With the possible loss of Crozer ambulances, Upper Darby is preparing to foot additional costs and considering the possibility of regionalization of EMS.
At its recent meeting, township council moved forward with a Declaration of Disaster Emergency regarding what members called the imminent potential, or sudden and unexpected loss of Crozer Health as the township emergency medical service provider.
Chief Administrative Officer Crandall Jones said the situation is very fluid.
During a presentation on the topic, interim Fire Chief Brian Boyce said even if Crozer Health survives, the EMS service it provides now at free or low cost is unlikely to continue and the municipality will need to bear the cost.
Boyce said local municipal and county officials have been having numerous meetings and work groups in direct response to the closure and how emergency service in the county will be provided.
He said municipal leaders, mostly area township managers, met to put forward a framework for a regional adoption from the participating municipalities.
Boyce said a number of municipalities were under the impression that the county was going to step in and solve the problem, but under the commonwealth system, the authority at the lowest level has jurisdiction.
Boyce said that during the meetings all municipalities were behind joining a regional solution to manage and deliver EMS service in the county.
“17 municipalities across Delaware County get their total (EMS) service from Crozer,” Boyce said. “The township is going to have to adopt financial responsibility,” Boyce said.
In addition to those 17, other communities get limited services such as advanced life support paramedics from Crozer.
Upper Darby is the largest user of EMS in the county. Officials said there are 13,000 to 14,000 calls per year in the township, with a large homeless population and a large overdose issue, which contribute to the amount of calls.
Long turnaround times for ambulances have been a problem since hospitals are overwhelmed Boyce said,.
In 2021, when Delaware County Memorial Hospital was still open turnaround time for an ambulance was 40 minutes, it has now increased up to 1 hour and 20 minutes and the times continue to increase, he said.
During a question period with council members, Boyce said operating at a regional level would allow EMS planners to analyze the data to fairly share costs with neighboring communities.
“If we don’t do that we will be competing against them when it comes to seeking grants and other issues,” Boyce said.
Regional solution
He said successful regional operations come up with funding formulas based on population and related the framework would detach the costs from the hospital for EMS.
He used the example of the Kennett Square area where 5 municipalities share a regionalized service. Two pay 40 percent each of the costs because they have the volume and population. The other smaller areas pay a lower percent.
Boyce said they are looking at every avenue to make EMS work and be more efficient.
One plan is a community health option for frequent users of EMS who really use it as a transportation service. A community paramedic goes to a person’s home and evaluates their needs, avoiding the need to go into the hospital system.
Boyce said there is recoverable money that EMS can receive from insurance but they are limited to only when a patient is transported. A proposal would change state law to allow first responders to charge for service that may not involve transport to a hospital.
Boyce said there has always been a problem with emergency medical service in the county, but the Crozer Health crisis has brought EMS to the breaking point.
“It’s always been broken and it’s always been piecemeal. It hasn’t been until we’ve hit this crisis situation that we’re being forced to deal with it on a systemwide level,” Boyce said.
Interim Fire Chief Brian Boyce. (Courtesy of Upper Darby Professional Firefighters Association)
Years ago most fire companies had ambulances that provided transportation to hospitals. As they got out of the business, other nonprofits became involved, but the call volume has overwhelmed the system.
Health systems such as Crozer or Mercy Fitzgerald often operated EMS as a loss leader to funnel patients to their hospitals, which provided a buffer to cover EMS costs.
“When private equity came in and took the money out of Crozer, there is no buffer zone left,” Boyce said. “There is no buffer for the hospital to provide the same level of care that they had been providing before.”
“Even if we save the hospital, the EMS probably won’t survive that,” he added.
Boyce warned that the crisis is at an epic level and also pointed out many doctors’ offices affiliated with Crozer could close.
“It really is a crisis of epic proportion for the county,” Boyce said.
DCMH tax collections
Later in the meeting, township solicitor James Gallagher gave an update on court issues, including one related to Crozer.
He reported Prospect Medical Holdings, the parent company of Crozer Health, had two of three claims accepted by the bankruptcy court, which secures the township’s place in line to collect taxes from the bankruptcy.
New solicitor vote
In a surprise, the majority democratic council voted against Mayor Ed Brown’s recommendation for a new township solicitor. By a 6-4 vote officials rejected Clarke Gallagher Barbiero Amuso & Glassman Law.
While Council President Hafiz Tunis pointed out the firm is current zoning solicitor for the township, others were not satisfied.
Republican Brian Andruzsko again raised his concern of one of the members of the firm had raised over $300,000 for Democrats saying he didn’t think they could be impartial.
Republican Meaghan Wagner again pointed to a Pennsbury School District free speech lawsuit the firm lost, adding she wouldn’t believe one thing they tell her.
Meaghan Wagner (COURTESY PHOTO)
Wagner said that despite his being a Democrat, she liked Bob Scott, who was on a short list of contenders that was interviewed.
Councilmember Matt Silva agreed and pointed out Scott is from the township and would have respect for residents.
“I am fearful if we don’t have respect for our residents, or our attorneys do not, we will find ourselves in trouble, again and again,” Silva said.
Andruszko, Wagner, Silva, Laura Wentz, David Banto and Michelle Billups voted against the pick.
Council vacancy
Council also voted to accept the resignation of Vice President Andrew Hayman in April when he moves out of the township.
Tunis said they will be looking for applications to fill Hayman’s 5th district seat. Council will interview prospective candidates and will fill the vacancy at the April 16 meeting.