In the latest blow to Virginia's emergency medical services providers, 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 in the second of a two-part series.
WMRA reported yesterday on the software system that local EMS agencies use to record information about their calls, their patients, and the care they provide. The Virginia Office of EMS used to offer one of those programs for free, but announced last month that they would be ending the service next summer. The cut follows the state's investigation into $33 million that were misspent by previous agency leaders. Besides the $4 million that Associate Director Adam Lamar Harrell embezzled, there's another $29 million in [quote] "discrepancies."
CHRISTOPHER LINDSAY: The rest of that is not necessarily, of course, something that we think was sent through his fraudulent company, but as you said, it was misspent.
Christopher Lindsay is the chief operating officer of the Virginia Department of Health. He's also an advanced life support provider with the Tuckahoe Volunteer Rescue Squad in Henrico County.
LINDSAY: There was $2.3 million taken out of the Trauma Fund. … There were several million dollars that were taken out of the Rescue Squad Assistance Fund … Much of that money was intended for other code-mandated purposes, that was taken and shifted to pay for the EMS symposium, so unfortunately we had to make the decision to cancel the EMS symposium for the last two years.
He noted that the cost of the symposium grew to about $1.7 million in 2022.
HAGI: What was that money spent on besides the symposium?
LINDSAY: So, many different things, and so of course four-plus million dollars of that went back to the former associate director. Some of the other funds, in fact, a lot of the other funds went towards projects, such as the PCR project.
That's PCR – patient care reporting – a.k.a. the patient care information system that's being eliminated. Within OEMS, Associate Director Harrell and others referred to this as the "data project." According to the audit report, it cost a total of $22 million over the last two and a half years.
Here's what we know about how the data project played out. In 2021, OEMS signed a contract with a new vendor for this software – ESO Solutions. Since then, OEMS has paid them $13 million to provide this system for the state and about half of the local agencies in Virginia.
A footnote in the report says [quote] "the ESO contract was entered into with no clear understanding of the final cost … The range for total cost depended on the number of agencies that chose to join the contract."
Lindsay said OEMS is paying this company another $3.1 million to provide the software through next summer.
LINDSAY: I just want to go ahead and say right up front, ESO's leadership team has worked with us throughout this process, and we have no reason to believe they were doing anything outside of what they were asked to do by the Office of EMS in the past.
It's a noteworthy defense of the company, because the data project that included the ESO contract was also the vehicle that Harrell used to pay himself most of that $4 million.
Before Harrell negotiated the multi-million contract with ESO Solutions, the state provided a patient care information system from a different company.
LINDSAY: I do know that ImageTrend is a company that many Virginia providers use, but I can't speak to exactly what the relationship was.
The industry website EMS1.com reported in 2009 that the Virginia Office of EMS had awarded Image Trend with the contract for a reporting program that would be provided to local agencies at no cost. But how much was the state paying for this software compared to the new one?
A renewal contract from 2020 says it was $104,000. About one thirtieth the amount the state will pay to ESO this fiscal year. I asked the VDH why ESO's software would cost millions per year when Image Trend's product was so much less.
Their public relations coordinator told me in an email that wasn't a complete picture of the cost four years ago. OEMS only paid for the base version of Image Trend's software. EMS agencies could choose to pay extra for add-on features. Because of that, "the true cost of the service was much more," but they don't know how much in total. She said there were also fewer agencies using the state-provided option than there are today.
For local EMS navigating this loss, there is some help on the horizon. Lindsay said OEMS will be offering grants for affected agencies to purchase another year of service, giving them until 2026 to get their own patient care information system. That was welcome news to Kim Craig, executive director of the Staunton-Augusta Rescue Squad.
KIM CRAIG: It's a promising thing, at least for a year, and I think what it also shows is that the office of EMS is trying to really work with the agencies now, and trying to help them as much as they can. … One of the discouraging factors that we run into as an agency, and I think other agencies as well, is we really don't know the cost.
Uncertainty is a cloud hanging over many first responders' heads, as Harrisonburg Fire Chief Matthew Tobia explains.
MATTHEW TOBIA: Unfunded mandates are being handed down that are having a really detrimental effect on EMS agencies' ability to provide essential services. … How does it impact the mental health and wellbeing of the emergency responders who are trying to provide care?
OEMS is currently searching for a new director to help lead the agency back to functionality. The Department of Health will begin interviewing candidates later this month.
