Lethally Tainted

The New York Times editorial today believes that anything connected with Governor Blagojevich is "lethally tainted".

Central Illinois Gym

Bob Rosa is the owner of Central Illinois Gym on South Adams in Peoria.

It is the best weight lifting gym in Peoria.

Bob tells it like it is and so do the members that work out there.

Big strong guys come in after work, cajole and taunt each other in typical locker room style and they scream bloody murder as they hoist huge weights above their heads.

The best weight lifter in the world in the 1980’s, Mike Bridges, is a member and he is still very strong.

I spotted bench for a guy named Frank a couple of years ago. He did 13 perfect reps with 405 lbs. And this was after he benched 500 lbs.

Interestingly, when the big guys inch towards 600 lbs. on their bench, they quit talking about it. They don’t want to be held to this number each time they stroll in off Adams street.

There are people with all sorts of backgrounds in the gym but no one has any enemies…at least in the gym. Yes, these big strong guys gossip some, and many seem to have women problems, but the weights take their mind off of some of their concerns outside the gym.

And the big strong weight lifters in the gym know the score about politics, the war, about unions, and about forces that control society.

They don’t read the New York Times or get on the Huffington Post website every day but they still know the score.

Corruption Crisis in Illinois

The "corruption crisis" in Illinois probably runs south of I-80.

Here is an article by the Peoria Journal Star emphasizing that what our Governor has touched may be tainted.

See comments that follow.


Corruption crisis creates confusion in Illinois

By CHRISTOPHER WILLS
Associated Press
Posted Dec 27, 2008 @ 03:40 PM

SPRINGFIELD —
Embattled Illinois Gov. Rod Blagojevich has made a point of regularly going to work at his office in Chicago. He has signed legislation and issued pardons. He has sent out press releases about predatory lending and fighting poverty.

But his arrest on federal corruption charges has clearly complicated his work as the state's chief executive and already cost the state some $20 million. The state is facing a potential $2.5 billion budget deficit and the governor doesn't have the same horsepower — or clout — to address the problem that he had just a month ago.

No one in the state capital trusts Blagojevich enough to give him authority to trim the budget on his own, as he requested in November. Any other idea he advances would probably be rejected out of hand. Yet no other official can take the lead.

"Everything just comes to a halt. You have complete paralysis," said House Republican Leader Tom Cross of Oswego.

Blagojevich, a second-term Democrat, was arrested Dec. 9 on charges accusing him of scheming to swap President-elect Barack Obama's vacant Senate seat for profit, shaking down a hospital executive for campaign donations and other wrongdoing.

The governor has defiantly insisted he's done nothing wrong and that he will not resign. His aides say he is going about business as usual.

His chief of staff, who was arrested along with Blagojevich, has resigned and been replaced by a deputy governor. Another deputy, one with a background in budget matters, has resigned and may not be replaced. Plus, a committee is expected to recommend in early January whether the state House should vote to impeach Blagojevich.

"I think it's difficult for him to manage government in the way a governor normally would," said state Rep. Gary Hannig, a Democrat from Litchfield. "This is a time when you need strong leadership from the governor's office."

The state must find a way to eliminate its deficit. If nothing is done, the most likely outcome is that it won't pay its debts to hospitals, pharmacies and nursing homes that care for the poor, forcing more of them out of business.

The problem cropped up two weeks ago when an effort to borrow money to pay overdue bills — one social-service vendor was owed $8 million and garbage collection stopped for 10 days at a state prison last month — was sidelined because the state attorney general's office refused to give immediate consent.

The delay — blamed on the governor's legal woes — cost Illinois $20 million in extra interest, according to Treasurer Alexi Giannoulias. Because the short-term borrowing plan was put off for several days after Blagojevich's arrest, the state ended up paying higher interest rates.

Standard & Poor's recently put out a negative "credit watch" on the state's AA bond rating, noting the budget deficit and the governor's legal situation could hamper efforts to find a remedy.

The governor's budget director declined an interview request. Blagojevich spokesman Lucio Guerrero said the governor is expected to soon get an update on the budget deficit — including potential solutions — from his staff.

"I think the governor has shown that he continues to govern the state and is performing his duties," he said.

Critics acknowledge that government will grind on despite Blagojevich's problems. State police will patrol. The Revenue Department will collect taxes. Snowplow crews will clear highways.

But when an emergency hits, Illinois will lack a real leader to solve the problem and smaller problems may pile up in the meantime.

Will Blagojevich be able to find people willing to serve under him on the boards and commissions that help set policy? Would those appointments even be approved? Can he hold on to his current staff and agency directors? If he delivers a State of the State address, will anyone even attend, let alone seriously consider his proposals?

"Everything he touches is tainted," said Jay Stewart, executive director of the Better Government Association in Chicago. "We know his thought process: Legal, personal, political. I don't see public interest anywhere in that."

Blagojevich won't be able to call on federal officials for help, even though Obama and some top officials in his incoming administration are from Illinois and Sen. Dick Durbin, D-Ill., is the No. 2 Democrat in the Senate.

And though Obama plans a huge public works program next year, Illinois may not be in position to get its share. State officials have failed year after year to approve construction money that would qualify for federal matching funds. That appears unlikely to change.

Some of the governor's critics say his new problems actually won't mean a dramatic change for Illinois because he wasn't trusted or deeply involved in government even before his arrest.

"We've been leaderless for a long time," said Sen. Christine Radogno, R-Lemont. "Consequently, our state is floundering."
___
Associated Press Writers John O'Connor in Springfield and Deanna Bellandi in Chicago contributed to this report.


Copyright © 2008 GateHouse Media, Inc. Some Rights Reserved.
Original content available for non-commercial use under a Creative Commons license, except where noted.

Comments:


haitianhearts

In 2007 the Illinois Finance Authority (IFA) under Governor Blagojevich loaned OSF-Saint Francis Medical Center in Peoria 460 million dollars for OSF's Milestone Project. This was the second largest loan in IFA history.

I wonder if this loan was tainted?

John A. Carroll, M.D.

Peoria


BC

Blagojevich is the governor until he is convicted or impeached. If any problems are arising it's from Legislature and the other government officials. Business as usual until this is settled, anyone refusing to work with him should be relieved of duties. At present the Legislature is busy putting back all the cuts despite the fact we can't pay for essentials. That is how we got in this mess and we will remain there as long as the same thieves are in the General Assembly. The governor got caught, but don't think for a minute he is the biggest crook. He had problems with members of legislature because he wouldn't co-operate with their brand of self help. All government is corrupt that is how business is handled. No state has wiped out corruption their elected officials just learned how to be more discrete. Every now and then one gets careless like the stupid move he made using his home phone.

Dr. Carroll..I do agree with you and your view of OSF. I doubt the money is tainted from Blagojevich. That would more come from some back scratching in our local area. The governor may have signed the necessary legislation, the crafting of it probably is closer to home. I thought OSF planned on fleecing the general public out of donations for their huge project. We both know the non-profit hospital is just a feeder for their many for profit enterprises. At least it's a loan, at some point tax payers will get it back unless OSF can figure a way around that. I have nothing but respect for the hard working staff of OSF, their corporate officials have one interest and that is profit at the expense of the patient.

Now, Katina...

When I was in Haiti last month I examined Katina.

Katina is sick and needs heart surgery again.

OSF in Peoria is rejecting her. She has sickle cell and a large lymph node on the right side of her neck. She needs to come to the United States for a good workup and surgery.

I don't have any place for her. Other medical centers don't want OSF's patients.

Here is a chat I had with Frandy yesterday regarding Katina:


12:22 PM Dejean: Hi dr Carroll
12:23 PM me: frandy,
how is katina? what is her problem??
12:24 PM Dejean: yes i am here and i've a couple of information for you
me: ok
12:25 PM Dejean: i got on the phone with her before yesterday and also this morning
me: good
Dejean: she's not doing well
me: tell me exactly what you mean
Dejean: ok
12:26 PM she's a stomac problem
12:27 PM and she feels it where she was operated on
me: please answer these questions:
Dejean: ok
12:28 PM me: 1. Is she short of breath? Soufle anle?
Dejean: no
me: 2. Does she have pain in her chest or abdomen? Li gen doule nan lestomak oubyen vant la?
Dejean: yes she does
12:29 PM me: 3. Is the boul on her neck still large? In other words, li toujour gen gwo mas la sou kou a?
4. Does she have a fever?
Dejean: yes and it is hurting her
no she does not any fever
12:30 PM she does not have any fever
me: Frandy, please tell her father that she needs a chest xray.
Dejean: ok
me: We have to find out why she has the enlarged lymph node on her neck.
12:31 PM Dejean: ok
me: thank you
Dejean: but do you think an xray would help you to find it out?
me: She can get the chest xray at Grace Children's or in a lab near Champ Mars
12:32 PM Dejean: ok
me: If she has tuberculosis, we could see tuberculosis in her lung (chest xray). Some times people have tuberculosis in their lungs and they have a lump on their neck....
12:33 PM Dejean: ok
me: The chest xray is the most important thing to do STAT...
12:34 PM Frandy, I will go for now, ok?
Dejean: ok i am gonna tell her dad everything
ok
me: thanks
Dejean: see you later
me: many thanks
Dejean: life is important to save!
me: yes
12:36 PM Dejean: you don't have to thanks me, you better thanks God for the way He helped you to save mine and for this great family i have in St louis.

Stupid Deaths, by Paul Farmer

I believe in health care as a human right. I've worked as a doctor in many places, and I've seen where to be poor means to be bereft of rights.

I saw early on, still just a medical student, the panicky dead-end faced by so many of the destitute sick: a young woman dying in childbirth; a child writhing in the spasms of a terrible disease for which a vaccine has existed — for more than a century; a friend whose guts were irreparably shredded by bacteria from impure water; an 8 year old caught in cross-fire. Li mouri bet — what a stupid death, goes one Haitian response.

Fighting such "stupid deaths" is never the work of one, or even of a small group. I've had the privilege of joining many others providing medical care to people who would otherwise not be able to get it. The number of those eager to serve is impressive, and so is the amount that can be accomplished. I believe that stupid deaths can be averted; we've done it again and again. But this hard and painful work has never yet been an urgent global priority.

The fight for health as a human right, a fight with real promise, has so far been plagued by failures. Failure because we are chronically short of resources. Failure because we are too often at the mercy of those with the power and money to decide the fates of hundreds of millions. Failure because ill health, as we have learned again and again, is more often than not a symptom of poverty and violence and inequality — and we do little to fight those when we provide just vaccines, or only treatment for one disease or another. Every premature death, and there are millions of these each year, should be considered a rebuke.

I know it's not enough to attend only to the immediate needs of the patient in front of me. We must also call attention to the failures and inadequacy of our own best efforts. The goal of preventing human suffering must be linked to the task of bringing others, many others, into a movement for basic rights.

The most vulnerable — those whose rights are trampled, those rarely invited to summarize their convictions for a radio audience — still believe in human rights, in spite of — or perhaps because of — their own troubles. Seeing this in Haiti and elsewhere has moved me deeply and taught me a great deal.

I move uneasily between the obligation to intervene and the troubling knowledge that much of the work we do, praised as "humanitarian" or "charitable," does not always lead us closer to our goal. That goal is nothing less than the refashioning of our world into one in which no one starves, drinks impure water, lives in fear of the powerful and violent, or dies ill and unattended.

Of course such a world is a utopia, and most of us know that we live in a dystopia. But all of us carry somewhere within us the belief that moving away from dystopia moves us towards something better and more humane. I still believe this.

(Dr. Paul Farmer is a founding director of Partners In Health, an international organization that provides health care to people living in poverty. Farmer established a health clinic in Hinche, Haiti, and has worked there for many years.)

Photo by John Carroll, Carefour, Haiti. November, 2008.

Independently produced for Weekend Edition Sunday by Jay Allison and Dan Gediman with John Gregory and Viki Merrick.

Christmas 2008, by Joe Zelenka

Christmas 2008

Another year and wondering what the future holds
So much to do and accomplish in so little time
Will I hear God calling me?
Will I stand up for justice?
Touch me Lord, Heal me, Come into my life

Christmas 2008

A newly elected President
A time for change
Putting behind us 8 years of turmoil and violence
Will we come together and create a new tomorrow?
Will we overcome hatred, bitterness and exploitation of others?
Will there be reason to hope?
Touch us Lord, Heal us, Come into our lives

Christmas 2008

Wars continue, racism still exists and hatred escalates into more violence
An economy that threatens our very existence
Our children look to us for hope
Will we give their world reason to believe in goodness?
Will our children inherit a world without war and violence?
We have a challenge
We have time to make this Gospel of nonviolence real
Touch us Lord, Heal us, Come into our lives

Christmas 2008

We have a mandate to feed the hungry and eradicate poverty
Will we make real the Gospel message?
Will our Churches preach the Gospel of nonviolence?
Will we work to make Jesus real in our lives?
Touch us Lord, Heal us, Come into our lives

Christmas 2008

Praise God daily, celebrate life
Pray a lot, laugh a lot, believe in yourself
See in every person you meet the person of God
Forgive, Forgive and Forgive
See everyone as made in the image of God
Make this Christmas a new beginning
And so, touch us Lord, Heal us, Come into our lives.

