BUFFALO, N.Y. (WIVB) —In the City of Buffalo, about 75 percent of the Fire Department calls involve an emergency medical situation.
“You pick up the phone and call...Buffalo Fire responds and we're there,” said Thomas Barrett, president of the firefighters union, Buffalo Professional Firefighters Association.
City resident Frank Sloan knows that it’s like to be waiting for help when he was recently suffering chest pains.
“I just wanted to breathe...I was scared,” said Sloan who has a history of heart attacks.
Gloria Sierra thought she too was having a heart attack in mid-January.
Her neighbor Yamil Astacio remembers those tense moments. “We were there calming her down,” he recalled.
Buffalo firefighters are among the first on the scene of a medical emergency.
And while they're trained Emergency Medical Technicians, they can only do so much. “We don't have the equipment or the advanced life-saving capabilities that the ambulances carry,” said Barrett.
Rural Metro, the city's exclusive ambulance provider, does perform advanced life support procedures and transports patients to the hospital. “They took forever to get here,” said Sloan.
Sloan waited 14 and a half minutes for a Rural Metro ambulance crew to arrive. “That 14 minutes is a life time,” said Sloan. “It felt like a half hour.”
Gloria Sierra waited about 25 minutes for an ambulance. Her neighbor translated as she spoke in Spanish. “It was a little weird to her because every other time that she called they get here at a reasonable time.”
Both of these calls are considered life-threatening emergencies, and require an ambulance response time of 8 minutes 59 seconds or less.
They are among over 1400 similar emergency medical calls in the Queen City this year in which rural metro ambulances failed to meet the required response time, a News 4 analysis reveals.
“It's almost a daily issue where the dispatchers are telling our crews that there's no ambulance available,” said Barrett.
Fire Dispatch captures ambulance delays
During an April 20 call for a baby delivery, firefighters waited nearly 40 minutes for an ambulance to arrive.
The Fire Department audio logs tell the story:
“Engine 26 unfortunately they still do not have an ambulance available.”
Barrett says waiting for an ambulance is "extremely frustrating" for his members.
“We can do basic life support, but when somebody needs more there's not much we can do,” he said.
Rural Metro has a five-year contract with the city that also gives the company an option for two one year extensions. Since winning the Buffalo contract last August, Rural Metro merged with American Medical Response, Inc., a national provider of medical transportation.
For example, life threatening emergencies require a response time of 8 minutes 59 seconds on not less than 90 percent of all calls in any month period.
But a News 4 investigates analysis of over 73,000 calls from last year and this year shows lapses in the required response time.
An analysis of 2015 calls shows that Rural Metro response times appear to be getting worse for the most serious calls. In Jan-June, there were 1003 calls for cardiac arrest or chest pain. Of those 243 or 24 percent had response times longer than the required 8 min 59 seconds; 40 waited 15 minutes or longer.
In July-Dec, there were 1067 calls for cardiac or chest pains. Of those, 322 or 30 percent had response times longer than the required 8 min, 59 seconds; 50 waited 15 minutes or later.
Erie County dispatches all 911 calls in Buffalo to Rural Metro. The county clocks when the call is transferred, when Rural Metro takes it and other benchmarks such as arrival at the scene.
The county also provides the city’s Emergency Medical Services Board which oversees Rural Metro a monthly review of the ambulance company’s performance.
Rural Metro fails to meet its contract with the city for the most serious calls, according to the county’s review of monthly calls from November, 2015 through March, 2016.
Rural Metro hit required response times an average 77 percent for non-life threatening and only 73 percent for life threatening.
The contract which was approved by the council last August went into effect starting July 1, 2015.
Fire commissioner confirms Rural Metro not in compliance
In an interview with Fire Commissioner Whitfield, News 4 Investigates pointed out that Rural Metro was not in compliance with its contract with the city.
“That's correct,” said Whitfield. “In some categories they are and some they are not.”
“It's my understanding that some of the metrics within the contract ..the 90 percentile have not been met as of yet , since we signed this contract.”
The county reports show that Rural Metro did meet the contract for the least serious calls known as Basic Life Support Emergent on average, in just over 91 percent of the calls. The monthly response times varied from a low of 89.4 percent in February to a high of 93.9 percent in March.
The contract expects that Rural Metro responds to 90 percent of those calls in 14 minutes, 59 seconds or less. It also requires that Rural Metro file monthly and quarterly reports with the board on its response times. News 4 Investigates has filed a state Freedom of Information Act request to obtain the reports.
Whitfield late Monday sent News 4 Investigates the April report on response times which is compiled by the county and vetted with Rural Metro. Whitfield said those reports are the board's official record of response times.
