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Local Volunteers See Threat From For-Profit Ambulance Service

(with photo)

BY STEVE BIGHAM

With a total of 51 dedicated members, the Newtown Volunteer Ambulance Corps

appears stronger than ever. Despite having to respond to a record high number

of calls this past year, the corps continues to respond to virtually every

call in a matter of minutes.

Despite its success and reputation for top-flight service, this non-profit

organization says it is faced with a continuing threat to its existence. A

for-profit ambulance service would stand to make a lot of money responding to

calls in Newtown, members say, billing patients about $450 per call.

Danbury Hospital has its own for-profit ambulance service known as Danbury

Ambulance, which provides both medic, emergency medical care and transport

service. Danbury Ambulance recently received a boost when the hospital's

director of emergency services, Dr George Terranova, gave it authorization to

transport patients when arriving on the scene in Newtown before the local

volunteer service. The idea, according to Dr Terranova, was to provide the

medic with an option to take the patient to the hospital if the ambulance

corps is late in arriving. However, in the eyes of local EMTs, it is an

attempt to undermine the local volunteer service.

"What would happen is [Danbury Ambulance] could stage in an area so that it

would be almost impossible for the volunteer ambulance to get on scene before

them," explained Newtown corps chief John Basso. "Newtown would dispatch them

for a medic, but they would respond with the ambulance."

Newtown currently uses Danbury Hospital's medic service at a cost of more than

$100,000 annually. Newtown, Bethel and Redding are in the middle of renewing

their contract with Danbury Ambulance, and have included a stipulation that

would prevent the medics from responding in transport vehicles.

Dr Terranova, chairman of Danbury Hospital's department of emergency medicine,

defended his decision to allow competing ambulances in Newtown.

"They felt it was an attempt on my part to destroy the volunteer system," the

doctor said Wednesday. "Frankly, I understand where they are coming from, but

I argued that they were wrong. My only concern is for the patient."

Conflict Of Interest?

But there are others who feel Danbury Hospital's interests may go beyond just

the patient. First Selectman Herb Rosenthal has played a key role in the

contract negotiations for medic service in Newtown. He too is concerned about

the well-being of the ambulance corps and fears there may be a conflict of

interest at Danbury Hospital.

There are two sides to Danbury Hospital. First, there is the medical staff

which represents the non-profit side of the hospital. Then there is the group

known as Business Systems, Inc (BSI), which represents the for-profit side.

BSI also manages Danbury Ambulance.

"I don't know whether there is a conflict of interest or not, but over time,

I've come to share some of the concerns that the non-profit part of the

hospital does things to promote the profit side," Mr Rosenthal said. "I don't

have proof, but there is certainly circumstantial evidence to support

something to that effect."

Dr Terranova has made several decisions that many say have undermined the

volunteer ambulance services in not only Newtown, but in other towns as well.

They are decisions that have led some to question the motivation of those

running Danbury's only hospital.

For example, Danbury Hospital no longer reimburses volunteer ambulance corps

for supplies used. "What that means to Newtown Ambulance is an additional

$15,000 to $20,000 per year in costs," Mr Basso said. "It takes a block out of

the foundation of volunteerism. It weakens us financially. It takes its toll

on the volunteer system."

But hospital officials claim they were ordered by the state attorney general's

office to stop the reimbursements. They point to an anti-kick-back provision

designed to prevent hospitals from enticing ambulance services to use their

hospital over its nearest competition.

Also, according to Dr Terranova, it is now against Medicare regulations for

hospitals to charge patients for supplies and equipment used outside hospital

doors.

In Bethel, Dr Terranova threatened to pull the Bethel Volunteer Fire

Department's "medical control" certification due to what were considered

"operational issues" not pertaining to patient care. In short, according to

Bethel department chief Dan Spanella, Danbury Hospital is looking to create

more and more paperwork for the volunteer companies. Mr Spanella called the

arrangement between the hospital and Danbury Ambulance "questionable at best."

"If the hospital continues to work against us, we're not going to be around

much longer. The only ones that will suffer are the patients, especially the

elderly," Mr Spanella said.

Unlike Newtown, Bethel and Redding, where the medic service is paid for

through taxes, Brookfield and New Fairfield residents pay for medic service

through a user fee. Even though those towns have volunteer ambulance service,

residents still get charged because of the paramedic's involvement.

"Some elderly people in those towns are afraid to call the ambulance because

they can't afford to pay the transport bill," Mr Spanella said.

With the Newtown Ambulance Corps responding to more calls than that of any

other town in the area except Danbury, Newtown could be considered a lucrative

market -- an untapped resource just waiting to be exploited.

That is not the case, Dr Terranova says.

"We have no intention of putting the volunteers out of business. They're the

backbone of the system," the doctor said. "This is not a conspiracy on the

part of the hospitals. We want to work cooperatively with ambulance services.

We depend on them."

Dr Terranova said Danbury Ambulance runs numerous programs each year to

benefit the volunteer ambulance groups. He said the most recent allegations

force him to shake his head.

Fairfield Hills & Garner

Since 1993, Danbury Ambulance has held the Primary Service Area (PSA) license

to respond to all calls at Garner Correctional Facility and Fairfield Hills.

However, in an effort to provide the best coverage for 100 percent of Newtown,

the volunteer ambulance corps is looking to get back its license for this

area. Not surprisingly, however, Danbury Ambulance is fighting this, despite

having to respond to calls all the way from Danbury.

It recently took Danbury Ambulance 59 minutes to response to a call at Garner.

Newtown responded to calls over the first six months of this year in 7.1

minutes.

Mr Basso wonders what would happen if a child was injured on the playing

fields at Fairfield Hills. Only Danbury Ambulance would respond, and that may

take a while. The parents can also expect a bill to arrive in the mail. The

situation is the same for those town employees who work at Canaan House at

Fairfield Hills. Any 911 calls from that area must be forwarded to Danbury

Ambulance.

"We are trying to gain this back to protect the people. Our only goal is to

ensure that Newtown residents get an ambulance in a timely manner," Mr Basso

said. "If George Terranova was truly out for the best patient care, he would

endorse us for [the Fairfield Hills] PSA."

Dr Terranova said he would be happy to support the Newtown corps in this

endeavor, but the support will be based on Mr Basso putting together a

credible program. The doctor believes it can be done, too.

"Newtown is one of the best corps in this region. I think they do an

outstanding job of organizing and quality assurance," he said. "A lot of my

concerns over response times have very little to do with Newtown. Their

response times are excellent."

But Mr Basso wonders if that endorsement will ever come. After all, he said,

Danbury Ambulance is an outfit that Dr Terranova manages.