Sunday, August 18, 2002

Paramedic's idea gives towns emergency help

From a crisis, a business is born

By Jennifer Peyton
Copyright © 2002 Republican-American

Vincent Wheeler formed and is chief of operations of Vintech Management Services.

HARWINTON — In 1998, Vincent Wheeler watched a crisis unfold.

One after another, ambulance corps were losing volunteers.

Wheeler understood. A paramedic and supervisor for Campion Ambulance, he also was volunteer ambulance chief in Harwinton, where he has lived since he was 4.

People were busy with work and family. Many volunteers worked far from home, unable to answer daytime calls. Others could not meet the time-intensive process of certification. Wheeler and Guy Tangarone, who in 1998 was chief of New Hartford Ambulance, got to talking about what their volunteer corps needed to stay alive.

Their talk inspired Wheeler to develop a solution. He formed a temp agency that provides certified medical service workers to ambulance crews in need of help. Now, five years later, he's spending 60 to 70 hours a week working for the company he founded, Vintech Management Services, Connecticut's first and so far only temp agency for emergency medical services.

Vintech provides personnel on an hourly, monthly or yearly basis. Since 1998, his client base has grown from one town, New Hartford, to 14, covering territory from Canaan to Litchfield, Southbury to Derby. Wheeler employs 143 people and, while he said he does not know how much he has earned since getting started, he and his partner, Kevin Teeling of Winsted, each take home about $700 a week.

"We're hoping we've found something that will help people out there," Wheeler said, so that if an ambulance crew can fill all its shifts except Mondays and Fridays, "we can squeak in there and take over."

"Rather than a volunteer ambulance closing its doors, it gives them a chance to keep going," said Teeling, who joined Wheeler as a partner in 1999, when Vintech was answering calls in New Hartford, Morris and Canton.

Business born from crisis

The need still grows for towns with volunteer ambulance corps. The state lost more than 2,600 licensed EMTs from 1997 to 2001, according to Mark Libby, the state's Office of Emergency Medical Services director.

At the same time, ambulance calls have been increasing, Libby said. Statewide, records show there were 80,000 more calls in 1999 than in 1994.

In July, Robert Corrigan, director of the Northwest Connecticut EMS Council, appealed to officials in Litchfield County to form a committee to recruit volunteer emergency workers.

"I've been pounding on people's heads to try and get their attention that we do have a major, major problem," Corrigan said. "I'll tell you when the message gets there is when the ambulance doesn't show up."

In towns Vintech serves, people who call for help are likely to encounter a Vintech employee. They respond to about 3,000 calls a year — 1,400 alone in Brookfield, VinTech's biggest client.

The hardest part is scheduling, Wheeler said.

"Every town is different, and they change," he said, explaining that one town might need eight people one day, five another, or just one another. "That's what our company does, but that's the worst part."

From their home to yours

Wheeler, 38, chief of operations, runs the scheduling from his living room in Harwinton, where he keeps a computer and phone. He keeps his pager with him.

Teeling, 37, who also was a paramedic supervisor for Campion, is the company's president. He handles the paperwork and finances from a spare bedroom in the Winsted home he shares with his wife Tracy and their two sons, ages 3 and 6.
Neither had business experience before Vintech, which stands for the v-i-n of Vincent and Kevin, and the "tech" of emergency medical technician. Wheeler is a graduate of New York Military Academy and started as an EMT with Campion in 1985. Teeling, a graduate of Northwestern Regional No. 7 High School in Barkhamsted, completed two years at Northwestern Connecticut Community College in Winsted before joining Campion as an EMT. Both completed paramedic training at Naugatuck Valley Community College in Waterbury.

By 1999, Wheeler and Teeling had a growing list of interested towns and ambulance corps. As their business grew, so did the concerns about the shortage of volunteers.

In 2000, the Legislature passed statutes that define a management service as "an organization which provides emergency medical technicians or paramedics to any entity, including an ambulance service."

The regulations established rules for any company wanting to provide that service and not a new paid ambulance corps with vehicles and equipment. Companies like American Medical Response or Campion hold different licenses allowing them to operate ambulances.

Wheeler and Teeling turned Vintech into a limited liability corporation and became the first state-licensed "management service."

Business model, social solution

The state requires start-up EMT management services to keep enough capita to cover salaries for six months, which for Vintech was about $60,000, Teeling said.

However, because Vintech works through other state-licensed providers, Wheeler and Teeling did not have to invest in an ambulance or medical supplies. Vintech employees respond using the same equipment a town's volunteers do.

Vintech covers its employees with its own workman's compensation and medical malpractice insurance. Wheeler estimated that 40 percent of his staff volunteer as EMTs and the rest are paid EMTs who also work for other companies.

Vintech employees are certified as medical response technicians, emergency medical technicians, or more highly-trained EMT-Is, who can administer fluids intravenously. Wheeler and Teeling work shifts.