I Need to Get Over This

Heurese is doing well after her surgery.

As readers of this blog know, Haitian Hearts started on the “Heurese project” in the middle of this past summer.

Please see Maria’s post regarding how Frandy “found” Heurese in Port-au-Prince…a city of 3,000,000 people. The story is almost unbelieveable. And if it didn’t happen in Haiti, I might not believe it.

And readers, please tell me if I should still be disppointed with all of the people of means in Peoria that denied medical care to Heurese. Maybe my disappointment should go away.

Maybe it is my problem.

Am I making too much of a big deal out of the fact that Heurese was repeatedly turned down by the very people that should have been helping her?

And Frandy, one of the poorest kids in the Western Hemisphere is the one that goes the distance for Heurese.

Intuition would not lead me to believe this.

I was not taught this during 14 years of Catholic education. And the priests, Bishops, and their homilies at mass do not say to walk away from people like Heruese. They all say to embrace her.

And OSF, our big Catholic medical center in Peoria, says their mission is to deny no one. But they do. And my Haitian kids are dying in Haiti.

But Frandy gave Heurese some more time that she hadn’t banked on.

I need to be thankful to God for Heurese and Frandy and get over this.

Hiding News is Not Good

The Journal Star published this editorial on December 15.

If the Journal cannot send reporters to Darfur, that is understandable. But they shouldn't hide news happening several miles from their front door.

Journal Star
Posted Dec 15, 2008 @ 10:30 PM

PEORIA — Between Barack Obama running his pre-presidency out of the Windy City and bringing all sorts of global movers and shakers into town, and Rod Blagojevich - no further explanation necessary - Chicago is the media hub of the universe these days.

In a news city, arguably there's never been so much news.

Ironic, then, that at the same time so much is happening and people seem to have such a thirst to know more about it, the city's flagship newspaper, the Chicago Tribune, is in Chapter 11 bankruptcy reorganization. Oh, well, at least the Trib isn't begging for a bailout.

It's a sign of the times, of course. News organizations across the spectrum of print and broadcast are struggling like never before, for a variety of reasons: the dismal economy, certainly; the overwhelming number of choices for fickle and unforgiving consumers, which makes it more difficult to draw sustainable market share; the competition from the Internet; the strain on customers' time; sometimes ownership's lack of appreciation for the unique demands of this business; the cultural changes in reading and spending habits and a sense that all information is equal and ought to be free.

To be sure, newspapers and other media aren't perfect any more than any human endeavor is, and some of their injuries are self-inflicted. But it still takes people and resources to go out and gather the news, organize it so it makes sense and distribute it, no matter the vehicle of delivery. It doesn't just happen spontaneously, effortlessly, without cost. Covering the Peoria City Council or the District 150 School Board or the Illinois Legislature - at least adequately - is not really something you can outsource to Bangalore, India, or do part-time, though some will no doubt try.

The risk of these unprecedented challenges to the industry is that the kind of investigative journalism that for decades has been uncovering the hard to get - the less-than-ethical exploits of an Illinois governor, or the abuses of an Enron, or the crimes of a Nixon administration, or the genocide of a helpless and innocent population far away - will just go away because it doesn't contribute enough to the bottom line, because the payoff isn't guaranteed up-front, because the potential return doesn't justify the commitment of time.

What this means for Americans is that we don't know what we don't know. Governments and institutions that in many cases would prefer to never have the light shine on their affairs will do things to us, and not always in our best interests. The decisions most make will be less informed. And that's dangerous in a democracy.


Comments:

rjd 2 days ago

The biggest problem with 'news' today is that a lot of it is actually editorial in nature. It's alot of political spin. Case in point, the JS's recent AK47 article. Nothing but a spin. Completely unfactual. A misleading article, to say the very least. People are not going to pay good money for a 'spin' rag. Most of the news media no longer reports the news. Why have a NEWSpaper then?

RealWorld 22 hours ago

I agree RJD. I would care if the newspapers went out of business if they already were not in the pocket of politicians and local money men.

I was personally glad to see the Chicago Trib go under. Really glad. Wouldn't it be funny if a newspaper started that actually gave people the real news, not just the stories that the editors say they can print. Since the reporters are such Private I's, why didn't the tribune know about Blago? Why didn't they report it?

haitianhearts 37 minutes ago

"What this means for Americans is that we don't know what we don't know. Governments and institutions that in many cases would prefer to never have the light shine on their affairs will do things to us, and not always in our best interests. The decisions most make will be less informed. And that's dangerous in a democracy."

Like most newspapers, the Journal Star does hide what they want to hide.

For more than a decade the Journal Star has been against the Peoria Fire Department (PFD) upgrading its services to provide better care for people who call 911 in medical emergencies. Peorias three hospitals did not want the upgrade and the three hospitals advertise a lot in the Journal. This summer when the PFD was finally allowed to upgrade their services for Peorians, the Journal printed not a word of this.

And when OSF stopped Haitian kids from returning with the Haitian Hearts program to OSF for repeat heart surgery, Haitian kids have died. And when surgeries were delayed for Haitian kids in Peoria, Haitian kids in Peoria have suffered. But the Journal did not report these local crimes. The Journal Star reporters knew about these events but were stopped from reporting.

Yes, Journal Star Editors, local institutions will do things to us that our not in our best interest. And for you to hide the light on their affairs only makes sure 'we don't know what we don't know'.

John A. Carroll, M.D.
Peoria

Eric Whitaker, M.D., Governor Blagojevich, Tony Rezko, Stuart Levine, and Peoria's OSF

A New York Times article today describes President Elect Barack Obama's close relationship with his friends back home on the south side of Chicago.

One of his friends is Eric Whitaker, M.D. A few years ago Obama recommended to Tony Rezko that Dr. Whitaker be given a State job. With the help of Rezko and Governor Blagojevich, Dr. Whitaker was "stunned" to find out that he was appointed Director of the Illinois Department of Public Health (IDPH).

Why would Tony Rezko be involved with IDPH? See this article by Lynn Sweet from the Chicago Sun-Times. This article is about Obama's pal Dr. Whitaker and the doctor's ties to Rezko. Also, see the comments which follow the article. Not everyone is totally trusting of Dr. Whitaker.

One of Dr. Whitaker's jobs at IDPH was controlling the budget of the Illinois Health Facilities Planning Board. This Planning Board controls when new hospitals are built, expanded, etc. This Planning Board was very corrupt and controlled (at least for a while) by Rezko, Stuart Levine, and Governor Blagojevich.

For years I have believed (like many others) that there is conflict of interest in Peoria regarding our Emergency Medical Services (EMS) run by OSF's Drs. George Hevesy and Rick Miller.

And Dr. Whitaker seemed to enjoy giving OSF awards for EMS advocacy in the Peoria Area.

Yet several years ago when I wrote Dr. Whitaker detailing my concerns regarding EMS conflict of interest in Peoria, he referred me to the EMS division of IDPH. It sure seems like he was heavily involved in EMS in Illinois.

I wonder why Dr. Whitaker didn't address my concerns in Peoria?

OSF's "Mission" Continues

Keith Steffen, OSF Administrator at the right, has said that OSF would bury Peoria Day Surgery Center. That doesn't sound like what a Christian hospital administrator should say, does it?

The medical mafia in Peoria continues.

The article below appeared in todays Peoria Journal Star.


Judge Throws Out Lawsuit Filed by OSF
Suit alleged Peoria Day Surgery Center violated federal racketeering laws
--------------------------------------------------------------------------------
By ANDY KRAVETZ
of the Journal Star
Posted Dec 10, 2008 @ 11:22 PM

--------------------------------------------------------------------------------
PEORIA — A doctor-owned surgery center has won the latest round in a two-year-old legal tussle that has potentially millions of dollars at stake for both the doctors and the area's largest hospital.

In a nine-page order issued Wednesday, U.S. District Judge Michael Mihm threw out a lawsuit filed by OSF Saint Francis Medical Center, but he will allow the hospital to refile its allegations by Jan. 2. The judge found the hospital's complaint didn't include enough detail to allege violations of the federal racketeering laws and is, in effect, giving them another chance to plead their case.

Dr. Joseph Banno, one of the main doctors involved with Peoria Day Surgery Center, hailed the order as a victory.

"We have always known that these allegations are unfounded and are gratified with the court's ruling today," he said. "We viewed the case as yet another attempt by Saint Francis to drive competitors out of the market and deprive Peoria families of a choice in where they receive health care.

"We hope that St. Francis will now employ its tax-exempt status in more productive ventures," Banno added.

The suit, filed in April by St. Francis, alleges Peoria Day Surgery Center and Banno violated federal racketeering laws by submitting inflated bills in an effort to circumvent the fact that St. Francis was Caterpillar Inc.'s preferred provider.

Lee Smith, one of the hospital's lawyers, said he hadn't spoken to his client yet to decide their next move. He declined to comment further.

In 2006, the surgery center sued St. Francis, saying the hospital company was trying to drive the surgery center out of business so it can raise prices.

The center seeks to stop St. Francis from entering into agreements with Blue Cross Blue Shield of Illinois and United Health Care for the hospital to be their exclusive provider of ambulatory surgical services in the area. If that were to happen, the suit contends, the center will be forced out of business.

That suit is still pending.



Andy Kravetz can be reached at 686-3283 or akravetz@pjstar.com.


--------------------------------------------------------------------------------
Copyright © 2008 GateHouse Media, Inc. Some Rights Reserved.
Original content available for non-commercial use under a Creative Commons license, except where noted.

Did Governor's Web of Influence Involve Peoria?

The New York Times had this flow chart to better understand the dealings of Governor Blagojevich, Tony Rezko, Stuart Levine, and others.

Mr. Levine had been on the Illinois Health Facilities Planning Board which allows hospitals to be built or added on to in Illinois.

For more explanation click on this link Rezko and Peoria.

Will OSF let Katina Die Too?

I examined Katina in Haiti just recently. She needs to return to OSF Children's Hospital for more heart surgery. Katina was operated at OSF in 2002.

OSF has denied all Haitian Hearts' patients that were operated at OSF repeat heart surgery. Two have died.

OSF is in the middle of their hospital expansion that will cost about $500 million. They got a loan from Governor Blagojevich to help out. OSF also had a lobbyist work with Stuart Levine on the Illinois Health Facilities Board to have another OSF project approved. Mr. Levine is in jail now.

OSF is a very busy medical center with alot of its interest at the state level. I doubt they will let Katina back in for heart surgery that she desperately needs. And OSF was founded for people like Katina.

Let me know if you have any ideas what to do to help Katina and many others like her that I am following in Haiti. Other hospitals are not excited about operating on OSF's heart patients from Haiti. They have told me so. (Katina was rejected by a well known medical center in Texas yesterday.)

It is not easy finding another medical center for Katina.

Please help.

Illinois Governor Helpful to Illinois Hospitals

Governor Blagojevich was helpful to hospitals in Illinois in May, 2005.

See this article.

OSF in Peoria had this response thanking the Governor:

“OSF Health Care System operates five hospitals in north and central Illinois and we are grateful to Governor Blagojevich and the General Assembly for passage of the new hospital assessment program. The assessment program will bring millions of new Medicaid dollars to our system, which are critical for us to meet the needs of our patients,” said Fred Kalsbeek, Director of OSF.

Illinois and Governor Blagojevich

Illinois Governor Rod Blagojevich was jailed this morning in Chicago.

Here is a letter I sent Attorney General Patrick Fitzgerald in June, 2008.


-------- Original Message --------
Subject: U.S. Attorney General Patrick Fitzgerald Letter
Date: Wed, 11 Jun 2008 14:17:05 -0500
From: John Carroll


Dear Mr. Fitzgerald,

I have been following the Rezko case closely.

The reason I am writing you is to make some comments and ask some questions regarding the State of Illinois and any connection they have with OSF-Saint Francis Medical Center (OSF-SFMC) in Peoria. OSF-SFMC is the largest medical center in downstate Illinois.

Peoria has an urban population of about 113,000 and metropolitan population of about 350,000.

1. I was told by a lawyer involved in discussions with OSF when OSF was constructing a new medical building (OSF Center for Health) in Peoria that OSF's attorneys (Hinshaw-Culbertson) appointed a lobbyist to speak with the Illinois Health Facilities Board for certification. The Board was run by Mr. Beck and Mr. Levine at the time. The OSF Center for Health was initially denied the certificate, but eventually the certificate of need was approved by the Board. The OSF Center for Health was subsequently constructed and is thriving in Peoria.

2. During a couple of the discussions wiretapped between Mr. Beck and Mr. Levine in 2004 the two men referred to Advocate and Saint Francis as hot issues that were coming up in June, 2004. They also alluded to the fact that Emil Jones was involved.

