emergency medical calls within the City of Bedford took more than 20 to 30 minutes for an out of county ambulance to arrive.

During that meeting, concerns have been addressed by the Lawrence County 911 Board through Kelly Mullis at the IU Health Ambulance Service. Both Kelly Mullis and Chris Jesse of IU Health have fielded numerous calls and questions about what IU Health Ambulance Service is doing to add coverage. Mullis says they are open to working with county officials to add additional coverage for the area.

In asking whether IU Health Lifeline presently will seek to provide an additional ambulance or services for Lawrence County, Hall responded by saying the EMS delivery system for the South Central Region is under review.

“The 911 is the first step in improving the delivery of service to Lawrence County,” said Hall.

However, with the COVID-19 pandemic, both ambulance services have been stretched thin and are dealing with a larger call volume.

In neighboring counties, Monroe County has purchased two ambulances for IU Health Bloomington during a 12 year period. In return, the county asked that they not be charged for transporting inmates from the Monroe County Jail.

Orange County Commissioners in 2020 signed a two-year contract with the Orange County Ambulance service to provide coverage. However, neighboring counties are covering their calls to handle shortages of ambulances available. Orange County pays approximately $260,000 with IU Health Lifeline.

Jackson County is a county-operated ambulance service whose budget is around $2 million.

Greene County is a county-operated ambulance service. In 2019, Greene County Commissioners were in discussions about discontinuing the county ran ambulance but decided to keep it in operation. The Linton Fire Department also provides an ambulance service, and the Center-Jackson Territory recently began a Basic-Life Support Ambulance service on an as-needed basis for Greene County.

Martin County contracts out ambulance services to private companies for their county with no local hospital affiliation. The contract is bid on whenever each contract expires at each term. Their contract only calls for one ambulance to provide paramedic service and one backup ambulance. The contract is about $250,000.

Brown County who is now covered by IU Health Lifeline has a contract for $500,000 to provide 911 ambulance coverage.

The issue was raised in 2020 during a 911 Board meeting. Currently the Lawrence County 911 Board and Lawrence County Commissioners have not created a short or long-term plan at this time to deal with the county emergency medical dispatch and ambulance coverage.

“If there is no ambulance available within the City of Bedford, we will have either the Bedford Police Department or Bedford Fire Department respond to the emergency until medical assistance arrives,” said Bedford Mayor Sam Craig.

Officials say Bedford, Mitchell and Oolitic police and fire departments, as well as all the county volunteer fire departments and the Lawrence County Sheriff Departments, have medically trained personnel to handle medical emergencies.

IU Health Lifeline provides medical guidance/instructions to all fire departments in Monroe County, six in Lawrence County, and all Orange County that are certified to provide basic Life Support (first response) non-transport services.

The IU Health South Central Region (SCR) Emergency Medical Services team integrated with Indiana University Health LifeLine on July 1, 2020. The integration made Indiana University Health Lifeline the largest provider in the state and one of the most comprehensive EMS programs in the nation.

The IU Health South Central Region serves Monroe, Orange, and Lawrence County. IU Health Lifeline has six critical care bases, five helicopters, and provides 911 EMS services, advanced life support, and basic life support in more than seven counties in the State of Indiana.

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