Pennsylvania ALS Provider Faces Possible State Penalties

GREGG TOWNSHIP -- The hospital that has an Advanced Life Support station in Penns Valley could face state Department of Health penalties unless the station returns to 24-hour-a-day operation.

On Nov. 1, Evangelical Community Hospital in Lewisburg cut the hours for its Penns Valley ALS service, choosing to operate it from 7 a.m. to 7 p.m. That, wrote a state Department of Health official in a Nov. 22 letter, is a "violation of the staffing and operational requirements" for an ALS service.

A hospital spokeswoman said Evangelical wants to keep the station running 12 hours a day and that most of the calls it responds to occur during the service hours.

The Health Department letter says that without the service, an average of 10 to 12 minutes is added to the time it takes an ALS ambulance to arrive at an emergency in the Penns Valley service area. ALS provides paramedics who can begin treatment at the scene and offer more advance treatment than ambulance crews.

Evangelical Hospital leases its space from Penns Valley EMS, at 3585 Penns Valley Road. The reduced hours do not affect Penns Valley EMS, a separate organization that continues to provide a round-the-clock ambulance service to the region and contracts with Evangelical for ambulance staff.

The changes have left some in the area concerned that the hospital, if told it has to operate 24 hours a day, could decide to stop the service altogether.

"Our biggest concern is that the level of service we have currently, which we did not have previously, will disappear," said Pat Leary, chairman of the Gregg Township supervisors.

The state is giving the hospital until Jan. 2 to work out a plan of operation with Seven Mountains EMS, the organization that contracts with the Department of Health to inspect ambulances for licensing and other services.

An Evangelical spokeswoman said the hospital has asked the department to allow it to continue the service with the reduced hours. The department had not received the request when it sent the warning letter.

Scott Rhoat, program specialist for Seven Mountains EMS, said his organization does not support the shorter hours.

"We want them to provide the service everyone else is obligated to provide," Rhoat said.

Evangelical Hospital opened the Penns Valley station in spring 2004. The state requires an ALS service to operate 24 hours a day, seven days a week, unless it gets a waiver from the state Department of Health.

Nick Klose, Evangelical's pre-hospital services director, said in a written statement that the hospital's ALS is responding to 1.3 to 1.5 calls a day, about 70 percent of which occur between 7 a.m. and 7 p.m. He said the volume of calls is not enough to justify 24-hour service.

"When we started this service in Penns Valley, it was under the stipulation that we would receive an average of at least two calls per day," Klose said. "In November we had a total of 29 service calls, amounting to an average of .96 per day."

But Rhoat said he told the hospital when it was considering offering the service that, based on municipal data, it could expect to get 1.5 calls a day.

"We said, if you're going to do this, you're going to do it all. Our position has not been to ask them to leave," he said, adding that Evangelical's services are an asset to the area.

Rhoat said if Evangelical Hospital does close its ALS, Penns Valley will still receive ALS service, but it will be provided by either Mount Nittany Medical Center or LifeLink.

Leary said while the care from Mount Nittany and LifeLink ALS services is excellent, they are farther away from Penns Valley, so it takes them longer to respond.

"The time factor in a medical emergency is sometimes the most important part," he said.

Leary said a hospital official said at a meeting that Evangelical is losing money on the Penns Valley service.

"I don't believe they're counting the good will that's engendered by their presence in the valley," Leary said.