Three private ambulance companies help service the city of Milwaukee's 911 calls, designed to allow the Milwaukee Fire Department paramedics to focus on the most life-threatening calls.
Bell, Curtis, and Paratech Ambulance companies handle what are called basic life support 911 calls, sprains, strains, and other minor injuries. MFD takes higher acuity calls, like overdoses and cardiac arrests.
"Normal items from a basic life support won't kill you right now," said Assistant Fire Chief Joshua Parish. "Advanced life support has that higher lethality in the short term."
But with increasing call loads, the companies are struggling to meet the demand for service in the city. When they can't make a call, it's called a turn-back.
If all three companies are turned back, the call falls on the MFD. The strain on the private ambulances and MFD may likely increase, as Paratech's parent company Midwest Medical Transportation, has indicated they plan to exit the city's agreement with the private ambulances.
"The pressure only ends up in one spot and that's here," said Acting Fire Chief Aaron Lipski.
Midwest Medical purchased Paratech in December. Since that time the rate Paratech turns back 911 calls has skyrocketed.
According to city committee reports, Paratech logged 248 turn-backs in December. By February it jumped to 643 and stood at 603 in March.
Despite the turn-backs, Paratech was responsible for 11,279 calls from September to March, 34 percent of all calls handled by private ambulance companies.
The heads of the remaining companies tell the I-Team, they won't be able to handle the additional call load.
"I don't think we're quite there yet," said Chris Anderson, the director of operations at Bell Ambulance. "We haven't had those discussions yet. At this point, we're not ready to do that."
"It's immediate, it's something we need to be concerned about today," said Curtis Ambulance CEO Jim Baker.
From September to March, only Bell was able to meet city turn back standards, less than 3 percent of calls. Curtis Ambulance turned back 21 percent of calls, and Paratech's turn back rate was 43 percent.
"The system is codependent on private ambulance agencies to handle a majority of the basic life support call volume," Parish said. "With that capacity being removed from the system it then falls on us as a provider of last resort to then offer those services."
Lipksi said there is likely no quick fix on the horizon. In the short term, MFD is adding two additional ambulances for basic life support calls, staffed by EMTs.
"Those will be basic life support ambulances only," Lipski said. "We are not touching the paramedic ambulances. They're already busy without this stuff. We're adding two BLS ambulances."
The MFD and the remaining private ambulance companies are considering long-term fixes, but Lipski asks the community for patience while they work it out.
"Don't hesitate to call," Lipski said. "You're still receiving care far above and beyond what many municipalities can lay out for you. I would ask for on those lesser acuity calls, those basic life support calls, where there may be discomfort, there may be a minor injury, I would beg the community's patience of the wait for that transport unit takes a little bit longer than maybe they think it should."
We reached out to Paratech and Midwest Medical for comment, they did not return our requests.
In Monday's Ambulance Service Board meeting, Ed Matteson of Midwest Medical told the board staffing was a major role in its decision to exit the city agreement.
"We are committed to seeing this through the end of our notice period and working as cooperatively and with as much conjunction we have with the fire department, as has been hit on the head here, staffing and labor is everybody's challenge and we share in that," he said.
The ambulance agreement requires 180-day notice if a company decides to end its partnership.
The I-Team is looking into how ambulance companies are paid by government insurance payers for Medicare and Medicaid patients and its effect on staffing private ambulances. You will find that story on Thursday. If you have a tip you want them to investigate, contact the I-Team at email@example.com or call 414-967-5556.