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Thursday, May 27, 2004

Who says 'There's no such thing as a free ride?'


The last thing you remember thinking, just after that awful, sickening sound of twisting metal, and the rapid light to dark inversion of sky, ground, sky, ground, is 'Well, at least I have my seatbelt on.'  

Then, everything seems to fade away momentarily.  The next thing you know, someone, calm and comforting, is in the seat beside you.  Instantly, several someones appear from out of nowhere, each moving rapidly all about you.  A board is being placed behind your back, a brace around your neck, stabilizing foam blocks on either side of your head.  

Suddenly, you grow agitated, and you come out of your fog long enough to try and shake off these many hands.  Although your arm does not seem to be working quite right, you fumble madly, using all the weight you can muster in an attempt to swing the limp appendage into action.  You're still not quite sure what is happening to you, but you know it can't be good, and it suddenly seems desperately important that you get to the wallet in your back pocket.   

You've heard horror stories about people without insurance not getting the same level of care as those who are fully insured.  

Now, no matter how much you flail, your arm seems to work less and less.  You grow more and more upset.  The world begins to spin.  Your vision blurs.  You can't find your voice. Still, as best you can, you call out.   

"Please, someone please, my card," you gurgle.

Then, again comes the calm presence beside you.  

"Don't worry, you won't need," it says in a soothing tone.
And only then, finally, do you begin to relax.  Everything is going to be all right.  

If there is one thing that the members of Buckfield Rescue are most proud of, it is that they are one of the very few units left in the State of Maine that does not charge for emergency transport.  

"When we're getting people, to load them into our ambulance, they'll often say 'I've got Blue Cross,' or, 'I have an HMO,'" says Training Officer Deirdre Cameron, "but I'll just say 'Congratulations, I'm happy for you, but we don't need that information.'"

"I've actually had people say to me that they can't afford to go in [the ambulance] because they have no insurance," adds Deputy Chief Lisa Buck, "and when you tell them, 'we don't charge for this' only then are they like, 'OK.'   

"The area that we cover is, a large majority of them, elderly people, and a lot of them don't have insurance," she adds.

Sources at Tri-County EMS, which oversees emergency medical services in Oxford, Franklin, and Androscoggin Counties, would state only that they do not keep track of which organizations charge for transport.  However, Drexell White, a licensing agent with Maine EMS in Augusta, was able to offer some perspective.

"I don't think that there are that many transfer services that don't charge anymore," he said.  "Probably a handful."

White also stressed that the only units likely not to charge would be the very small, rural organizations.  But the mission, and the coverage area, of Buckfield Rescue is anything but small.

Originally known as Buckfield-Hebron Rescue, the unit was founded in 1971 by Paris attorney David Whittier.  By that fall the unit was fully active, transporting patients in an old laundry van that members had purchased for $800 and converted into an ambulance.  In that first year of operation, the unit answered 13 calls for emergency assistance.  

After splitting from Hebron in 1985, Buckfield Rescue began to operate as its own autonomous unit, eventually branching out to cover East Sumner and a portion of Hartford.  Today, the unit serves nearly 3,000 people spread across more than 50 square miles.  They now answer approximately 200 calls per year with an average response time of 5-7 minutes.

Emergency calls, which are dispatched to the unit by the Oxford Country Radio Communications Center in Paris, can range anywhere from a scraped knee to life-threatening trauma.  Additionally, the rescue unit goes out each time one of the fire departments in its coverage area is toned.

David Hamann, an Emergency Medical Technician (EMT), and a past chief of the unit, recalls the day he responded to three "codes" -- when a person has stopped breathing-- in one day.  The challenges incumbent upon members of the rescue unit, he believes, are increasing incrementally.

"Every year the number of calls goes up," he says.  "When I first started, sixteen years ago, it was like 70-80 calls a year.  And the calls every year are getting worse and worse.  I think we are getting more trauma calls than we used to get."

"We're just volunteers, we're human too," says EMT John Wiley.  "We get up in the middle of the night for free."

All members have tales of springing up in the middle of dinner, or during family holidays, to rush out the door in answer to a call for help.  

"Some of us have not just taken calls for rescue," adds Cameron, "but taken calls for baby sitting services.  

"I have an 8-year old, and if my 13 year old is gone, and we get a call, I have no place to leave him," she says, noting how rescue members will frequently take turns watching each other's children.

"Once you've joined, the rescue bug bites you," says Wiley, who has now been on the department for three years, and licensed as an EMT for just over one.  "I don't regret any of it."

Buckfield Rescue Inc. is a non-profit corporation, independent of any municipal government, and is licensed through Maine EMS to the EMT-Basic level.  As such, they are required to provide an EMT on call 24 hours per day, 7 days a week.   This can mean a burdensome load for their members, all of whom serve their community on a strictly volunteer basis, with most of them holding down regular full-time jobs besides.  Of the unit's 21 members, only nine currently hold an EMT license.  However, in addition to the EMT, each call requires at least a driver and, in many cases, a "helper", both of whom must be certified to perform CPR and other basic first aid skills.