3. My questions are: Was the Saint Francis they were speaking about the Saint Francis in Peoria? If it was OSF-Saint Francis Medical Center in Peoria, was the discussion about the new Milestone Project that OSF was embarking on? And how and why was Emil Jones involved? (The Milestone Project is OSF's campus expansion and new Children's Hospital of Illinois costing about 500 million dollars. Incidentally, OSF is located one block from Peoria's Methodist Medical Center which is starting on its own 400 million dollar expansion.)

4. Why did the Illinois Finance Authority (IFA), with Governor Blagojevich's approval, loan OSF 460 million dollars in bonds for the Milestone Project? Did Governor Blagojevich get anything in return for the second largest loan in the history of IFA (which has been run by "pay-to-play" people, as you well know.)

5. Were there any improprieties between OSF-SFMC and the Illinois Department of Public Health under the guidance of Eric Whittaker, M.D.? Mr. Beck and Mr. Levine referred to Dr. Whittaker in their taped conversations. Dr. Whittaker gave OSF numerous awards even after I informed him of my concerns regarding OSF's unethical and improper Emergency Medical Services (EMS) monopoly in Peoria.

Thank you for your consideration of these questions and concerns. And thank you for your persistence in insisting on justice in Illinois and the United States of America.

Please call or email if you need further information.

Sincerely,

John A. Carroll, M.D.
Peoria, Illinois
61615

www.pmmdaily.blogspot.com
www.peoriasmedicalmafia.com

Mirterlande Makes It

Well, our young 16 year old girl Mirterlande made it through surgery. She is up and walking and acting like nothing happended. She will be discharged from the hospital today. (See Maria's description of Mirterlande's saga on Live from Haiti.)

The tiny muscles and tendons that support her mitral valve in her heart were all “scrunched up” (medical term) and destroyed from her previous rheumatic fever. As these muscles became distorted over the last few years, the valve leaflets also were injured and the leaflets did not open and close the way they were designed. So with each beat of her heart, blood was regurgitating up into her lung and then, when the heart rests in diastole, too much blood would rush down into her left ventricle which caused it to swell and become weak.

Clinically, because of the above scenario, Mirterlande was barely able to walk because she was in congestive heart failure. When Haitian Hearts first examined her two years ago in Haiti, she was much more robust appearing. She has lost alot of weight due to cardiac cachexia. And she survived a month in the General Hospital in Port-au-Prince earlier this year when she was critically ill and treated for severe heart failure.

Her mother lives in the Artibonite Valley in Haiti and could not provide care for her. The tropical storms washed away her mother's garden in the Valley. So Mirterlande was living in Port-au-Prince with her older sister Karmin who saved her life multiple times during the last couple of years.

Many thoughts rush through my head each time I see one of my Haitian patients asleep on the operating table in the US. I think of all the suffering they have had. I think of what all their families back in Haiti have been through just to keep them alive. When a family member is sick in Haiti, the entire family is stressed. A cow may need to be sold and other family members need to do without.

In the hospital this week, the surgeons and heart surgery team in the operating room worked as a family to save Mirterlande’s life. They have worked for decades together and made a very difficult surgery look routine. The perfusionist, anesthesiologist, and surgeons are constantly talking to each other about the patient’s status during the case. There is no radio playing music, no one is listening to the city council chirp in the background, and there is no idle talk in the operating room.

All eyes and thoughts were on Mirterlande lying in the middle of the cold room.

After surgery, as Mirterlande was wheeled down the hall adjacent to the operating room, in a seamless fashion the cardiovascular intensive care team took control from the operating room team. They are all professionals and know how to troubleshoot any problem that may arise in the early hours after surgery.

This is not the biggest medical center in the world, but it is the best medical center in the world for Mirterlande and many others like her.

In reality, Mirterlande had to wait too long in Haiti for this surgery. And she should have been able to have this surgery in Haiti by Haitian physicians.

And if I really want to be honest, Mirterlande should not have got rheumatic fever in the first place. But poverty breeds diseases like this that steal away young people like this one. However Mirterlande so far has cheated poverty out of another innocent victim.

OSF and Peoria Catholic Diocese View Humanae Vitae and Haitians the Same

OSF and the Catholic Diocese of Peoria are hypocritical.

Their actions do not seem to respect life at conception or the lives of Haitian children.

Both OSF Corporate Ethicist Joe Piccione and the former Catholic Diocese Vicar-General Monsignor Steven Rohlfs helped design the OSF contraceptive policy and both men helped destroy Haitian Hearts in Peoria.

Does not sound Catholic to me.

Below is a Peoria Journal Star Forum article written by my brother Tom and me regarding OSF and the Catholic Diocese of Peoria's describing OSF's way of getting around Humanae Vitae.



Forum: OSF Contraceptives Policy is at Odds with Catholic Doctrine

Journal Star
Posted Nov 07, 2008

Re. Oct. 18 story by Gary Panetta, "Catholics & Contraception":

Panetta correctly points out that the Catholic Church's policy regarding artificial contraception is "maligned and misunderstood." Sadly, much of that is due to inconsistent teachings and actions from Catholic leaders.

In the mid 1990s, OSF and Bishop John Myers implemented a policy that allowed OSF physicians to write prescriptions for oral contraceptives on OSF property. This policy, still in place today, was created so OSF could stay competitive in the medical marketplace.

This flies in the face of the church's consistent position that it is a serious sin to prescribe or use contraceptives.

The loopholes used by OSF to justify this policy are known as "Limited Private Practice" and "Third-Party Payer." The idea that OSF physician employees are suddenly transformed into "non-employees" for the few seconds it takes to prescribe an oral contraceptive would be laughable if it were not so obviously wrong. And sorry, but using a "third party payer" to administer payouts for contraceptives doesn't change the fact that OSF HealthPlans covered them. Long before HealthPlans was sold to Humana, contraceptives were listed by brand name on the plan's Web site of preferred drugs.

Perception is very important. What are people to believe about the Catholic doctrine of Humane Vitae when they can go to an OSF office and come out with a prescription for birth control pills?

OSF Corporate Ethicist Joe Piccione stated that the "policies were approved by our local bishops." Therefore, we ask Catholics in the Peoria Diocese to petition Bishop Daniel Jenky to change a policy that is so obviously against the teachings of the Catholic Church.

Tom Carroll
Peoria

John Carroll, M.D.
West Peoria

Copyright © 2008 GateHouse Media, Inc. Some Rights Reserved.
Original content available for non-commercial use under a Creative Commons license, except where noted.

We Hope Pekin Does Not Make Peoria's Mistake

Pekin Times

November 19, 2008

Letters to the editor


Exclusive Provider

To the editor:

It appears that Advanced Medical Transport (AMT) wants to be the exclusive provider of ambulance emergency care in Pekin. The Pekin City Council will vote on this issue.

In Peoria during the last 15 years AMT was the exclusive provider of paramedic and transport care of emergency patients. Unfortunately, the Peoria Fire Department firefighters with paramedic skills were not able to use their skills unless AMT was on scene.

The Peoria patient frequently had to wait valuable minutes until AMT arrived before they received advanced life support.

The Pekin Fire Department Web site states they have 49 firefighters with 21 of them having Intermediate or Paramedic skills.

In other words, many Pekin firefighters have the ability to provide advanced skills for the patient.

My hope is that the Pekin Fire Department will not be restricted in the same way as was the Peoria Fire Department.

OSF in Peoria is the main supporter of AMT. OSF controls Emergency Medical Services (EMS) in this entire area. The physician in charge of EMS works for OSF and the Director of the Emergency Department at OSF is the Corporate Medical Director of AMT.

Sue Ann Kortkamp, a Pekin City Councilperson, is Executive Director of Saint Francis Medical Center Foundation in Peoria. Ms. Kortkamp should abstain and not cast a vote regarding AMT becoming the sole provider of ambulance care in Pekin due to her conflict of interest.

The people of Pekin deserve fast expert care that the people of Peoria have not been able to receive. Conflict of interest with businesses interests need to come after citizen safety.

Whether it be the Pekin Fire Department paramedics or AMT paramedics, the earliest-best-trained individual on the scene, should be able to provide emergent care for the people of Pekin.

Some background for this article is at www.pmmdaily.blogspot.com

John A. Carroll, M.D.

Peoria

-----------------------------------

City, AMT Eye Deal for Services
By Ed McMenamin


Times staff writer

PEKIN - Pekin City manager Dennis Kief said he hopes a deal with Advanced Medical Transport that would formally establish the company as the only ambulance service in town can be finalized by May 1.

He said a potential contract with AMT would tighten communication between AMT and the city and require AMT to pay a fee for its exclusive medical transport privilege.

AMT pays about $80,000 annually to Peoria in a deal similar to the one Pekin is seeking, he said. He estimates a fee paid to Pekin could be around $38,000.

Currently AMT pays a fee to the Tazewell Pekin Consolidated Communications Center, as does the city of Pekin and other agencies that use the center's dispatching services.

He said a deal would “formalize a lot of loose ends.”

Language in the potential contract could require annual sit-down meetings between Pekin and AMT, the sharing of Geographic Information Services and other technology and communications equipment.

Kief said agreements of this type are common, similar to contracts with utility companies or cable television providers. A contract wouldn't significantly alter the services AMT provides in Pekin.

Typically, when an emergency call is placed, the Pekin Fire Department is the first responder to the call, followed by AMT, according to Pekin Fire Chief Chuck Lauss.

He said the department has firefighters certified at all three levels of emergency medical training, but the department is only licensed to perform EMT intermediate services. AMT staff are the only personnel licensed to provide EMT paramedic services - the highest level - in Pekin.

“The firefighters and the paramedics on the street work well together,” he said. “(Firefighters) know that when the ambulance gets there they turn over patient care and the patient will be transported to the hospital and taken care of.”

Firefighters with EMT Intermediate training can intubate and establish an IV to administer medications and fluids, among other services. He said EMT paramedics can provide some more advanced medications and services.

Peoria physician John Carroll said in a letter to the Pekin Daily Times (see page A13) that AMT's service in Peoria restricts firefighters from using their paramedic training, resulting in patients waiting for AMT to arrive before receiving care.

Lauss said that is not an issue in Pekin.

“The firefighters that are on scene are there working the patient continually until the transport agency gets there,” he said. “As far as just waiting around - they don't just wait around - they do work with that patient, give the patient care until the agency gets there.”

He said that a requirement mandates any firefighter hired on since 2000 has to attain the intermediate level of training at the first available class.

“What happens is when the 911 calls come in, because of the strategic location the fire stations are in, we generally arrive on scene first,” he said. “We're able to assess the situation and get things started prior to the transport agency getting there.”

AMT spokesperson Sharon Kennedy said the business uses three ambulances in Pekin, but that number fluctuates depending on the time of day. Each ambulance has a crew of two people.

She said a potential deal would be a “financial arrangement more than anything.”

“It allows us to more securely invest in the marketplace,” she said. “We feel much more secure Š in buying more ambulances and training people.”

She said a deal would provide job security to both AMT employees and security to Pekin residents knowing they have a locked in transport provider.

“It's kind of a win-win. I suppose, for everybody,” she said.

She said she was not aware of any other private ambulance businesses in the area, but that many communities provide their own, municipally owned ambulance services.

“Some of the cities around us have asked (AMT) for proposals at certain times and could have saved a lot of money by not getting into the transporting business,” she said. “But because of (individual politicians') political concerns, (they) have done that.”

Heureuse Survives

A very well-meaning missionary with tired eyes brought her to me.

When I first met Heureuse in Haiti in the early 2000’s she was the same petite and polite woman that she is today.

With my stethoscope placed over Heureuse’s heart, I could hear a loud gushing noise coming from her diseased aortic valve. A hole in her heart was nestled just below the bad valve.

Heurese needed heart surgery to stay alive.

Heureuse’s sister Eva had kept her alive while Heureuse’s body was all bloated with fluid. Eva had even made tapes for her. When Eva was in the capital, and Heureuse was lying on her mat in her home in the coastal village of Bainet, Eva’s recorded voice would tell Heureuse to stay alive.

Heureuse did stay alive, got out of Haiti, and survived major heart surgery performed by a large medical center in the United States.

But this year Heureuse has become real sick again and now the large medical center does not want Heureuse back for repeat surgery. It seems they are comfortable letting Heureuse the survivor silently slip away in Haiti.

Incredibly, last week, Heureuse was accepted by another excellent medical center in the United States for surgery.

So what exactly has Heureuse survived?

She survived dark lonely breathless nights in a slum of Port-au-Prince. Her family was far away.

She survived the powerful macrostructures far from Haiti which control her world and influence her misery.

She survived the rich and powerful of her own government and business community that don’t view her as human, let alone a human with dignity.

She survived the kidnapping business in Haiti and the haphazard bullets of the Blue Helmets.

She survived four tropical storms--- Ike, Gustav, Hannah, and Fay. She survived the subsequent brown mud and sewage that ripped down the mountain into her slum and shanty.

She survived the loss of her children’s father as he vomited blood and moaned as he died.

She survived giving away her children this year as she prepared to die.

She survived the disappearance of Eva in the Dominican Republic.

She survived heart failure this year as the operative repair she had done at the big medical center fell apart.

