Mayor questions no-charge medical services

Wednesday, January 14, 2004

Cape Girardeau's firefighters handle far more medical emergencies than fires, rushing to the scene in pumper trucks even when there's no blaze to extinguish. The city's firemen used to be just that. Now, more often than not, they're responding to medical emergencies at a time when finding the money to keep the fire trucks running is a major concern.

Mayor Jay Knudtson said he has heard repeatedly from residents who question whether it's cost effective for the financially strapped city to send pumper trucks to every medical emergency.

He used the recent example of firefighters responding to city hall to assist a woman who had fallen but wasn't seriously injured.

The fire department provides medical care for free in contrast to Cape County Private Ambulance Service, which charges for its services. The fire department doesn't routinely respond to medical emergencies at health-care facilities or nursing homes because they have trained medical personnel on staff at such places, city officials said.

Knudtson said he's not advocating eliminating the first-responder program. But he said the city might have to start looking at charging for the service.

That might eliminate calls for minor emergencies, the mayor said, while adding, "I am not in any way asking people to compromise safety."

Cape Girardeau firefighters responded to 1,375 medical emergencies last year. All other calls, including fires, totaled 1,333. In 2002, 62 percent of the 2,753 fire calls were for medical emergencies and rescues.

Mark Hasheider, interim fire chief, said fire departments historically haven't charged fees for emergency medical service.

He said the public might consider it "double billing" for the ambulance service and the fire department both to charge fees for the same service.

Hasheider said handling medical emergencies hasn't been a drain on the fire department, which operates on a $3.4 million annual budget.

Personnel costs make up the bulk of the department's expenses. Those expenses would exist whether firefighters are in the station houses or responding to medical emergencies or fighting fires, he said.

Hasheider said the city can't afford to buy smaller vehicles just for emergency medical runs. And if the city had such vehicles, it would require more manpower because the department would have to assign firefighters to man them while also having crews to man the fire engines, he said.

"It is not economically feasible."

The first-responder system is a good investment for the city because it saves lives, the interim chief said.

The city's firefighters almost always are first on the scene -- in 4.5 minutes on average -- and first to dispense medical care, Hasheider said. Firefighters typically arrive before the ambulance service paramedics and emergency medical technicians, he said.

"With four stations, we have the operating ability to respond much quicker."

Cape County Private Ambulance Service operates out of its headquarters at 1458 N. Kingshighway and responds to medical emergencies throughout the county. It has a fleet of seven ambulances and staffs four ambulances daily, including one in Jackson.

While firefighters trained as emergency medical technicians and paramedics will treat the sick and injured, they won't take people to the hospitals. That's left up to the private ambulance service, which has been in operation since 1968.

Hasheider said the first-responder program, which began on May 21, 1993, has helped save lives. The program had been scheduled to start in July of that year, but city officials moved up the start date in response to a deadly accident earlier in the year, Hasheider said.

A Southeast Missouri State University student fell through a plate glass window at a house on Ellis Street and bled to death only a few blocks from a fire station. Firefighters might have been able to save the man's life, Hasheider said.

He estimates firefighters have responded to 15,000 medical emergencies in the last 10 years. "There definitely is a need," he said.

Bill Lamberson, 38, of Cape Girardeau said he owes his life to quick-acting firefighters.

On Sept. 18 last year, Lamberson's right hand went through the glass of a door at this home at Ellis and Independence. He severed a major artery. Badly bleeding, Lamberson walked 100 yards to Cape Girardeau Fire Station No. 1.

"By the time I got over there, I had lost five pints of blood," Lamberson said. "Everything went black. I went unconscious."

Two firefighters who had been standing in the station bay gave him IVs. Lamberson said he would have been dead before the ambulance arrived if it weren't for the actions of the firemen.

He was taken by ambulance to Southeast Missouri Hospital where he received 300 stitches.

While the City Council considers ways to cut city government expenses, Lamberson said he hopes the city doesn't cut back on police and fire department spending.

"The first priority ought to be the fire department and the police department," he said.

mbliss@semissourian.com

335-6611, extension 123

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