The April report finds that Rural Metro continues to lag the 90 percent mark for the most serious calls. The company met the response time of 14 minutes, 59 seconds or less for 96.02 percent of the basic life support calls.
For the Advanced Life Support Non-Life Threatening, Rural Metro was in compliance 82.88 percent. The contract requires that at least 90 percent of its calls are responded to in nine minutes, 59 seconds or less.
In the Advanced Life Support Life Threatening category, Rural Metro had a compliance rate of 80.29 percent. The contract requires that at least 90 percent of the calls are responded to in eight minutes, 59 seconds.
Whitfield is the chairman of the city's emergency medical services board -- which includes ambulance oversight.
He told News 4 that the board has not fined Rural Metro.
The city's contract with rural metro includes penalty payments that range from $750 up to $25,000 depending on circumstances and the frequency of non-compliance.
Non-compliance for a month carries a $1,500 fine. A full quarter of non-compliance can result in a $7,500 fine; four quarters could result in a $10,000 fine with 30 days to correct. Failure to correct after 30 days, could mean a $25,000 fine.
When asked why not, Whitfield responded, “Because there are a number of other issues surrounding response time that the board has to consider."
Whitfield said, “One of the jobs of this EMS board is to monitor those things and that 90 percentile is in there for a reason,” said Whitfield. “It is a metric or a measurement that we would use to determine whether in fact the needs of this community are being met.
“More importantly than the fines. More importantly than anything is the level of care that's being provided to this community. And the fines are there for a reason. In times where we would deem their lack of compliance egregious, negligent and that's what the fines are for.”
Rural Metro tells board it is moving in the right direction
Recently, Whitfield appeared before a Buffalo Common Council Finance Committee meeting when some city lawmakers expressed concerns.
“I would hope that if the ambulance company is not living up to the contract that we will immediately place monetary fines on them,” said North District Council Member Joseph Golombek, Jr.
Added Fillmore District Council Member David Franczyk: “We have to be on top of this because we don't want any backsliding. I mean I think we're in the right direction.”
Former Regional Director Jay Smith put it like this during a city EMS board meeting in April. (Smith confirmed Saturday that he left the company this week. “It was my suggestion that we mutually agree to separate. I was not forced out by any means.”)
“We know we're moving in the right direction. We're confident in that,” Smith told the board.
News 4 Investigates wanted to know exactly how the company plans to improve response times in the city. But numerous requests for a sit-down interview with Rural Metro officials were declined.
Instead, they sent a statement:
*In one of the three areas of response times, we are exceeding our goals.
*We are taking aggressive actions and nearing full compliance.
Rural metro goes on to state that it has made significant investments in Buffalo:
*Purchasing 25 new ambulances, increasing our fleet from 48 to 70 ambulances;
*Hiring new EMTs and paramedics
*Investing in new equipment
*Implementing two new technologies to improve communication and response times.
After the meeting News 4 talked to Lovejoy Council Member Richard Fontana, the finance committee chair : “We want to make sure that this is actually working per the contract. If it's a growing pain...really shouldn't be because they've already expanded into the City of Buffalo for all these years. They've been working in the City of Buffalo. We haven't gotten any bigger.”
Pastor James Giles of Back to Basics Outreach Ministry serves on the city's EMS board as a community representative.
Giles said he was confident that Rural Metro will improve response times.
“We're confident that that's going to happen. We have a very good relationship with them. They've been open. It's not like we had to kind of dig in, go out and investigate, investigate the investigators. No they've been open and kind of fair in terms of expressing to us where the defects are.
“We're looking at the numbers ourselves,” Giles added. “We have the same concerns that the residents.”
Giles added: “I certainly represent not just the City of Buffalo. I represent the residents of the City of Buffalo that utilize this service that depend upon that service.”
Fixing those defects can't happen soon enough for city firefighters who often find themselves waiting, as the Fire Department dispatch captured on April 20:
“Engine 26 has been waiting for an ambulance for a while.”
“Engine 26 unfortunately they still do not have an ambulance available.”
"We would like to see better monitoring from the ambulance board and the commissioner's office,” said Barrett, the firefighters union president. “We'd like to know what are the peak times and are they actually following through, and what's going to be done if they're not.”
Commissioner Whitfield promises ambulance response times will get better.
He's hoping to add a medical director to the fire department to help with oversight.
Whitfield said the medical director will help Rural Metro meet response times.
“This position will also include being a compliance officer for the EMS board in terms of monitoring this contract,” Whitfield said.
“There's going to be eyes on monitoring 24/7 monitoring of Rural Metro's responses, being able to vet the issues surrounding those things and having a full fledged medical doctor at the table representing the Buffalo Fire Department and the City of Buffalo on all these measures, something we've never had before and I'm very , very excited about what that brings to the table.”
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