She survived the painful memory of the United States and all of its rich food and clean water. She survived the memory of the blan that cared for her then…

She survived the silence and abandonment of people at the large medical center that should have said something, should have done something, as she was being led to the gallows.

She survived the silence of the Bishops and Monsignors and Sisters and medical center chaplains who should control and influence the true philosophy of the medical center.

Heureuse has survived total despair.

She needs to survive a few more days.

E-Mail to Pekin City Council Member and OSF Foundation Director

Sue Ann Kortkamp is Executive Director of Saint Francis Medical Center Foundation.

She seemed to be an able leader but I think she was caught in a tough spot at OSF.

For example, Paul Kramer, Executive Director of Children's Hospital of Illinois, asked one of Sue Ann's employees at Foundation to divert money from Rotary Club North to Children's Hospital of Illinois. The money that Rotary collected was to go to Haitian Hearts directly---not Children's Hospital.

Sue Ann must have been cringing.

Also, Mr. Kramer did all he could to get his hands on $180,000 dollars raised by Haitian Hearts volunteers when we built and sold a new home in East Peoria in 2002. Mr. Kramer told the the Haitian Hearts people that constructed the house that "there is no such thing as Haitian Hearts". (Mr. Kramer also asked Jim Sullivan, who was holding the house money for Haitian Hearts, to release the money to Children's Hospital. Mr. Sullivan refused. Haitian Hearts donated the entire sum to Children's at the end of 2002, right before Mr. Kramer called the American Consulate in Haiti.)

Again, Sue Ann must have felt bad to see this happen.

And a physician at OSF made very generous contributions to Haitian Hearts that never made it to Foundation (according to Sue Ann and her secretary) and Haitian Hearts was never credited with the physican's gift.

Haitian Hearts received no evidence from Foundation that people had donated significant monies to Haitian Hearts in late 2003. We pressed the issue and asked Foundation many questions...finally, after multiple attempts on our part, at the end of 2003, Keith Steffen signed a check over to Haitian Hearts of donations that had come in for Haitian Hearts patients in 2003. Haitian Hearts doubted that we would have ever received that check from OSF if we had not pressed Foundation to pressure OSF Administration to give us money that was donated to Haitian Hearts.

Sue Ann may have wondered where Caterpillar, Inc. donation to Haitian Hearts went in 2001. Caterpillar Inc. was donating $10,000 dollars a year for Haitian Hearts to go directly to Children's Hospital of Illinois. (Paul Kramer told me in his office that Haitian Hearts was becoming too much competition for Children's Hospital.) However in 2001, the computer printout revealed that Caterpillar Inc. had donated only $500 dollars to Haitian Hearts. In other words, Haitian Hearts would only have been credited with a $500 dollar donation to Children's Hospital of Illinois. I wonder where the other $9,500 dollars of Caterpillar money went?

And during the late 90's and early 2000's Haitian Hearts donated over 1.1 MILLION dollars to Children's Hospital of Illinois. We were honest amidst the dishonesty that was surrounding us at OSF.

A spokesperson for Attorney General Lisa Madigan told me that OSF had "done Haitian Hearts wrong."

Sadly, Sue Ann had to watch as OSF turned their back on dying Haitian Hearts patients in Haiti that had been operated at OSF. She watched as Paul Kramer told the pediatric cardiology group to cancel an important test on one of the Haitian children in Peoria. She watched as Paul Kramer notified the American Consulate in Haiti to stop the kids from attaining non-immigrant visas to come to Peoria for heart surgery.

Sue Ann could not have been happy with OSF at that point. But what could she do? OSF is her boss.

Sue Ann sits on the Pekin City Council. She will vote regarding AMT becoming the exclusive provider of ambulance care in Pekin.

I sent her the following e mail the other day:

Dear Sue,

As a council person in Pekin, you have the most first hand information how OSF "works" in Peoria. You have also seen how OSF has worked against Haitian Hearts patients that needed repeat heart surgery and did not survive. You were obviously unable to change OSF's policy abandoning Haitian kids.

I hope you can use your position in Pekin to protect the people of Pekin.

I read in the Peoria Journal Star that AMT would like to have an exclusive contract with Pekin.

My hope is that the earliest-arriving-best-trained-person is able to provide immediate care for the person that calls 911 in Pekin.

Please see these two links regarding Peoria's EMS situation. They provide a background regarding EMS, the Peoria Fire Department, AMT, and the way the policy regarding EMS care has evolved in Peoria.

http://www.pjstar.com/news/x158039658/Pekin-in-talks-with-AMT-for-ambulance-service

http://pmmdaily.blogspot.com/2008/09/peoria-emergency-medical-services.html

Thank you.

John A. Carroll, M.D.
Peoria

Pekin and Advanced Medical Transport...Here We Go Again

Pekin in talks with AMT for ambulance service
Deal would make AMT the only service in town
--------------------------------------------------------------------------------

By KEVIN SAMPIER
of the Journal Star
Posted Oct 31, 2008 @ 08:29 PM

--------------------------------------------------------------------------------
PEKIN — Advanced Medical Transport and city administrators are working out a deal to make AMT the only ambulance service in town, and the company will pay the city for the privilege.

"We'd like to get this accomplished by the end of the year," City Manager Dennis Kief said Friday about the pending franchise agreement giving AMT an exclusive contract to provide ambulance service in Pekin.

Kief said negotiations are in the earliest stages, and the franchise agreement would benefit both parties.

Pekin and others cities commonly enter into franchise agreements with telephone, cable, water and power companies, eliminating competition for those businesses.

In exchange, companies pay cities for the privilege of being the only provider of a particular service.

"It does in fact generate a fee for the municipality," Kief said of the pending agreement, but a specific amount is still being negotiated.

Currently, AMT provides ambulance service in Pekin and pays a portion of costs incurred by the city and county dispatch center.

Kief said an agreement would also bring better efficiency because the city and AMT would share reports and could better collaborate when emergency calls are received.

"I think it's a good thing for both sides," he said.

Administrators with AMT could not be reached for comment Friday.

Mayor Dave Tebben said the agreement would be modeled after the one between AMT and Peoria.

"We're in the early stages of discussion," Tebben said, adding that he and Kief have met with AMT only once.

Tebben said the agreement could also provide city firefighters with additional training.

Kief said the city is preparing an offer to give AMT, which will then make changes and recommendations to the proposal.

The Pekin City Council will have the final say on the agreement.

"It's not yet on the agenda," Tebben said.



Kevin Sampier can be reached at 346-5300 or ksampier@pjstar.com.

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Comments (1)
AMT wants to be the exclusive provider of ambulance service in Pekin. In Peoria for the past 15 years this has meant that Advanced Medical Transport (AMT) has been the only provider of paramedic service and transport. AMT did not want the Peoria Fire Department to be in the ambulance service.

I hope the Pekin City Council makes the right decision. Many lives depend on this.

The history of Emergency Medical Services (EMS) in Peoria is complex and has not been transparent. It is also shrouded in conflict of interest. And I hope that Pekin does not make the same mistakes that we have made in Peoria.

Quick history of EMS in Peoria:

An EMS region in the state of Illinois is controlled by a medical doctor. This medical doctor is called the Project Medical Director (PMD). He is the physician in charge of EMS units in municipal areas, rural areas, volunteer fire departments, and Advanced Medical Transport (AMT) based in Peoria.

This physician is employed by OSF in Peoria. This physician controls what goes on in Pekin too.

For many years the PMD in Peoria was Dr. George Hevesy. Dr. Hevesy is currently the Director of the Emergency Department at OSF and is Corporate Medical Director of AMT. He receives a salary from both OSF and AMT. AMT has been the only paramedic and transport agency in Peoria for many years.

The current Project Medical Director works for OSF and Dr. Hevesy is his boss.

The three hospitals in Peoria and Pekin Hospital all have a big interest in AMT. They all support AMT and have had hospital administrators on AMTs board.

If AMT gets the exclusive contract in Pekin, it would mean that AMT calls the shots and I believe that the Peoria based Project Medical Director is going to support AMT. I worry about what this may mean since the Peoria Fire Department has been mired at a basic level and the Peoria Fire Department doesnt even own an ambulance for transport. AMT has stated in the Journal Star that the Peoria Fire Department could not upgrade if AMT was the exclusive provider in Peoria. What kind of community service is this?

Many cities in Illinois and around the country have their EMS based out of their fire department. They often work in conjunction with transport agencies such as AMT.

Reviewing the Pekin Fire Department website reveals they have 49 firefighters and 21 of them have Intermediate or Paramedic skills to provide for Pekin when 911 is called for someone in distress. In other words, many Pekin firefighters can provide advanced skills for the patient.

People want to know that the best trained person that arrives at their home be able to help them immediately. When the Pekin Fire Department arrives at the scene of a medical emergency and they have paramedic/firefighters with them, these paramedic/firefighters should be able to provide emergent care right away. For many years in Peoria, the Peoria firefighter/paramedics have NOT been able to provide this service for Peorians. The patient had to wait until AMT arrived to receive advanced care. How many lives were lost with this policy?

This is a highly political issue. Physicians are afraid to speak out in support of the most appropriate care for the 911 patient because of all of the business and hospitals that support AMT.

The Pekin City Council will get inundated by people that support AMT. However, these same people may be looking at the business side of medicine and not the compasionate side. We can only hope that the Pekin City Council makes the right decision for the people of Pekin and that conflict of interest does not get in the way as it has in Peoria.

John A. Carroll, M.D.
Peoria

This is Good News

Haitian Hearts has another patient accepted...Heureuse!!

More to follow....

This is Bad News

October 15, 2008

Poor to suffer meltdown as well

By ALEXANDER G. HIGGINS
Associated Press

GENEVA -- The world's poorest people will be hungrier, sicker and have fewer jobs as a result of the global financial crisis, and cash-strapped aid agencies will be less able to help, aid groups are warning.

The charities that provide food, medicine and other relief on the ground say cutbacks have already started, but it will take months or more before the full impact is felt in the poorest countries of Africa, Latin America and Asia.

During global recessions in the 1970s and 1990s, aid spending dropped sharply and took years to recover, said Matt Grainger of the British-based charity Oxfam International.

Aid agencies face more than just the prospect of plummeting donations. Higher food prices and more joblessness are greatly increasing the number of people who need assistance.

Philippe Guiton of World Vision told the Associated Press that his agency plans to cut back hiring, which will have implications for delivering aid to the needy.

"What we are going to do now is to issue an order to reduce spending, to delay recruitment, delay purchases of capital assets, etc., until we can see clearer how much our income has dropped," he said.

Robert Glasser, secretary-general of CARE International, said the agency has "a number of major donors who have invested heavily in the markets and have now seen their portfolios take a big hit."

What that will mean on the ground could take months to gauge and perhaps years for a complete recovery, aid groups said.

In impoverished Haiti, funding for projects to rebuild from tropical storms that killed nearly 800 people and destroyed more than half the nation's agriculture hangs in the balance.

"It's too soon to tell yet because we haven't heard back positively or negatively from our major donors," Greg Elder, deputy head of programming for U.S-based Catholic Relief Services, said by telephone from the battered port of Les Cayes.

The group is waiting for word from the U.S. Agency for International Development on whether it will get $2 million for 10 new food-for-work projects, which provide Haitians with rations in exchange for building roads, irrigation systems and environmental projects.

That means problems across the board, said CARE's Glasser. Wealthy countries will stop investing in developing countries, and cut back on imports from poorer countries, leaving their governments with less money to pay for health care and schools, he said.

In Zimbabwe, a Red Cross food program for 260,000 orphans and HIV-infected people began last month to make sure AIDS victims have sufficient nourishment in a nation where millions are going hungry because of drought and land-seizures that have devastated agriculture.

HIV-infected people are especially vulnerable because without food they cannot tolerate their medicine.

"The farmers' food stores are depleted. There is no food available," said Peter Lundberg, country representative of the International Federation of Red Cross and Red Crescent Societies.

"I spoke to a family a few days ago and I said, 'How are you coping?' Basically this was a poor farmer family. And they said, 'We used to have three, maybe four, meals a day and now we're down to one meal.'"

Medecins Sans Frontieres, which runs AIDS clinics in the Cape Town township of Khayelitsha in South Africa, said it's "far too early" to determine the impact the crisis would have on donations.

"The money we're spending now was collected some time ago," said Henrik Glette, a South Africa-based spokesman for the group.

But Neil Tobin, an employee of UNAIDS in Sierra Leone, warned: "It is well documented that AIDS is a problem compounded by poverty. Thus the concern is that any sharp economic downturn may present increased challenges, particularly for developing nations in responding to the epidemic."

Top scientists meeting in Cape Town, South Africa, said they feared the financial turmoil would curb research into a new AIDS vaccine.

Dr. Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases, said "the increases in the budget we had hoped for will not be forthcoming."

Alan Bernstein, head of Global Vaccine Enterprise, said the financial meltdown is "not good news for research in general and vaccine research in particular."

Associated Press writers Jonathan M. Katz in Port-au-Prince, Haiti; Michelle Faul and Donna Bryson in Johannesburg, South Africa, and Clare Nullis in Cape Town, South Africa contributed to this report.

