My View

'Transparency and accountability are fundamental'

By MATTHEW CONTRERAS AND BOB ROCHE   
Posted 5/16/23

WE SUPPORT OUR LOCAL FIRE AND EMS SERVICE. 

We have family who are police, fire and EMS personnel. Our statements regarding emergency medical services are being misrepresented by …

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My View

'Transparency and accountability are fundamental'

Posted

Editor's note: This My View has been altered slightly as of Friday, May 2, to reflect changes made for the June 1 edition of the print paper.

WE SUPPORT OUR LOCAL FIRE AND EMS SERVICE. 

We have family who are police, fire and EMS personnel. Our statements regarding emergency medical services are being misrepresented by Osterberg/Schmalzle and their supporters in this primary election. We have nothing but the utmost respect for EMS personnel and all first responders, including firefighters, police officers and our 911 dispatchers.  

The EMS untruth that Osterberg/Schmalzle continue to tell is that we will remove funding and eliminate progress. We will not. The truth is, that the EMS crisis our opponents endlessly claim to have miraculously saved, is a crisis of their own making. Failed leadership and the lack of foresight, coordination, and planning, are the reason emergency services were and still are in jeopardy.

Winter storm Riley of 2018 and Covid-19 highlighted the lack of communication and coordination in the county regarding EMS and emergency management. However, these issues have long plagued the county and townships. Osterberg/Schmalzle, like many before them, chose to “kick the can” down the road. This was unacceptable then and remains so today.  

Also, the matching funding that is currently being provided is a band-aid on a large festering wound. The available money is finite. It is from a pool of Covid relief funds that will run out, sooner rather than later. And when that money is exhausted, the county and the townships will face the prospect of raising taxes on constituents ONCE AGAIN, likely in difficult financial times for all citizens. We believe there is a better way. 

The archaic ways and thought processes of running rural county government MUST give way to new, fresh, innovative ideas to preserve essential services and fiscal responsibility. For too long politicians have forgotten that it IS NOT, their money, they are spending, it is OUR MONEY. We believe that millions of dollars per year without any strings attached is not fiscally responsible. Money should be tied to response times, clinical, patient-outcome standards, crew staffing, or equipment standards.  ALS services should be available to all residents of Pike County, not just a select few municipalities.  

We are grateful that Osterberg/Schmalzle finally took the initiative to begin proper funding of our local EMS system. It is a step in the right direction, and contrary to what our opponents have said, we have no intention of reducing the funding for EMS, or any other emergency service entity supported by the County. However, transparency and accountability are fundamental. Funding for the comprehensive EMS system would be streamlined by appropriate coordination and effective leadership. 

Additionally, we should all recall that Pike County did have comprehensive ALS service provided by Atlantic Health System during Mr. Osterberg’s tenure. Unfortunately, under his failed leadership, the county lost both comprehensive ALS service and the Urgent Care facility they provided. We are glad that Matt Osterberg is finally taking steps to correct the problems that he has allowed to metastasize. Let’s not forget he has been in office for 37 years and has been aware of the vulnerabilities the County has faced with each passing election cycle. Remember, Atlantic Health had stations in Milford Boro, Blooming Grove Township, and Palmyra Township that provided the County with comprehensive service. They left under his watch. 

We have done much research on local and national issues involving EMS. We have met with local EMS personnel and read countless peer-reviewed articles. We firmly believe several issues need to be corrected.  

We would have used the two million dollars in “seed” funding that the commissioners dedicated to a “hospital”, to be spent on EMS/ALS services. Two million dollars may not even cover the salaries of a small hospital for a month, but it could make a world of difference in our EMS system for years to come. A hospital in Western Pike County will not benefit the residents of Eastern Pike County, who are served by many other hospitals, including one that is only 1.5 miles away from the Pike County border. All of the surrounding hospitals require volume to sustain them. A government-funded hospital in Pike County will only harm the hospitals which already serve our community. We do not want to see unnecessary harm done to any of our existing hospitals. Especially those that are trauma centers, stroke centers, or cardiac centers, and must maintain certain thresholds to continue their accreditations. 

Without the “election cycle” hospital Osterberg/Schmalzle continue to exaggerate about, the provision of advanced life support services is even more critical. Basic life support with a tiered ALS response can be used as an important adjunctive measure while transporting a patient to a hospital. Advanced life support (ALS) can start IVs, administer dozens of medications, perform ECG monitoring, manual defibrillation, cardiac pacing, and advanced airway management procedures, including cricothyrotomy and endotracheal intubation. ALS ambulances are sometimes referred to as mobile intensive care units because of their advanced abilities. We currently have a lack of ALS resources in the County and we intend to correct it.  

Identified issues in the county’s Assessment of Emergency Medical Services report in 2018 highlight the issues of ambulances taking the brunt of mental illness and intoxicated person calls, instead of law enforcement and mental health workers. Nothing has been done to correct this issue. We should explore alternative response models including the use of alternative transportation like the County’s transportation department, patient referrals, and alternative treatment pathways. We should work with law enforcement, mental health workers, crisis teams, and local hospitals to address this problem. We believe we can “walk and chew gum” at the same time.  

We believe the closest and most appropriate EMS unit should assist someone when they dial 911. This includes the use of AVLs (automatic vehicle locators) which are low-cost tracking devices that several counties around us utilize and have for decades. These devices also help keep EMS providers safe by ensuring the unit's location is monitored 24/7 by trained staff at the 911 center.  

The current commissioners like to tout the reduction in average EMS response times, which are only important for a small percentage of emergency incidents such as cardiac and severe trauma respiratory emergencies. We should strive to continue to reduce the response times for these incidents. However, average response times for all incidents is an old metric and not one based on clinical outcomes. Response times for someone with a stubbed toe, or tooth pain, aren’t important. Response times for someone with a life-threatening emergency are important. Our plan would further reduce response times through the use of better technology and coordination, resulting in better patient outcomes for critical illness.  

Further, there is no coordination of the EMS system in the County and unfortunately, many EMS services in the County do not meet the requirements under the Department of Health Regulations in conjunction with Pennsylvania’s EMS Act, because they do not provide 24/7 coverage to their residents. Many ambulance services simply do not provide service during nighttime hours. This may be alright, as long as there is a state-approved plan in place to ensure the residents of Pike County have access to an ambulance both day and night. The Pennsylvania Bureau of EMS does permit EMS agencies to not provide 24/7 coverage as long as they participate in a “county-level or broader EMS response plan approved by the Department (of Health)”. NO SUCH PLAN EXISTS IN PIKE COUNTY. Osterberg/Schmalzle have allocated resources with no plan in place. No plan means no accountability and no appropriate oversight OF YOUR MONEY. Coordination and leadership are free.  

Finally, emergency services shouldn’t be political. Sadly Osterberg/Schmalzle have made it so. Our police, fire, and emergency services personnel are selfless, and too often, unappreciated. We should not parade around, for political purposes during election cycles, our tireless working Fire/EMS personnel. It is self-aggrandizing and inappropriate.

When government officials dismiss differing views based on ego and old ways of governance, the public interest is not served. The fundamental role of government is security and protection. We can and should have adult conversations about how to improve government services without ruling the county like a feudal kingdom. We believe in a collaborative community discussion. Team Roche/Contreras plan to do just that. We hope you allow us the opportunity. 

Matthew Contreras and Bob Roche live in Pike County, PA.                                                          

Matthew Contreras, Bob Roche, EMS, Pike County, elections

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