In the latest blow to Virginia's emergency medical services, the state has announced they will no longer provide an essential software system to local agencies. The news comes alongside more details about the state's investigation into mismanagement and corruption at the Office of EMS. WMRA's Randi B. Hagi reports.
It's been more than a year since the Virginia Department of Health launched an internal audit of the Office of Emergency Medical Services, or OEMS – the state agency that oversees and is meant to provide education and funding opportunities to local rescue squads and fire departments. Since then, the former associate director, Adam Lamar Harrell, has pled guilty to embezzling more than $4 million from the agency. He faces up to 20 years in prison and is scheduled to be sentenced next month.
The audit turned up even more "financial discrepancies" – a total of $33 million that was spent improperly. As the state tracked down the extent of the damage, OEMS suspended several programs that local agencies relied on – including grants for cardiac monitors and ambulances, scholarships for paramedic training, and an annual symposium that fulfilled first responders' continuing education requirements.
The latest item on the chopping block is a software system that tracks patient care information. Local EMS agencies are legally required to have one, and the state has provided one for more than a decade. But first responders found out last month that OEMS is cutting that service as of next July. And a deeper look into the audit report reveals that this program is tangled up with a lot of the misspent state funds.
MATTHEW TOBIA: Every time an agency that is licensed to provide emergency medical services in the commonwealth of Virginia, and really throughout the United States, responds on an emergency call, we are required to create a patient care record of our interaction with the patient.
Harrisonburg Fire Chief Matthew Tobia said his department already has their own contract for software provided by the company Image Trend. They pay about $14,000 a year for it, and it's customized to their needs. But Tobia acknowledged that smaller agencies relying on the state for software don't have the budget he does.
TOBIA: I know volunteers who are literally fueling the ambulances out of their own pockets.
He showed me what all goes into the reports that paramedics can type up on tablets. It's a lot.
TOBIA: The call location. The census tract. … Time we arrived on location. … We have the ability to scan the patient's driver's license bar code. … It also lets us know whether this is one of several patients at the scene of an emergency or just a single patient at the scene of an emergency. … Why were we called? Why are we here? … It lets us record [clicks] medications and procedures. … Where did we transport to? Did we turn the patient over to somebody else? … We can evaluate them by what's known as the Cincinnati stroke scale. That, if they score a particular number, might result in the patient being directed straight to the CAT scan … to see whether or not they would benefit from a clot-busting drug.
It's just as sophisticated on the outgoing end – the program sends reports to the hospital for their patient records, the National Fire Incident Reporting System, and the state's EMS Patient Care Reporting System. It can make referrals to the city's community paramedic program, send evidence of abuse to Child Protective Services, and inform the crew of a medevac helicopter airlifting someone from the scene.
TOBIA: It's just a seamless way to ensure that information is shared.
Wintergreen Fire & Rescue, which provides emergency medical services for all of Nelson County, has relied on the state-provided system. The county's annual budget there is an eighth the size of Harrisonburg's. After the Department of Health launched its investigation into OEMS last year, Chief Curtis Sheets allocated an extra $25,000 to cover losses in state funding.
CURTIS SHEETS: We put a line item in our budget that's actually, kind of tongue in cheek, it's labeled "surprises from Richmond." … We're going to exceed our line item … but not by a whole lot.
He said they expect the patient care information system to cost them an additional $7,000 to $10,000 a year.
SHEETS: This is just going to add one more thing, another log to the fire, if you will. Which, honestly, is probably not going to be all that impactful for a large county, but for small ones like Nelson, it is.
In the face of this cut, on top of so many others, local first responders wonder – where did all the money go? Besides the $4 million that Associate Director Harrell embezzled, there's another $29 million in "discrepancies." We'll look further into that issue, and how the patient care information system plays into it, in part two of this report.