--------------------------------------------------------------------------------

Haitian Hearts Has Another Patient Accepted

Today was a great day.

Miterlande is a 16 year old girl who lives near Port-au-Prince.

We examined her for the first time two years ago. She has severe mitral valve regurgitation and stenosis. This valve was destroyed because of rheumatic fever.

Miterlande was accepted today into an excellent medical center in the United States with a great cardiovascular team. She will have heart surgery soon!

Work on her visa has already started.

(For the three of you who faithfully read this blog, Heureuse still patiently waits in Carrefour.)

Haitian Deportations...Catholic Bishops Say "No"

Posted on Wed, Oct. 15, 2008

U.S. bishops call for halt in Haitian deportations

The U.S. Conference of Catholic Bishops, citing humanitarian reasons, has joined the growing call for the Bush administration to designate Temporary Protected Status for undocumented Haitians living in the United States.

The TPS status -- set aside for countries suffering from political tumult and natural disasters -- would allow undocumented Haitians to reside legally in the United States and obtain work permits.

In an Oct. 8 letter to President Bush, Cardinal Francis George of Chicago, president of the U.S. Conference of Catholic Bishops, argued that Haiti qualifies for TPS because of the recent devastation of consecutive storms and an earlier food crisis.

The letter, made public Tuesday, calls for TPS for an 18-month period and also noted that conditions in Haiti are comparable to or worse than those in countries that recently received an extension of TPS, such as El Salvador, Honduras and Nicaragua.

--------------------------------------------------------------------------------

© 2008 Miami Herald Media Company. All Rights Reserved.

New York Times Editorial

October 13, 2008

New York Times Editorial

Help for Haiti

This year has been especially cruel to Haiti, with four back-to-back storms that killed hundreds of people, uprooted tens of thousands more and obliterated houses, roads and crops. A far richer country would have been left reeling; Haiti is as poor as poor gets in this half of the globe. Those who have seen the damage say it is hard to convey the new depths of misery there.

The Bush administration promised Haiti $10 million in emergency aid and Congress has since authorized $100 million for relief and reconstruction. The United Nations has issued a global appeal for another $100 million. We have no doubt that Haiti will need much more.

There is something the United States can do immediately to help Haitians help themselves. It is to grant “temporary protected status” to undocumented Haitians in the United States, so they can live and work legally as their country struggles back from its latest catastrophe.

This is the same protection that has been given for years, in 18-month increments, to tens of thousands of Nicaraguans, Hondurans, Salvadorans and others whose countries have been afflicted by war, earthquakes and hurricanes.

While the Bush administration has temporarily stopped deporting Haitians since Hurricane Ike last month, it has not been willing to go the next step of officially granting temporary protected status to the undocumented Haitians living here.

Haiti’s president, René Préval, and members of Congress have urged the administration to change its mind. We urge the same.

There is very little that is consistent in the United States’ immigration policies toward its nearest neighbors, except that the rawest deal usually goes to the Haitians. Cubans who make it to dry land here are allowed to stay; those intercepted at sea are not. Hondurans and Nicaraguans who fled Hurricane Mitch 10 years ago have seen their temporary protected status renewed, as have Salvadorans uprooted by earthquakes in 2001.

Haiti, meanwhile, more than meets the conditions that immigration law requires for its citizens here to receive temporary protected status, including ongoing armed conflict and a dire natural or environmental disaster that leaves a country unable to handle the safe return of its migrants.

If Haiti is ever going to find the road to recovery after decades of dictatorship, upheaval and decay, it will take more than post-hurricane shipments of food and water. Haiti desperately needs money, trade, investment and infrastructure repairs.

It also needs the support of Haitians in the United States, who send home more than $1 billion a year. What it does not need, especially right now, is a forced influx of homeless, jobless deportees.

ER Crowding Still a Hot Topic

The day after I wrote OSF's Administation about Emergency Room overcrowding in our Emergency Room in Peoria, I was put on probation for six months.

Here is my letter that eventually got me fired.

That was September, 2001.

ER overcrowding is still a big issue in the Emergency Medicine literature.

Emergency Medicine News has this online article this month. It was written by Dr. Peter Viccellio.

He said that patients should not be boarded (held in hallways) in the ER. They should be admitted. In the ER at OSF we were holding patients for hours in the hallways. And patients in ER rooms and hallways were not getting admitted in an appropriate time fashion in my opinion.

Dr. Viccellio writes that ER overcrowding is a systemic hospital problem. And that is I why I wrote Keith Steffen and many others because this problem could not be solved only at the ER level.

Heureuse Means Happy

This following is an online chat I had with Dejean (Frandy) today regarding Heureuse. Heureuse is the 29 year old Haitian gal that needs heart surgery....Dejean is our 19 year old Haitian young man who helps Haitian Hearts on the ground in PAP when we are not there...please pray we find a medical center for Heureuse very soon.

She was operated at OSF in Peoria in 2002, but OSF will not allow her to return for repeat heart surgery.

From: Dejean Frandy
Date: Sat, Oct 11, 2008 at 1:09 PM
Subject: Chat with Dejean Frandy
To: haitianhearts@gmail.com

12:55 PM me: frandy are you there?
Dejean: yes
how are you doing?
me: talk to me...
12:56 PM Dejean: ok
She's not doing ok for now
she can't breath well
12:57 PM and she's losing weigh seriously
she looks very thin
me: is she taking her medication?
Dejean: her heart is beating so quick
yes
12:58 PM she's taking the same piles
12:59 PM me: ok
Dejean: but they don't do nothing to reduce the pain
1:00 PM she cried when i saw her
me: why did she cry?
where is her pain?
1:01 PM Dejean: because she's surffering
she can't hold her stomac
me: is she able to walk outside her house?
Dejean: when her heart beats
1:02 PM yes
but she's pretty afraid of her health condition
1:03 PM me: tell her to decrease her furosemide to twice each day...not three times each day...she needs to eat bananas also
Dejean: i asked her to save her money food
1:04 PM i don't let her call me
ok
1:05 PM me: frandy, let her call you once each day...
tell her we are working hard to find her a hosptial...are her kids gone?
1:06 PM Dejean: so i am doing my best to visit her everyday
they are gone ok
me: thanks
Dejean: they are in her country side
me: can you take her to dr pilie this week?
is there anyone that can stay with her if she is admitted to the general hospital??
Dejean: ok i will
1:07 PM me: tell her not to give up and to kenbe fem...
Dejean: she wants to do that for now
she just needs your word
me: wants to do what?
1:08 PM Dejean: she wants to be hospitalized over there
me: tell her maria and i have not forgotten her...i sent her medication this morning...it will go to gertrude
Dejean: ok
1:09 PM me: tell her not to take enalapril for two days to see if she feels better...
Dejean: ok
i got you
me: see you later, friend...
1:10 PM Dejean: ok
me: also, you are going to get your computer this week from dr ebel...
Dejean: yes he told me that
1:11 PM me: au revoir...
Dejean: you know what? they are very good
me: yes they are...
Dejean: tell them i said "merci beaucoup"
me: dako..
Dejean: they really want to take me out of poverty
1:12 PM with only one thing
education
i like it
me: dako...
Dejean: thank you very much
thank you
byeeee
me: du rien...
Dejean: let me write him back
me: dako...

Two Years Later, Angel Gets a Chance

Almost two years ago Haitian Hearts examined a 5 year old girl named Angel. Her exam and echocardiogram revealed congenital heart disease.

We did admit her to a Haitian children's hospital for pneumonia in November, 2006 and she reovered nicely.

We documented Angel's plight on this post.

Guess what?

Angel is having heart surgery TODAY in the States. There is a God.

Stanley, the other child described in the post, has been "lost to follow up".

Look How Joliet's EMS Works

Click on this link to see how the Joliet Fire Department works for Joliet.

Joliet has Paramedics in every station. Peoria has only been "cleared" to have two stations function as Paramedic.

Why?

The Joliet Fire Department has 9 ambulances for Paramedic care. The Peoria Fire Department doesn't even own an ambulance.

Why?

And all firefighters in Joliet must be Paramedics. Sounds like the Joliet Fire Department is supported by the city and Provena Saint Joseph Medical Center.

Quite a bit different than Peoria.

Why?

Peoria Emergency Medical Services Timeline (Update X 4)

Ethics/Emergency Medicine

OSF in Peoria has done egregious things during the past decade. OSF-SFMC is the largest medical center in downstate Illinois.

The OSF-Emergency Room is overcrowded and understaffed and the Medical Center does not allocate enough hospital beds to accommodate the ER patients that are waiting. Studies have shown increased morbidity for patients that wait excessive amounts of time in the ER hallways.

OSF has turned away dying Haitian kids who have been operated at OSF in the past and need surgery again. Haitian Hearts has offered substantial funds for their care to no avail. Two patients have died in the last two years and four more OSF Haitian Hearts patients are in Haiti now and need repeat heart surgery soon or they will die too. A recent letter to the OSF-CHOI International Committee regarding these patients went unanswered.

A few years ago OSF-SFMC closed their Psychiatric Unit. It was not making enough money. Peoria’s psychiatric patients are given poor care and with the closure of this unit their care was compromised even more.

And, in my opinion, OSF has helped create a monopoly regarding ambulance services in Peoria. And in my opinion this has delayed and hindered the care of many Peorians who call 911. There is conflict of interest here and this is what this article will describe in a timeline.

The timeline will consist of articles in the Journal Star, excerpts from articles in medical journals, articles off the Internet including Peoria's Medical Mafia , discussions I have had with people regarding Peoria’s EMS, and my comments regarding the situation.

Here is a brief summary of the timeline with the full text below the summary.

Summary:

1. February 18, 1996—Peoria Journal Star editorial stating that the Peoria Fire Department should not go into the ambulance business. Dr. George Hevesy concurs. Editors don’t report that Hevesy receives a salary from Advanced Medical Transport (AMT).

In February, Andrew Rand, Executive Director of AMT, is interviewed by InterBusiness Issues (II), a local magazine. Mr. Rand is asked this question and responds:

II: But since the fire department already responds to some 911 medical calls, they say it is a natural extension of their services to take over the paramedic ambulance service.

AR: I would think that workers trained to spray the wet stuff on the red stuff are not trained to meet the standards of our people who use very skilled procedures to insert tubes in patients’ lungs, needles in their veins, apply electricity to their hearts and administer lifesaving medications and other treatments. This is hardly an extension of putting out a house fire. The medical training of fire personnel is minimal in comparison to an advanced life support system. The services they provide presently include basic CPR, bandaging and minor splinting. In the grand scheme of an acute life-threatening injury or emergency, the firefighter’s role is very brief and limited. The role of our paramedics is very substantial to the total time spent caring for a patient.

My comments:

Wow...Mr. Rand knows how to spin.

Jumping ahead 6 years to 2002, Rand said that if AMT got the contract from the City of Peoria for the next 10 years, he would agree that the PFD could upgrade their emergency medical care and this would improve quality of care. And this would not be "brief and limited care" as Rand describes above. And Rand didn't explain how EMS is based out of many municipal Fire Departments in Illinois, and somehow these firefighters are "educable" regarding providing advanced care to 911 patients.

And Mr. Rand did not describe how he had the local Project Medical Director, Dr. George Hevesy, in his back pocket. Also, when this interview was done, Peoria did not know that just a few years later, AMT would be found guilty by federal investigators of Medicare fraud and fined over 2 million dollars. So, even though Mr. Rand gave the impression he cared about Peoria's taxpayers, AMT was ripping them off. The three Peoria hospitals paid the fine, which caused local health care to increase all the more.

Unfortunately, it is all about money.


2. May 1, 1996---Ernie Russell, Peoria Fire Chief, states that the PFD wants to upgrade services. Ambulance plan blocked again.

3. November 17, 2002—My OP-ED article stating that the PFD should be allowed to advance its medical care for Peorians.

4. December 2, 2002---Journal Star article reporting that Andrew Rand, Director of Advanced Medical Transport, is worried about the PFD upgrading their services.

5. January, 2003---Journal Star article reporting that AMT wants a contract with City for next 10 years. Peoria Fire Department Union disagrees and plan voted down by Peoria City Council. A follow up Journal Star editorial is about the same as their editorial in 1996. It supports AMT and the doctors that advocate for AMT. (You just have to read the Firehouse Forums article written about this vote, Dr. George Hevesy, the Advanced Medical Transport Medicare fraud, and conflict of interest in Peoria. I have it copied for you. It is very good and written from the inside of Peoria's EMS.)

6. December 15, 2003---The Catholic Diocese of Peoria states they can do nothing about the alleged ambulance monopoly in Peoria…largely supported by OSF. They advise me to discuss this situation with Rome.

7. 2004---Multiple Forum articles by my brother, Tom Carroll, and me discussing multiple EMS topics, the danger of the ambulance monopoly in Peoria, and the Peoria Fire Department being forced to sell its only ambulance.

In September, a consulting firm from California, studies the EMS situation in Peoria and reports to the City Council. They think that having four advanced life support units run by the PFD would be reasonable.