"We're hurting on daytime coverage," said Hamann. "It's our single biggest challenge.  And it's not just EMT coverage, it's driver coverage too.  We really need both."

At this time, all members of Buckfield Rescue commit to a minimum 36 hours per month — 24 on weekends and 12 during the week — during which they are available to respond to calls. 

"Some people give the 36 because that is all they can give, and some give more because they have that capability," said Cameron.  

Given the current number of active members standing ready to divide call time, some members are, in fact, forced to give "much more."

"We need volunteers desperately," Hamann added, noting that the unit could lose its license to operate if it is ever unable to meet its coverage obligations.  However, even before it comes to that, there is a fear among the members that they may lose the ability to provide transport services without billing patients directly.  

"If we don't have adequate daytime coverage, we may have to hire somebody, and create a payroll," said Cameron.  "We'll have to get income from somewhere."

"As long as we can keep enough members active on the unit where we have enough coverage, where we don't have to pay somebody, we'll be able to stay without charging," added Hamann.  "But if it comes to a day that we have to hire somebody for daytime coverage, then we'll have to no choice but to charge, just to make up the payroll.  

"Of course, we hope that day never comes," he said.

Currently, the unit is funded through contributions from the serviced towns; each appropriating annually a nominal sum based on the populations served.  

"Last year we finally raised the price because we had been charging the same amount for many, many years," said Buck

Without the benefit of additional income derived from charging patients, or their insurance companies, the members routinely engage in fund raising activities in support of their mission.  Fundraisers include everything from occasional car washes to the semi-annual major fund drives held over the Memorial Day and Labor Day holiday weekends.

Members will sometimes combine their fundraisers with community service events.  For example, a car wash held in 2003, which raised $300, was combined with a free blood pressure clinic.  

The unit has also recently undertaken a printer cartridge-recycling program.  Persons wishing to donate can pick up postage paid envelopes at Cornerstone Healthcare, the Buckfield Mall, the Buckfield Town Office, Tilton's Market, and Lowell Lumber.  Used printer cartridges are then inserted into the pre-addressed envelope and simply dropped in the mail.

"We get anywhere from 50-cents to two dollars for something that they would have thrown in the trash," says Cameron.

This range of contributions, from the small 50-cent cartridge fees, to the roughly $1,500 raised annually during the holiday drives, attests to the generosity of local residents.

Of course, the funds raised can be eaten up fairly quickly.  Last year, the unit needed to finally purchase a new stretcher at a cost of more than $2,500.  

"For us, that's a big chunk of money," says Buck.

And as of January 1, all gloves, blood pressure cuffs, and stethoscopes had to be replaced in keeping with new regulations requiring all rescue equipment to be latex-free. 

"That was not something that we knew when we prepared our budget for this year," notes Cameron, "so, that was a cost we incurred that we had to put our fundraisers towards for this year."

Still, the members of the rescue unit are appreciative of all assistance that they receive.

"All the businesses, everybody here, is well supportive," says Hamann, swelling with obvious pride.

"We rely on a lot of different people and organizations to help keep us running the way we are," agrees Buck.  "This unit is well supported by the town, we really are."

As a testament to this, members credit three local residents — Chris Hayward, Jim Whitmore, and Dennis McAllister — who act as "mystery plowers," although the unit is cognizant of their actions.  These persons donate their time and equipment towards keeping the rescue station cleared of snow during winter months.  

"That's the really nice thing," says Cameron.  "To go in after, or during a snowstorm, and not have to wade in snow up to your knees to get to the ambulance."

Lowell Lumber also allows one of its employees, Tony Albert, to actually leave work should a rescue call come in.  

"On the payroll, they've been doing that for a long time," adds Buck emphatically.

"A lot of times that's what gets us a driver during the day, because he is able to leave a local business to respond, and remain on the payroll," notes Wiley.

And of course, there has been the contribution of local community leader Virgil Titlon, proprietor of Tilton's Market.

"When we first started," recalls Hamann, "during the daytime Virgil would literally leave the store and drive the ambulance if we needed somebody.  He has driven that ambulance many times.  All you had to do was stop in there, and yell, and Virgil would run out of his store, sometimes with his apron still on, and drive that ambulance."

Heather Richardson, the rescue unit's newest EMT, who also serves as the department's secretary, is quick to point out some other contributions that help to keep costs down.

"I think one of the biggest things we should say is a thank you to Turner Rescue and United" she offers.  "We can only do basic life support on people.  If they need medication, or I.V., we call ALS [Advanced Life Support].  They jump on board for us and we still do not charge, and they do not charge, for the service."

"What happens," adds Cameron, "is we meet them on route, and their paramedic gets out of their ambulance and gets into ours with their equipment, treating our patient with the exact same care they would have gotten in their unit. And they don't send a bill either."

Buckfield Rescue members also thank Turner Rescue for the additional back-up coverage that they provide.  Besides the time spent on the emergency scene, a one-way transport to the nearest hospitals can take 30-40 minutes.  The total run time for a call can take 2-3 hours, from the initial tone to the time the unit is back in service at the Buckfield station.

"The longest part of the time is filing out the run sheet," says Hamann.  "You have to document everything."  

