Medics shift focus to keeping patients at home

By Lyndsie Kiebert-Carey
Reader Staff

Bonner County Emergency Medical Services Chief Jeff Lindsey obtained approval from county commissioners Sept. 21 to transfer funds from the county’s American Rescue Plan Act trust account for both the current and upcoming fiscal years. Citing increased call volumes — due mostly to coronavirus cases — heightened costs of medical supplies and a loss of revenue from current operations, as EMS attempts to keep patients at home rather than transporting them to Bonner General Hospital, it’s a dire situation.

“A lot of our revenue is based on transporting people,” Lindsey told commissioners. “With the hospitals being full, and crisis standards of care being enacted throughout the state, we are now trying to work on keeping people in their homes rather than transporting them to the hospital.”

Bonner County EMS is experiencing twice its average call volume for this time of year. Courtesy photo.

Commissioners unanimously approved Lindsey’s request to transfer $269,000 to help EMS maintain operations under the current budget, as well as $531,300 to “mitigate COVID-related calls and increased costs of their supplies” in the 2022 fiscal year. While Bonner County is slated to receive $8.8 million from the federal stimulus package, Clerk Mike Rosedale told the Reader during the budgeting process that those funds were designated for use on water and sewer projects, broadband expansion and other infrastructure not under Bonner County control. However, ARPA funds can also be used, under federal guidelines, to support EMS services during the pandemic.

Now that hospitals statewide have activated crisis standards operations, meaning that resources are prioritized for the most severe cases in overwhelmed health care facilities, local EMS is feeling the pressure to “stem the tide” of patients going to the hospital, according to Lindsey.

Bonner County EMS is currently experiencing twice its average call volume for this time of year, with 80-90% of those calls being COVID complications. To keep up with demand, Lindsey has an additional ambulance staffed at all times — a massive cost he plans to cover with the help of ARPA funds. The funds will also cover the inflated cost of medical supplies (a box of gloves increased from $2 to $8 during the pandemic), as well as UVC lights for a couple of new ambulances — a technology that uses special lights to disinfect the unit after transporting a patient — and automated CPR machines that prevent medics from having to be face-to face with highly contagious COVID-cardiac arrest patients.

The ARPA funds will also fill the financial gap as EMS loses revenue in favor of keeping patients at home, rather than transporting them to BGH. Lindsey said a recent call to treat a severely dehydrated COVID patient in Sagle is a perfect example of current EMS practices. The medic administered fluids and an anti-nausea medication, then stayed with the patient until they felt better, also encouraging them to follow up with their primary physician.

“Normally we would take that patient to the hospital, no questions asked,” Lindsey said. “But, under crisis standards of care, my medics are going to be treating you at home if possible … We’re going to make you comfortable. We are going to do basically what the hospital is going to do without taking you to the hospital and then having you discharged home.”

Lindsey said that in his 27 years as an EMS professional, he’s never felt so close to a “collapse” in the health care system. While he sees the broader issue as “politically motivated by both right and left sides,” Lindsey sees himself as “the guy in the center” as he and his crews “try to drown out all that white noise in the background.”

“I’ve got patients who need help, and we’ve got to figure out how we’re going to help these people, and I don’t care if they’ve had the vaccine or not had the vaccine, whatever,” he said. “Our job as emergency medical service providers is to get these people help, and if we can’t take them to the hospital then we have to figure out how we’re going to help them where they’re at.”

Lindsey said it is “frustrating” to hear community members calling the virus a “conspiracy” or spreading rumors that the “hospitals aren’t full.”

“Feel free — not literally — but feel free to come walk in our shoes and see what we see on a daily basis,” he said. “Same with the hospitals. Go walk in a nurse’s shoes. Go walk in a physician’s shoes. Do what they do, and stop making unsubstantiated statements like that, which isn’t helping anything.”