Council Member Ardis also expressed his concerns regarding emergency services in the Fifth District. He discussed the inexpensive option of establishing four-ALS engine companies. He said he would be interested in exploring this in lieu of spending $1 million to open a new fire station. He said Council should look at this in terms of policy direction.

No action is taken and the PFD stays at Basic. Where were Drs. George Hevesy and Rick Miller advising that PFD medical upgrades happen?

8. February 1, 2005---The City Council voted to sell the only PFD ambulance they owned. The Project Medical Director and previous Director of the Emergency Department at OSF, Dr. Rick Miller, did not allow them to staff or use it to respond to 911 calls by Peorians. It sat in a garage on Galena Road until it was sold on e bay.

9. July 5, 2005—I addressed the City Council and told them of a man who was denied advanced life support after collapsing in a Peoria restaurant. The next day the Journal Star had an article quoting Dr. Rick Miller and Andrew Rand who stated that I was making inflammatory statements. However they did not deny that the horrible event I described happened. And behind the scenes Miller makes changes which allows the PFD to upgrade their care a little bit. I think this news about the patient in the restaurant frightened Dr. Miller when he realized the serious ramifications for Peoria's EMS.

10. June, 2008---Bus accident occurs in Peoria. Peoria Fire Department watches as Peoria City Link (public bus transportation) transports injured to local emergency departments. My Forum article describing this “killed” by Journal Star editor.

11. July 7, 2008---Peoria City Council votes unanimously to approve a contract between the PFD and the City which will allow, for the first time ever, two Peoria Fire Stations to offer advanced life support for Peorians. (The Journal Star does not report this historic vote.) Hopefully, as time passes, more PFD firefighters will advance from Basic to Paramedic and the entire city will be covered by firefighters who will provide advanced life support.

12. My recommendation on a course of action regarding conflict of interest.

----------------------



Detailed Description of Peoria's EMS Timeline:

February 18, 1996:

Peoria Journal Star Editorial---

The Journal Star editors did not think that the Peoria Fire Department should go into the ambulance business.

“What we have heard is a medical community speaking up in support of AMT…George Hevesy, emergency services director at St. Francis Medical Center, says he fears city-run service would lack the expertise, the funding and the medical supervision to provide a high quality of care.”

This was an amazing statement by Hevesy because he was in charge of all the emergency agencies in central Illinois including the PFD and if the PFD lacked the expertise or lacked the medical supervision, that was Hevesy’s responsibilty.

The Journal Star did not report that Hevesy was on AMT’s payroll and that their was obvious conflict of interest. Hevesy was in charge of about 70 EMS units in central Illinois.

Hevesy later told the Peoria City Council that there would be “duplication of services” if the Fire Department went into the paramedic/ambulance business. This would become the PAEMSS mantra for the following decade to attempt to monopolize advanced emergency medical care for AMT…the company that was paying Dr. Hevesy.

Here are excerpts from the document stating that Hevesy receives a salary from AMT that I obtained through the Freedom of Information Act filed with the Illinois Department of Public Health:


“The stipend is justly provided to the EMS Medical Director for oversight and consultation provided to this comprehensive EMS provider. This EMS provider accounts for the majority of the System’s EMS responses and interfacility transfers. Additionally, this EMS agency provides a unique regional critical care (inter-facility) transfer service under the direct medical control of the EMS Medical Director.

”This stipend does not create an agreement or atmosphere which makes the EMS Medical Director answerable to or directed by the EMS provider. Nor has it influenced the Medical Director’s assistance of other providers.The Peoria Area EMS Medical Advisory Board and the Ambulance Board of Directors, consisting of representatives of the Peoria area hospitals, have reviewed the stipend and believe there is no potential or actual conflict of interest.”

My comments:

The “EMS provider” stated above is AMT. I wonder what the PFD would say about influencing the medical director’s assistance with regards to the PFD? The Ambulance Board of Directors must be the AMT Board of Directors because there are no other ambulances in Peoria.

This is truly an amazing document.

Locally and nationally, people in EMS believe this represents "conflict of interest".

Firefighters stated that they “tap their toes nervously” and wait for AMT to arrive when they have a patient with severe breathing problems and are unable to help the patient other than give basic life support, even though the PFD had firefighters with advanced skills (Intermediate and Paramedics). Firefighters in the Peoria area have told me that Hevesy “obstructed” their departments when they attempted to upgrade their services for their citizens. The municipal fire departments are not paying Hevesy---AMT is. AMT is the only paramedic and transport service in the city of Peoria.

Three are two fundamental ethical premises that guide prehospital medical care. The principle of justice implies that the system be fair and equitable. The principle of beneficence requires that actions and intentions are in the best interest of the patient.

Are these ethical premises adhered to in Peoria?



May 1, 1996:

There was an interesting article in the PJS headlined: “Ambulance Plan Abandoned–Fire Department to Add Defibrillation Program”.

The article seems like it could almost have been written yesterday.

AMT was worried that the PFD would go into the ambulance and transport business. Andrew Rand, AMT’s Director was worried about the financial ramifications for AMT if the PFD advanced to paramedic and transport.

Peoria Fire Chief Ernie Russell stated, “When we first started looking at this we had to answer was the service being offered now at a quality that we wanted. We said “no”. We wanted quicker response and the defibrillation ability…”

However, the decision was made once again for the PFD to stay at basic level. The PFD couldn’t even give basic drugs and the 911 patient had to wait for AMT to arrive at the scene to receive defibrillation (electrical shock to the heart) and advanced drugs. (The Peoria Fire Department eventually bought their own defibrillators to shock hearts during a cardiac arrest in ‘96 or ‘97. And AMT had been shocking cardiac arrest victims for years.)



November 17, 2002:

I wrote an Op-Ed article that said that the PFD should be allowed to upgrade to Paramedic and transport, i.e. take patients to local emergency departments in a PFD ambulance.

“As a physician who worked at OSF St. Francis Medical Center for 20 years, I know that the AMT paramedics, municipal firefighters and volunteer fire departments do their very best under difficult circumstances in urban, suburban and rural areas. The many firefighters I have spoken to have been frustrated that they have not been permitted to attain and use these life-saving skills. Lives hang in the balance during these crucial minutes, and care that is late or sub-optimal contributes to poor outcomes. The Peoria firefighters know this all too well, as they have witnessed patients that they couldn’t give paramedic care to and deteriorate when they couldn't even "load and go."


Dr. Todd Nelson, a graduate of the OSF-ED Residency program in Peoria is now an EMS director in Manitowoc, Wisconsin. He wrote a Forum article disputing what I had written in the Op-Ed. He is associated with the University of Wisconsin School of Medicine.

Dr. Nelson was recruited by OSF in Peoria and it is my gut feeling that he was asked to write this article. He tried to instill fear with his article.

His article starts with the following paragraph:

“Just imagine your house catches on fire. A lengthy time passes prior to the firefighters arriving, so it burns to the ground. The reason for the delay was that the crew normally at your fire station had been called out on an emergency medical call. This left nobody at the station to provide protection against a fire. If firefighters are to assume the additional duties of providing advanced life support and transporting of patients to area hospitals, the above scenario may become reality.”

The scenario that Dr. Nelson describes is obviously hypothetical. A separate fire and cardiac arrest elsewhere in the same precinct happening at the same time in Peoria is unlikely. And if this DID happen, AMT would be called for the medical emergency. It is not impossible but it is a stretch and takes a leap of faith to believe what Dr. Nelson is writing.

Dr. Nelson used the same mantra, “duplication of services”, that Dr. Hevesy had used years before to contest the PFD moving into the advanced life support and transport business. Neither doctor of course wanted to see AMT lose any business… and Dr. Hevesy was being paid by both AMT and OSF.

Dr. Nelson ended his article with this sentence:

“Why then increase their (PFD) responsibilites even more by having them (PFD) acquire and maintain skills needed to provide quality ALS care?”

What Dr. Nelson left out of his article, of course, was that the PFD already had licencsed Paramedics who could have used their skills right then at the scene of a medical emergency if the Project Medical Director (the doctor in charge of all ambulances in the area) had allowed them. And Dr. Nelson should not have worried himself about the fire fighting responsibilities of the Fire Department.

Shouldn’t Dr. Nelson, being an EMS physician in Wisconsin, have advocated that the best trained and earliest arriving provider give the care? And the PFD could have provided quality ALS at the scene to dying people when minutes are precious… if they were allowed. But they were not allowed to...

Neither Dr. Hevesy or Dr. Nelson should be worried about the PFD fighting fires. Neither are experts in this area. Money and relationships were guiding them to say what they said.

(I sent Dr. Nelson an e mail recently asking him what he thought about the new 2008 policy in Peoria which will allow the PFD to give advanced life support at the scene…something he did not even mention as a good alternative when he wrote his forum article in 2002. I received no response from Dr. Nelson. Addendum: I finally did receive a response from Dr. Nelson. And believe it or not, he is medical director of two municipal fire departments that provide advanced life support with Paramedics. Hmmm...)


December 8, 2002

Another Journal Star article about the PFD wanting to be allowed to give better medical care--

“The city of Peoria wants to upgrade its fire department from offering basic life support services as it does now to becoming an intermediate service that can also administer medication in emergency situations.”

My comments when this article was written: There are 3 levels of prehospital care: Basic, Intermediate, and Advanced. Advanced is the same as Paramedic care. The PFD still is just Basic which is the lowest level. Up until just a few years ago, the PFD couldn’t even give an aspirin at the scene of a heart attack even when aspirin is most useful when given early and can decrease mortality up to 40%. The project medical director was Dr. George Hevesy for most of the 90’s and he was on AMT’s payroll as well as OSF’s payroll. AMT is the only Paramedic provider in Peoria even though the PFD has firefighters who are Paramedics and Intermediates.

The article went on to report that most ambulance services are certified to provide advanced life support services (Paramedic). However…"for years AMT has balked at the fire department entering this arena". Andrew Rand, director of AMT, stated that AMT is willing to help the fire department advance to the Intermediate level, but it (AMT) does not want the department to transport patients. Rand went on to say, “They can provide more comprehensive care than they do now (in 2002)”.

My comments: Why would Mr. Rand be stating this? He did not want to lose the transport business to the PFD. And AMT makes very big money.

Where was Dr. Hevesy in this? He was being paid by AMT. So, as it turned out, because AMT did not get the 10 year contract that they wanted several weeks later, the PFD was still at Basic life support and cannot transport, and cannot give life sustaining drugs during a cardiac arrest in 2005.

I would like to see Dr. Hevesy’s written directives that the PFD must increase its level of services to the citizens of Peoria. Did he write any or did he just support AMT as the only paramedic providers in town as he picked up his check from them as their “Corporate Medical Director”.

The Journal Star continued:

“Proponents of letting the fire department transport patients argue that the fire department should be in the ambulance business because it is usually first on the scene of an emergency situation and provides basic life support. They argue that two or three minutes can make a difference in saving a life. In addition to transporting patients, proponents want the firefighter to be able to administer the necessary drugs and bill the patient for the service.”

My comments at the time of the article: Medical studies have shown that advanced life support definitely helps with chest pain patients and patients who are short of breath. The PFD gets thousands of these 911 calls per year and can only give basic life support with very basic medications. This seems like a travesty to me but most people just simply don’t understand this and when they see the PFD truck with RESCUE painted on the side, they believe it. Frequently firefighters do RESCUE people, but not with the advanced life support drugs they should be able to carry and use.

Dr. Rick Miller was the current project medical director and former director of the OSF ED when this article was written and the PFD did not advancing its care rapidly under his guidance either.

I have spoken to many people involved in emergency medical systems in the state of Illinois, and they know how it plays in Peoria.

The Journal Star article continued: “Rand disputes that the fire department is usually the first responder.”

“That is absolutely false,” Rand said.

My comments: Rand was proven wrong two years later by the Matrix study done in 2004 which showed that the PFD arrived approximately 2 minutes quicker to the scene involving life threatening situations.

Councilman Jim Ardis went on to say in the PJS article,”If we want to have a highly trained fire and medical department in the city , there is nothing that AMT can do to prevent us from doing so”. “I don’t think that anyone can make the argument that anybody would not want the best trained people to be there for them all the time in case of an emergency. Why would you not want that?”

My comments: Councilman Ardis (now Mayor Ardis) was exactly right.. The EMS system in Peoria is shrouded in conflict of interest. (In early 2003, AMT lost the vote for the 10 year contract they wanted, but they continued to monopolize the paramedic industry in Peoria with the help of OSF and the physicians who should be protecting you in a 911 crisis.)

I sent a letter regarding this conflict of interest to OSF leaders including Jim Moore, Sister Judith Ann, Gerry McShane, Joseph Piccione, and Howard Wiles (the compliance officer for OSF Corporate) in May of 2002 (approximately 7 months before the PJS article above). I received no response from anyone of the above. Joe Piccione, the OSF corporate ethicist told me in the fall of 2001 that I was mandated to report conflict of interest, but when I did, no one responded.

OSF is of course one of the main supporters of AMT and the base station for all emergency response services in Central Illinois.

