Milwaukee council pushes for ambulance changes after death at bus stop, delays new contracts

The Milwaukee Common Council on Tuesday backed a proposal urging that first responders be required to get out of their ambulances to search for people in need of help in situations like the one in which a woman died last month at a Milwaukee bus stop.

And, in separate action, the council on a 12-2 vote delayed extending the city's existing agreements with private ambulance services, citing the opportunity the contracts present to ensure that policy changes are put in writing.

The legislation urging changes comes after the Fire Department and Curtis Ambulance faced backlash over the death of Jolene Waldref, 49, on Jan. 15. Waldref died in subzero temperatures near a bus stop at the busy intersection of North 76th and West Congress streets, despite having called 911 saying she couldn't breathe.

An ambulance crew from Curtis Ambulance, a private service that responds to low-priority calls, drove through the intersection twice but did not leave their ambulance to look for her. The crew did not see her on the ground and left.

It was more than 20 minutes between her 911 call and the moment a passing driver spotted her, pulled over and called 911 again after checking on her. By then, it was too late.

The 14 Common Council members present Tuesday voted in favor of the legislation urging changes and reviews. It was sponsored by Ald. Lamont Westmoreland, with additional members signing on.

Mayor Cavalier Johnson is "supportive of the file's intent" and anticipates signing after he reviews it, according to his spokesman.

Legislation urges exiting ambulances, review of 911 technology and dispatch protocols

The legislation backed by the council urges a series of changes and reviews in hopes of preventing future deaths under similar circumstances.

"This fatal incident calls into question the efficacy of existing emergency response standard operating guidelines, as (Waldref) likely would have been found had the rescue team exited the vehicle and physically searched the area immediately surrounding the location to which they were dispatched," the legislation states.

It urges the fire chief and all certified ambulance service providers to adopt or change their procedures to require rescue crews to get out of their vehicles to search for people requesting help when weather, environmental conditions or "obstructions" make it harder to see in the location the responders were dispatched to.

Under a state law that went into effect last year, a policy decision such as requiring ambulance staff to leave their vehicles to search for a patient would now fall to the fire chief instead of the civilian Fire and Police Commission. However, the Common Council could "suspend or modify" the Fire Department policy by a two-thirds vote of its members.

The legislation also urges the fire chief to review "available and future technologies" for locating 911 callers who are using a cellphone and to review existing 911 dispatch protocols for opportunities to improve emergency response for patients who are outside in extreme weather.

The chief is also urged to "undertake a review process with the City’s private ambulance service providers" and report back to the Common Council within seven days of the resolution going into effect.

Milwaukee Fire Chief Aaron Lipski in a text message declined to comment on the legislation.

Council members express skepticism of intent to change policy at Curtis Ambulance, hold contract

The council's votes come after Curtis Ambulance's president reversed course this week on earlier comments that no policy changes were needed in the wake of Waldref's death.

Still, council members expressed skepticism about whether the company would make the changes policymakers are seeking, given comments Monday by Curtis Ambulance President James Baker in which he initially maintained that he was not reconsidering requirements for ambulance crews to leave their vehicles to search for people in circumstances similar to Waldref's. He later said he would change protocols if pressed by city officials.

Council members cited those comments as they considered the legislation authorizing an extension of the city's existing agreements with private ambulance services while the city works to negotiate a new agreement.

Ald. Lamont Westmoreland, who made the motion to send the file back to committee, said the contracts present an avenue to ensure policy change.

"I think this is a good opportunity for us to ensure that they’re improving their policy to better serve folks that are calling for help, and I think this is a good opportunity to hold them to that," he said.

Ald. Marina Dimitrijevic said holding the contract to ensure policy changes are codified was not punitive but rather good policymaking.

"I don’t want to approve it today and fix it later," she said.

The council sent that legislation back to committee with objections from sponsors Alds. Mark Borkowski, the chair of the city’s Ambulance Service Board, and Mark Chambers Jr.

Borkowski contended that delaying the contract extension was a "knee-jerk reaction" that puts people in jeopardy and comes even as policy changes are in the works.

"I can assure you that in the next month, there will be things in writing that will make significant changes," he said. "But to hold this item and to jeopardize the entire system makes absolutely no sense."

Still, he said, he expected the private ambulance companies would continue to work in the community in the meantime. And, he said, he did not think a death like Waldref's would happen again, regardless of whether policies are put in writing.

Westmoreland disagreed that the delay would put the ambulance system in jeopardy, saying that his understanding was that the private companies would continue to operate under the current contract until an agreement is reached on a new contract.

Representatives from Curtis Ambulance and Bell Ambulance, the city's two private providers, did not immediately respond Tuesday to emails seeking further details on the impacts of the delay.

Council's actions come ahead of Wednesday meeting between private ambulance providers, Fire Department

Ald. Milele Coggs said she hoped the council's suggestions would be discussed at a meeting Wednesday between the private ambulance companies and Fire Department officials where policy and protocol changes are to be taken up.

The meeting will be held "to begin the process of creating a revised standard operating procedure for situations where a patient is not immediately locatable when arriving on the scene," according to a statement Monday night from Bell Ambulance.

Baker previously told the Journal Sentinel they would discuss ways to ensure ambulance crews are made aware of callers' GPS coordinates, returning to a protocol in which a fire engine would be sent with an ambulance for patients outside on extreme weather days and requiring that ambulance crews searching for patients like Waldref pass through an intersection from all four directions.

Still, he said Curtis officials would argue against required foot searches but would ultimately comply with city demands. He argued searching with a vehicle allows first responders to cover more ground when a patient can't be immediately located at a place like a bus stop.

He also contended that city dispatchers did not tell Curtis Ambulance crews that Waldref was having trouble breathing, information he said required a high-priority response.

Westmoreland said after the meeting he is looking into Baker's assertion that Curtis Ambulance crews were not advised she was struggling to breathe.

As for the proposed changes Baker described, Westmoreland said there is always an opportunity to improve but that it's especially necessary when lives are on the line.

"All of that stuff sounds cute. It's great," he said of the proposed changes. "However, one thing that's missing is getting out of the vehicle."

Elliot Hughes of the Journal Sentinel staff contributed to this report.

Alison Dirr can be reached at adirr@jrn.com.

This article originally appeared on Milwaukee Journal Sentinel: Milwaukee council delays ambulance contracts after bus stop death