Some towns reported paying Vintech $50,000 to more than $100,000 a year, just to make sure they have enough staff. Brookfield, which with 15,644 residents is about the size of Wolcott or Seymour, as of July paid Vintech $326,784 a year for round-the-clock paramedic service and EMTs who cover 16 hours a day. Volunteers cover the additional eight hours a day.

"It's worth it because for the town you need medical coverage," said Michelle Brady, acting president of Thomaston Ambulance. The corps began working with Vintech in January and signed its first one-year contract. "You can't run the risk of not having coverage. There's really no other way. Vintech is the only option."

Thomaston Ambulance saved enough to pay for the first six months of Vintech's service, but asked for the town's help if the corps' new billing system did not generate enough revenue, Brady said.

More ambulance corps have also started billing patients who use the ambulance, using that income to offset the cost of hiring Vintech.

"Nobody likes having them, because it's more money in the tax bill. But if people in town don't want to step up and volunteer, they've got to pay," said Lewis Clark, the fire chief in Morris, where Vintech staffs the ambulance five days a week, from 8 a.m. to 4 p.m.

In Southbury, where ambulance president Henry Velthuisen said donations are not enough to keep the ambulance service going, the corps two years ago started billing patients a basic rate of $302, plus a mileage fee of $8.95 per mile. Proceeds go toward VinTech's services.

"It's an expensive taxi ride," Velthuisen said. "Of course, Medicare and Medicaid don't pay that amount. They pay less."

Clark and others said they compared the cost of hiring Vintech with what commercial companies, such as AMR, charge and Vintech was less. Towns that contract with Vintech also keep their identity, so when a Harwinton resident looks out the window, she sees the Harwinton ambulance coming, not someone else, Wheeler said.
Tom Lenart of Storm Engine Ambulance and Rescue Corps in Derby, said that is more important than people realize. "I've had elderly people sit on the stretcher and the first words out of their mouths are, ‘I don't know you. Why should I trust anything you tell me?'" he said.

Wheeler said he and Teeling are making enough money to invest in the company, such as recently building a Web site. "Ten years from now we're going to be comfortable," he said.

An unclear future

About 76 percent of Connecticut is served by volunteer ambulance corps, Wheeler said.

"We're here to help the volunteers stay alive. If a town comes up and said to us, ‘Can you do our staffing 24-7?' we would," he said.

But Wheeler contends that's not Vintech's goal. The company tries to encourage volunteers, he said. Vintech employees and volunteers decide who is in charge based on who has the highest level of training. But Vintech EMTs also know when to back off, such as in a town like Morris, where the ambulance gets about 125 calls a year, Wheeler said. "(The volunteers) sit at home for hours and then the one call comes in. You don't want to see them not do anything. We try to let them do as much as possible, because that's what they live for."

Vintech employees also volunteer in their towns, and Wheeler and Teeling teach certification courses and still volunteer, Wheeler in Harwinton, and Teeling in New Hartford. Also, getting hired by VinTech often keeps EMTs in the business, Wheeler said.

"People are generally saying, ‘I need a second job. I can't volunteer anymore.' Rather than go to Cumberland Farms, wouldn't you rather stay in town (as a paid EMT)? We help out a little bit in that area," he said.

In Thomaston, Brady is concerned that once corps hire Vintech, they will become complacent about recruiting. "Although we love 'em (Vintech), we don't want to keep them forever. We want volunteers back in our town. "It's not that there's not a lot of people out there in the towns that are not qualified," Brady said. "It's easier to write a check to donate than to donate your time."

At least one town questioned who should get that check. In Burlington, the selectmen decided to upgrade to a full-time paramedic and hired Bristol Hospital EMS, not VinTech.

"The price was cheaper. We liked the idea of being affiliated with a hospital," said First Selectman Ted Schiedel. But the Burlington Volunteer Fire Department now questions whether the hospital can legally provide the service.

The question turns on the very statute that created management services, which even Wheeler admits is vague. But he interprets it to mean that volunteer and commercial ambulance services, like Bristol's, cannot provide EMTs or paramedics the way VinTech does.

On the town attorney's advice, Burlington selectmen have asked Bristol Hospital EMS to write a letter certifying it can perform duties outlined in a proposed contract. "We're going ahead with the contract...unless we hear differently," Schiedel said. "We're hoping to start as soon after Sept. 1 as possible."

The state will have to decide the issue, Wheeler said.

Meanwhile, other companies in eastern Connecticut are in the process of being licensed as management services, Libby said.

Wheeler and Teeling hope Vintech grows to keep volunteer services alive.

"I don't know how many times I hear, ‘It's so nice to hear the (dispatcher's) tones go out and then the ambulance,'" Teeling said, recalling a story about a town that sent out seven requests for an ambulance call before someone finally responded.

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