I picketed OSF with a sign stating that OSF and AMT had a monopoly of paramedic services during the summer of 2003. Sue Wozniak, CFO at OSF and AMT board member scolded me one afternoon as she was leaving work for picketing the hospital. I asked her what she thought about Hevesy receiving a salary from AMT when he was director of ALL ambulances in Central Illinois. She said it was a good idea that Hevesy “stepped away from this” as he was PROMOTED to director of the Emergency Department at OSF. Incredibly, she stated that Hevesy was still paid by AMT. I couldn’t believe that she would admit this. I thought that she would require that I go through the Freedom Of Information Act again to get this information.

I kept the Catholic Diocese of Peoria informed regarding this conflict of interest. I believed then and believe now that it needed the pastoral care of Bishop Jenky and that he should stop this at OSF and its “affiliate” AMT. If OSF wouldn’t provide checks and balances for itself, maybe the Bishop would.

I presented this to Monsignor Rohlfs and Patricia Gibson in the Monsignor’s office in the spring of 2003. I told them that I wanted to petition the OSF Sisters for a Catholic tribunal court. Patricia Gibson and Monsignor had helped me write one petition in December of 2002. Monsignor Rohlfs told me that if I petitioned the Sisters for ANYTHING, the Diocese would come out against me in the media. I asked him what he meant by this and he replied that the Diocese would “come out against Haitian Hearts in the media.” I told him that I needed to do this and presented this to Bishop Jenky the next day at the chancery.

Bishop Jenky told me “there will be no tribunal against OSF….it is a $1.6 billion industry, doctor.” True to form, after I filed the petitions for the tribunal court (one being for conflict of interest regarding emergency medical services—see below),the Diocese advised me to go to Rome to solve this problem and the Diocese pulled their nominal support for Haitian Hearts while I was working in Haiti reported on a front page Journal Star article in mid-July, 2003.


January 11, 2003--

The Journal star had an article that headed up the Local section with big headlines-

AMT Wants City to Sign 10 Year Contract:

“Representatives of Peoria’s sole ambulance service want the city to sign an agreement giving them exclusive rights to continue treating and transporting patients for the next 10 years.

“Every time you turn around the fire department is proposing to start up ambulance service,” said Andrew Rand, Advanced Medical Transport executive director.” “We want to create some stability…who needs to be in fear of municipal takeover? It’s a distraction to our principle goal of tending to patients.”

The article continues:

“For several years, city officials have discussed the option of allowing the Fire Department to expand its role to include transporting patients to the hospital and providing advanced life support, the highest level of Paramedic care.”

Mr. Rand was fighting for his business. It would not have have hurt AMT’s pocketbook if the PFD Paramedics were allowed to treat the patient at the scene. AMT would have still transported the patient because the PFD was not allowed to transport and even had to sell the only ambulance they owned on e bay.

George Hevesy was brought into the picture again, as he was in 1996, to fight for AMT, the company that he worked for. He was also Director of the Emergency Department (ED) at OSF, moonlighting in other ED’s in the State, working for a company that placed ED physicians in ER’s, and Director of Region II EMS for the Illinois Department of Public Health. He was very busy while the OSF-ER carried the lowest patient satisfaction scores at OSF-SFMC.

According to this article, Hevesy claimed that if Peoria firefighters took up that role ---paramedic and transport---it would threaten to fragment the current EMS system and potentially jeopardize patient care.

What this translates to is that Hevesy was fighting for AMT that paid him to make statements such as these.

Again Hevesy tried to scare the public like Dr. Nelson did a few months before.

Hevesy asked “Does that mean two ambulances will be racing to be first at the scene?” He added that firefighters also might then be distracted from their primary role which is fighting fires--the same tactic used by Dr. Nelson.

Hevesy even told the City Council that he feared “duplication of services”, which was just what Dr. Nelson was “worried” about.

What Hevesy should have done, if he was not going to sanction the PFD becoming a transport agency, was to demand that the PFD Paramedics be allowed to treat patients at the scene. (This is what has happened now in 2008.) But Hevesy and Rand and OSF were afraid if the PFD administered life saving drugs at the scence, it would not be long before they were able to use an ambulance and take people to hospitals and this is where AMT would have lost money. The patient may have done better by arriving at the hospital quicker, but I don’t think this was their priority.


January 14, 2003:

Journal Star article had a headline:
“Firefighters Union Opposes AMT Deal”

The article reported that the Peoria City Council was to vote later in the day regarding the franchise agreement between the City and AMT. The proposed franchise agreement would have allowed AMT to treat and transport patients in Peoria for the next 10 years. It also stated that if there was an agreement to this effect that the PFD would be allowed to upgrade training from Basic to Intermediate (NOT Paramedic) so the PFD could administer some drugs at the scene.

However, even with Peoria hospital support of AMT, Dr. Hevesy talking to the City Council, the editorial board at the Journal Star, and multiple people like Dr. Nelson and others writing the Journal, the City said “no” to AMT. The City Council voted down an agreement that would have prevented city firefighters from upgrading their medical training to Paramedic or moving into the ambulance business anytime soon.

So finally, after all of these years, the City said no to AMT and Peoria’s hospitals that support AMT. The City did not want handcuffs put on the PFD to stop the PFD from providing better care. And these restraints were put on the PFD by the very people that should have been helping the PFD provide more advanced care for Peorians.

In this article, Peoria’s late Fire Chief Roy Modglin hit it right on the head:

“No private business, not-for-profit should be allowed to limit the level of (medical) service provided to citizens. If this City Council want to allow our city firefighter to be doctors, that should be our perorgative.”

Ironically, local doctors were trying to STOP the PFD from upgrading its medical service.

(And I heard from a very good source that a local Project Medical Director approached the PFD and said that if he were paid by the PFD, they would upgrade their services for Peorians. I think he thought if Hevesy was paid by AMT, why shouldn’t he be paid for upgrading the PFD services. The PFD refused this offer from the local doctor because they felt they were dealing with the "devil in disguise".)

Also, Council members stated that if they would have voted for the agreement between AMT and the City, it would not have held AMT accountable for its performance. What this meant was response time and other parameters. AMT and OSF, of course, did not want people to know that AMT was about one and one half minutes behind the PFD to life threatening emergencies.

And predictably once again the editors of the Journal Star were not happy with this decision by the City.

An editorial a few days later stated that the Peoria Fire Department does not need to be in the transport business.

The editorial contained an interesting paragraph that quoted Dr. James Hubler, who was acting EMS director and Tony Ardis, President of the PFD Union.

“James Hubler, EMS Director at OSF Saint Francis, says that if Peoria were to go its own way, area residents would end up with a fragmented system that would damage the quality of care. Ardis Argues that the hospitals’ judgement is biased because they helped set up AMT and share some high-ranking personnel. Could be.”

It is more than a “could be”.

Dr. Hubler had actually been working behind the scenes with the PFD to help them upgrade so they would be allowed to use four PFD vehicles for transportation. However, late one night when Andrew Rand and Dr. Rick Miller heard about this, they discussed it on the phone and with community support were able to stop this upgrade. Dr. Hubler would eventually resign as EMS Director. He had run-ins with Andrew Rand and Dr. Hevesy, who was Hubler’s boss, would support Rand and AMT and not Dr. Hubler.

The Journal Star Editorial concluded:

“But when the experts say a system as critical as ambulance service is best left the way it is, Peorians should be extremely reluctant to throw it out, whether or not money could be made.”

The “expert” of course was mainly Dr. Hevesy and again, as they had done in 1996, the Journal left out that Hevesy was paid by AMT.



Now read this if you want a great perspective of Peoria's EMS up till this point on the time line...it appeared in Firehouse Forums on March 6, 2003 and was written by FFMEDIC51:

FFMEDIC51
03-06-2003, 05:36 AM

OSF St. Francis and the Management at Advanced Medical Transport of Central Illinois (AMT) will lead people to believe that the Emergency Medical Services (EMS) System in Peoria is one of the best and progressive systems in the nation. The Peoria EMS system is flawed and has been for years. They feel there is no reason that the Fire Department should enter into providing ALS care because it would compromise over all patient care and fracture the great system we now have in place. WOW!!!!! What a load that is. Working in the Peoria area for 15 years as a Paramedic, I worked in the system when the transition was made from Mobile Medics to AMT in 1990. Paramedics who worked in the system, including the Fire Departments (paid and volunteer) were optimistic about the new ambulance service. Some of the reasons that the Peoria hospitals restructured Mobile Medics were because there were only two advanced life support (ALS) ambulances and three basic life support (BLS) ambulances covering the City of Peoria. Peoria County was served by a very small BLS private ambulance service. The advantage to the hospital based Paramedics were the experience that they carried, low turnover, good moral, and patient care was excellent. The problem was not the quality but the quantity of ALS ambulances.

The hospitals then decided to create a third service (non-for-profit) owned by the hospitals and managed using a board of directors. Each hospital would have a representative on the board and the rest would consist of powerful private sector business leaders. AMT was created. One thing that was funny was that the Project Medical Director (PMD) (who was over every EMS provider in the Peoria EMS system) was on AMT’s payroll as their Corporate Medical Director. He has since been promoted to the Director of Emergency Medicine at OSF St. Francis (our system resource hospital) and still holds the title of Cooperate Medical Director with AMT. Isn’t this conflict of interest? I found in the early stages of AMT that management at AMT wasn’t interested in working with other departments within the Peoria EMS system. They were mainly interested in monopolizing every aspect of EMS. They’re only competition was small private services and the Fire Departments. AMT purchased all the smaller ambulance companies, but the Fire Departments would be a thorn in their side causing a threat to always be there. They are currently trying to keep all the fire departments at the basic level and getting in the way of advancing their care.

Three years ago AMT paid out over 3 million dollars to our state and federal governments, because of a settlement, over a charge against them of Medicare/ Medicaid fraud. Talk about screwing the public. Hardly anything was said about this and it was kept quite. The hospitals and private sector did a good job keeping the lid on that whole mess by taking care of the fine. They are currently on probation. Another misconception is the fact that AMT received a perfect score on a national accreditation, which was advertised a great deal in the media. The truth is that they had to pay approximately $20,000 to receive that accreditation and the Medicare / Medicaid fraud was never brought to the surface to the accreditation company.
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Another problem with AMT is that the workforce doesn’t retain experienced paramedics. The average medic works about one year, gets experience and leaves for other services or fire department jobs. This inexperience causes the EMS system and ultimately the patient to suffer. The PMD doesn’t even trust his medics on the street, making the Peoria area system behind in the times as far as advancement. I found it interesting how fast the system catered to AMT and when the local fire departments wanted to upgrade their services from BLS to ILS (intermediate life support) or paramedic level. The fire department ran into many obstacles because of AMT. It was said that the Fire Department was trying to put AMT out of business. AMT threatened a huge negative smear campaign against Fire Based EMS and Firefighters. They say the fire service wants to justify their existence. The truth is Peoria Firefighters or any Firefighters don’t have to justify their existence or their jobs. The Peoria Fire Department has been providing service to the citizens of Peoria for over 125 years and will be here long after AMT is a memory. There is no reason why the Fire Department shouldn’t be able to provide advanced life support (ALS). They have been trying for the last 12 years. They have Paramedics on staff now and they are in the process of training more.


The latest act against the Fire Department was the 10-year contract. AMT wanted exclusive transport rights in the City of Peoria good for 10yrs paying only $60,000 a year to the city in exchange for the 911 dispatching and the fire department supplying help to them when it is needed. Also the contract stated that the Peoria Fire Department could in no way upgrade to Paramedic level within the contract (Why not?). There would be no accountability for their poor response times, number of ambulances available for 911 calls, and no penalties if the service were to deteriorate further. The contract didn’t mention that any other private company could come into the city and operate at the paramedic level, but SPECIFICALLY excluded the fire department from doing so. Talk about paranoid. This contract was brought to the Peoria city council with representatives from all three hospital administrations, AMT’s board of directors, Project Medical Director, and Emergency Medical Director. The vote was close but it failed. I am sure that this is not a closed issue. This contract will be modified slightly and brought back to the council.

I really find it a shame… AMT does have the potential to be one of the best EMS providers in the system; the management of that company could work with the fire department, treat their employees better with higher pay and incentives for retention. AMT management made a choice early on to compete with the providers and not work with them. I wish that it was a different situation but unless there is a big change in management and changes throughout the resource hospital, I feel it’s going to get much worse before it gets better. There is no reason the Firefighters should roll over on this issue and keep quite while the system suffers. They have tried on numerous occasions to work with AMT management and OSF St. Francis to improve this situation and ultimately improve overall Pt. care. The Firefighters priority is the Pt. and the community they serve and I’m sure most street Paramedics priorities are the same. I have no doubt the Fire Department will be providing ALS services in some capacity soon. It’s a win win for the city and the citizens. Some forget why we are here in the first place. “It will play in Peoria” It’s just a matter of time…
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The person that posted above is a fire fighter on a fire fighter's forum and he has his bias...but he seems pretty fair and objective as he described the situation in Peoria.