Turner Rescue routinely stands by to provide emergency services to residents in the Buckfield Rescue coverage area during those times that the Buckfield unit is already out on a call, or otherwise in service.

"It happened a couple of weeks ago," notes Richardson.  "We have one unit, we were on one call, and we got another call five minutes later.  We had to call Turner and they were like 'no problem.'"

Now, as Buckfield Rescue moves forward under the leadership of Chief Tony Lord, they have set several goals for themselves, which they believe will help them serve the public to an even greater capacity.

"Our next biggest goal, hopefully this summer, is we want to build a new rescue station," says Hamann.

The current station, located at the intersections of Loring Hill Road and North Hill Road, was originally built with all-volunteer labor from rescue members and local contractors.  This building is a simple garage, with no running water, no bathroom, no meeting room, and no office or storage space.  

"The lack of running water is a cause of sanitary concern," says Lord, noting challenges in cleaning the unit after certain calls.

The space is so limited that, when the unit purchased its current ambulance in 1995, the building actually had to be raised to accommodate the new vehicle.  At that time, local contractors and masons turned out to lift the garage, adding more bricking until the requisite clearance had been reached.

"And the ambulance currently just fits," stresses Buck.

However, the Town of Buckfield owns nearly an acre of land around the current building and rescue members hope to raise funds, and solicit the requisite volunteer labor, to allow them to rebuild the station.  Members hope to create enough space for an eventual second unit, as well as facilities for meetings, training, and administrative work.  

Anyone wishing to donate to the building project can send funds made payable to Buckfield Rescue, PO Box 99, Buckfield ME, 04292.

Private donations will be vital to making the project a reality as members are reluctant to charge patients for transport, or to burden the towns in their coverage area by raising rates again so soon.  Most of the current budget is, of course, already spoken for. 

"The heaviest part of our budget is training," says Buck.

These costs include over $600 to train and license each new EMT, which includes $475 for the 200-hour class, $50 for textbooks, and over $80 in fees for testing.  Once a new member serves six months as either a helper, or a driver, the rescue unit picks up all costs for that member to become a licensed EMT.  The unit also covers expenses for additional and ongoing training classes required in order for an EMT to renew their license every three years.

This is all in addition to the department's regular monthly training drills.

Given the amount of time that they work and train together, members of the rescue unit tend to become a close-knit community, with many members referring to the department as a sort of second family.  Members spend additional time together at annual holiday parties and cookouts.  

Also contributing to the bonding factor of serving on a rescue unit is the need to maintain patient confidentiality.

"What happens on that call, stays on that call," says driver Joe Collingwood.  "That's one of the disadvantages of living in a small town, because everyone always wants to ask you what happened, but we really can't say any more than is said on the radio."  

"We have the funny calls that we laugh about, but we also have the serious calls that no one wants to talk about," notes Hamann.

Members try and look out for each other's welfare, but the stresses of the job can become overwhelming.  This is especially true given that, in these small western Maine towns, the patients rescue members are called to help are rarely strangers.  Often they are neighbors, relatives, or even, as has happened before, one's own children.

"Those feel good stories that happen at the end of every rescue 911 show on TV, those don't happen very often," says Cameron.

For this reason, members rely on the Tri-County EMS special crisis teams for occasional counseling.  Buck estimates that the unit calls on the crisis team's services "a couple of times per year."

"There no easy way to put it," she says, "but you get hard after awhile, and things don't effect you.  But we get new members on, or people who might not have seen something like that before, and its nice to bring in the crisis team to talk about it."

The emotional toll is a lot to ask of neighbors who come to your aid without thought of monetary compensation.  These are people who do it simply because the need is there, and it is the right thing to do.  But there is the occasional "save" that can help to compensate for the bad times.  Members still like to reminisce over the child they helped to deliver last fall while transporting the mother to Stephen's Memorial Hospital in Norway.

"Not everything is a good outcome, so when you do get something like that, it's nice," recalls Richardson.  "It's different.  It's a high that keep you going."

Lord stresses that, while the demands are not for everyone, anyone is welcome to join the department and assist in its efforts to serve the community.  Any person within a reasonable distance of the call area is welcome to apply.

"You do have to have a certain amount of physical ability because you might be lifting, moving a cot," notes Wiley.  "Sometimes we will have to physically move a person off of a couch, or out of a ditch."

However, any and all assistance, from people of all walks of life, is welcome.

"We've had a real variety of people on rescue over the years," recalls Buck.  

Lord states that anyone interested in joining the department, or even just obtaining a more in-depth view of what the rescue unit is all about, is welcome to attend one of their monthly meetings.  Business meetings are held at 7:00 p.m., on the first Monday of every month, in the second floor meeting room of the Buckfield Fire Station.  Regular training drills are held on the last Thursday of each month, at the same time and location.

Interested parties are also invited to call Chief Tony Lord at 336-2462, or Deputy Chief Lisa Buck at 336-3939.

Then, as the members prepared to rush out in answer of the latest call for assistance, Dave Hamann spoke for the entire group.

"We just want people to know how proud we are of what we do, what we do for all three communities, and how proud we are to be a non-profit and to not charge [for transport]."