Priority One EMS Delivers Penn. Patients to Medical Care

July 07--Since the closure of UPMC Braddock hospital more than four years ago, the people of Braddock have made do with a patchwork of health care services.

There is the Braddock Family Health Center on Braddock Avenue, open weekdays during business hours by appointment only. On weekends, there is a free clinic in the Braddock Borough building, and a tour bus dental truck comes through periodically.

Local access to health care will get a big boost this fall when the Allegheny Health Network opens a new urgent care center, also centrally located on Braddock Avenue, which will operate from 9 a.m. to 9 p.m. daily.

But one 24-7 constant through the turmoil after the hospital closure and demolition has been the local EMS service, Priority One, which has served Braddock, North Braddock, Rankin and East Pittsburgh for the past 25 years.

Housed in a former trucking company plant in North Braddock, the privately held service operates 10 ambulances that last year made 4,719 runs for situations ranging from routine transports to true medical emergencies. "These ambulances get run hard," said Gavin O'Neill, executive director of Priority One.

None of the ambulances in Priority One's fleet is less than 5 years old, he said, and some have been in service for a decade. Two full-time mechanics and one part-timer keep them running.

In a sense, Priority One has kept Braddock running, too, at least from the standpoint of making sure local residents get to needed emergency medical care.

But it has come at a price.

Many of those who previously would have gone to Braddock Hospital's emergency room for minor ailments now call Priority One. That has included a recent 3 a.m. call from someone whose toe hurt and another instance where someone called EMS because of a toothache. The service also gets occasional calls from people complaining of headaches.

Mr. O'Neill said the service responds to all of them. "We don't have to do it, but we do."

He estimates 20 percent to 25 percent of their calls "are unbillable. The insurers won't pay for it, and we accept that. It's part of the business."

There are also others who have no insurance and cannot pay. "We can send them a bill, but in a tight economy, medical bills are the ones that get pushed aside."

David Hughes, an activist with the community group Save Our Community Hospitals that fought UPMC's closure and demolition of Braddock Hospital, said he asked UPMC to subsidize free ambulance rides. He said UPMC declined, saying it could not fund such a service because it would be illegal to give the appearance that it was steering patients to its hospitals.

So it falls on Priority One's staff of 22 paramedics and 36 emergency medical technicians. Because they operate almost entirely from insurance payments, "We run very tight," Mr. O'Neill said.

Besides the unbillable transports, Priority One and other EMS operations have had to adjust to Medicare cuts, including a 10 percent cut in payments for non-emergency calls. The combination means "we need money all the time," he said. "It's a business with very, very thin margins. We can't make too many mistakes."

Losing UPMC Braddock has made a real difference.

Instead of a three-minute, two-stoplight drive to Braddock Hospital, it is 20 minutes and 12 stoplights to UPMC Presbyterian, which means a crew will be unavailable for other emergencies for 90 minutes instead of the previous average of 40 minutes. (Life-threatening injuries would have gone straight to the city even when UPMC Braddock was open.)

"It's more just a resource management issue, in that we don't have the ambulance available as quickly," Mr. O'Neill said. At Priority One, even the administrative staff members are trained EMTs. "If things get real bad, the office staff goes."

That's why the planned November ribbon-cutting on AHN's 5,000-square-foot urgent care center, which Braddock Mayor John Fetterman predicts will be "the finest urgent care center in Western Pennsylvania," is eagerly anticipated.

The center will feature 12 exam rooms, digital X-ray and an area for blood draws, filling some of the void left when the hospital closed. Perhaps most importantly, it will accept all insurance plans, including Medicare and Medicaid.

"Braddock Hospital was the epitome of a community hospital," Mr. O'Neill said. "People almost used it as a [primary care physician] office. They knew the staff; they knew the doctors."

Priority One has taken on some of that role, with crews checking in with some chronically ill local residents when they can. Mr. O'Neill said, "We've been here 25 years, and we don't intend to leave."

Steve Twedt: stwedt@post-gazette.com or 412-263-1963.

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