A fire chief in a very large city in Illinois told me, “You have a very unfortunate situation in Peoria.” He was referring to OSF’s monopoly of the Paramedic and transport situation in Peoria and OSF’s influence in Springfield at the Illinois Department of Public Health.



November, 2003

I wrote Bishop Daniel Jenky expressing my concerns regarding the ambulance monopoly in Peoria which was supported by OSF.

I received this letter in reply:

OFFICE OF THE VICAR GENERAL
412 N. E. Madison Avenue Peoria, Illinois 61603-3720
Telephone 309-671-1550 FAX 309-671-1558
December 15, 2003


DIOCESE OF PEORIA

Dear Doctor Carroll:

Bishop Jenky is in receipt of your fourth petition regarding OSF St. Francis and the alleged monopoly carried on by the Advanced Medical Transport Company at OSF St. Francis.

After taking canonical counsel on the matter he wishes to state once again that any such issue involving the Third Order of St. Francis would have to be taken up by Rome itself rather than the diocese, as it is an "Exempt Religious Congregation of Pontifical Jurisdiction". It is the considered opinion of our canonists that the Bishop would have no jurisdiction over the issues which you have presented.
I know that this will come as a disappointment to you but it is truly futile to continue asking for a diocesan tribunal against a congregation of pontifical jurisdiction.

With warmest personal regards, I remain

Sincerely in Christ,

Monsignor Steven P. Rohlfs, S.T.D.
Vicar General-Chancellor



February 28, 2004

My brother, Tom Carroll, wrote this article published in the Journal Star Forum:

Let fire department transport critically ill patients


The Peoria Fire Department purchased one or two ambulances recently. A Feb. 3 Journal Star editorial asked, " ... what good is a fire department ambulance if it can't transport patients to the hospital?" Good question. Perhaps a better question is, "Why can't the fire department transport patients in the first place?"

Fire department personnel, many of whom are trained paramedics, are the first responders to emergency medical calls every day. However, the fire department is not allowed to transport patients to a hospital and cannot provide advanced medical care at the scene. Trauma patients must wait for paramedics from Advanced Medical Transport, a private ambulance company, to arrive. Since patient survival improves with faster response, the firefighters should be allowed to use their skills.

Control of ambulances and emergency medical services lies in the hands of the project medical director. The OSF-employed physician who held this post for nine of the last 12 years, Dr. George Hevesy, was paid a salary by AMT. Freedom of Information documents from the state of Illinois reveal that OSF administrators knew and approved of this arrangement. There is an immense conflict of interest when a project medical director accepts money from a private ambulance company. Small wonder the fire department is not competing with AMT in the paramedic and transport business.

OSF should not allow an employee to accept money from an ambulance company he or she regulates. OSF also needs to explain why corporate profits have been given greater importance than fast emergency response times. City Manager Randy Oliver's commission on emergency services must address this conflict of interest.

The present project medical director, Dr. Rick Miller, needs to assure Peoria that the Peoria Fire Department will be adequately trained and allowed to transport patients in their new ambulances and that financial gain will not be allowed to override the public's right to the fastest and most efficient medical care possible.

Tom Carroll


July 27, 2004

I wrote the following article describing Peoria’s medical mafia limiting emergency care. I compared Peoria’s situation to the corrupt Illinois Health Facilities Planning Board. (This Board’s president was Stuart Levine. He worked with OSF officials allowing OSF to build the Center for Health. Levine was found guilty in 2008 of multiple illegal activities.)


”Re. July 16 editorial, "Send corrupt health facilities planning board to morgue":

The Journal Star states that in Illinois, "Any board with this much authority over this much money becomes a trough of corruption." Truer words could not have been written. For 30 years lobbyists, attorneys and politically connected people have influenced the decisions made by this nine-member board regarding construction of new hospitals and expansion of existing ones in Illinois.

Unfortunately, similar conflicts of interest and cronyism are currently occurring in Peoria. The stakes are very high here with lives and money on the line.

In Peoria we have one paramedic transport company, Advanced Medical Transport (AMT). Its medical director is Dr. George Hevesy, who happens to be the medical director of OSF-St. Francis' emergency department. Dr. Hevesy is salaried by both OSF-St. Francis and AMT. OSF is the main supporter of AMT and is also the base station for all emergency medical services in central Illinois.

The AMT board of directors, composed of prominent Peorians, has the support of the OSF-St. Francis board of directors. Dr. Hevesy's relationship with the Illinois Department of Public Health in Springfield, which regulates paramedics and ambulances in the state, is well known in emergency medicine circles throughout Illinois. And finally, the Peoria City Council, which will decide if AMT remains in total control of paramedic care and transport in Peoria for the next decade, will consider the findings and recommendations of a California-based consulting firm.

Some members of the council suspect a pre-existing relationship between AMT and this California firm. One needs a scorecard to keep track of this local health care travesty.

In the meantime, the Peoria Fire Department continues to respond to medical emergencies, can only provide basic life support (not paramedic care) and cannot transport patients, even with its one ambulance. The PFD obviously does not enjoy the support of the abovenamed individuals, boards and state agencies.
The real loss, of course, is for Peorians who suffer an out-of-hospltal medical emergency.

State-of-the-art, pre-hospital emergency care is not offered in Peoria, not because we can't, but because our medical mafia will not allow it.

Dr. John Carroll
Peoria


September 28, 2004:

The Matrix Consulting Group presented its findings to the Peoria city council regarding Emergency Medical Services (EMS) in Peoria. The city hired Matrix for $79,000. Currently, Peoria has two EMS responders: the Peoria Fire Department (PFD) and Advanced Medical Transport (AMT) a private, ambulance company co-owned by the three Peoria hospitals. AMT responds to 911 calls, provides three levels of life support: basic, intermediate, and advanced (paramedic), and transports all Peoria patients. The PFD responds to 911 calls and is only permitted to provide basic life support. They are not allowed to transport patients.

Two gentlemen from the California-based firm made a very polished PowerPoint presentation accompanied by an impressive-looking 149 page report. The presentation covered issues ranging from PFD organizational issues to paramedic and transport services provided in Peoria by AMT. Matrix’s primary recommendation, after all was said and done, was for Peoria to make no changes in ambulance service. How and why they arrived at this conclusion remains a mystery. Their report contains evidence that suggests changes to ambulance service could be beneficial to Peorians. Furthermore, data crucial to evaluating EMS and ambulance service is no where to be found in the report.

According to the report, the current EMS system in Peoria is supervised by the Illinois Department of Public Health (IDPH), which maintains a district office in Peoria. When I spoke to a representative from the office, he stated that he was unaware of the contents of the Matrix study and had only general data from AMT. He was unable to answer my specific questions regarding how Peoria pre-hospital patients suffering from chest pain, breathing problems, cardiac arrest, or trauma had done over the last decade.

The Matrix report states that AMT’s performance data was also submitted to the project medical director (the doctor in charge of all EMS and ambulances in central Illinois) who is located at OSF St. Francis Medical Center. When I spoke with the emergency services manager in the EMS office at OSF, she stated they had no aggregate data regarding how AMT performed in 2003 or for any year. How could the project medical director not have this data? Data that normal EMS systems collect would include: successful cardiac resuscitation in the field, survival to hospital admission, survival to hospital discharge, etc. Where is Peoria’s data?

Consistent with my conversations, the Matrix report contains absolutely no data about patient outcomes. The report states that performance data is provided to IDPH and the project medical director, but my conversations with individuals from these offices indicates that this data has not been compiled or analyzed.

The Matrix report continues with a chart depicting the average response time by the PFD and AMT to life-threatening emergencies. The PFD arrival is almost two minutes quicker than AMT. The consultants go on to explain how medical research shows that advanced life support (ALS) may help people with chest pain and breathing problems. Indeed, patients suffering severe trauma incur five percent increased mortality for each minute that they are not transported (remember Princess Diana?) The PFD is not permitted to provide ALS or transport patients. Of the more than 9,000 EMS calls the PFD responded to in 2003, 1,800 were for breathing problems, 900 for chest pain, and 1,700 for trauma.

Based on the above, Matrix outlined a plan that would “increase the level of service” by allowing four fire department engines to be staffed with paramedics to respond to “targeted areas” in Peoria. If the PFD could provide ALS, lives would be saved as Matrix notes that “early establishment of intravenous fluids and certainly advanced airway management will be beneficial in certain cases.” The seriously ill or injured patient would no longer have to wait for AMT to arrive for advanced interventions.

Matrix then did a cost analysis of the above and stated that for a “relatively low cost of approximately $100,000 per year . . .the city could move to a four company ALS engine company system.” What Matrix overlooked was the fact that the PFD firefighters who are currently paramedics could provide their expertise for the four engines if only the project medical director would agree. This may be difficult because the medical director’s supervisor at OSF is the corporate medical director at AMT.

The Matrix report states that the PFD recently acquired a transport capable ambulance. They state that since there are no “service gaps” (i.e. AMT is always available) the PFD ambulance is not necessary. Many EMS providers in the Peoria area and families I have spoken with give numerous examples of “service gaps.” Patients and Peoria firefighters have waited precious minutes for AMT to arrive at the scene. AMT has even called the PFD for help when AMT finds themselves overextended responding to emergencies. Matrix notes that AMT maintains the “proprietary nature” of its staffing and financial information and so this information was not contained in the report. Just imagine if the PFD wouldn’t reveal where they were located or their operating budget.

Matrix’s conclusion that there are no gaps in service is incorrect. However, their advice to sell the only existing PFD ambulance may be sound since it sits unused for emergencies. According to the Matrix report, “the PFD has applied to the project medical director for permission to outfit the ambulance with various basic and life support materials and equipment. This request has been, to this point, denied by the medical director. . .”

In conclusion, evidence and healthcare statistics regarding emergency medical services in Peoria are glaringly absent from the Matrix report. Conclusions based on invisible or non published data are opinions and nothing more. If leaders are to make credible decisions about Peoria’s EMS and ambulance services, these judgments must be based on complete, unbiased, accurate data. We should ask the question: why is such critical information so hard to come by?


December 12, 2004

Should Peoria Fire Department sell its only ambulance?


What will the city do with the one Peoria Fire Department ambulance that sits alone and unused? Will It be sold for something more important than saving people's lives?

In September, the Matrix Consulting Group evaluated Peoria's emergency medical services. Matrix reported that the fire department's average response time to life- threatening emergencies was almost two minutes faster than Advanced Medical Transport's. Since the fire department can only provide Basic life support, patients frequently wait until AMT arrives for Paramedic intervention.

One plan formulated by the consulting firm to improve service was to target certain areas with four non-transport fire department engines. These vehicles would be staffed by Firefighter/Paramedics who would provide advanced life support. The fire department has Paramedics who could provide their expertise for these engines.

The problem is the two physicians who have controlled ambulances in Peoria for the last two decades don't support the fire department's advancing from basic life support service to advanced life support. Unfortunately, Peoria Firefighter/Paramedics are not allowed to use their Paramedic skills at emergencies.

Matrix noted the fire department has applied to the physician in charge of ambulances to outfit its only engine with various basic and advanced life support medications and equipment. That request was denied.

The boards of directors of our local"health-care Industry," and the doctors who have been responsible for ambulances in Peoria, need to disclose their private interests and explain why seiling the one and only fire department ambulance Is beneficial to sick and Injured pre-hospital patients In Peoria.

Dr. John Carroll
Peoria


February 23, 2005:

Let Peoria Fire Department Operate its Ambulance


On Feb. 1 the Peoria City Council voted to sell the only fire department ambulance, which has been sitting idle in a garage. It was never allowed to respond to 911 calls. Numerous firefighters who are certified paramedics are not allowed to use their skills. They have been wasted.

To help rectify this situation, I will purchase the PFD's ambulance at its present market value and donate it back to the PFD if these conditions are met:

1. This ambulance will be used for sick or injured Peorians and staffed by PFD firefighters/paramedics allowed to use their advanced life support skills in Peoria.

2. Doctors George Hevesey and Rick Miller have been directors of the Emergency Department at OSF for the past 15 years. They have controlled all ambulances in the area. Both physicians need to publicly declare any fees, stipends, salaries or other benefits they've received from their relationship with Advanced Medical Transport, the only company allowed to operate in Peoria.

3. OSF's Emergency Medical Services Department needs to provide health-care data for the past decade to the city manager and City Council revealing how Peoria's pre-hospital patients did when cared for and transported by AMT. This data was conspicuously absent in the 149-page consultant's report that evaluated fire and emergency medical services in Peoria last year.

The medical ambulance debacle in Peoria, plagued by conflicts of interest, needs to end.

Dr. John Carroll



July 5, 2005

I addressed the Peoria City Council at the Citizen’s Forum and presented this tragic situation that occurred in Peoria:


The PFD responded to greater than 9,000 health-related 911 calls in 2003. They can provide only BLS at the scene and cannot transport. Even though the PFD has paramedic firefighters, they are not allowed to use their skills in Peoria. With that background, consider the following vignette and put yourself in this patient's place and see what you think:

Several weeks ago, a man in Peoria who was eating in a Peoria restaurant, collapsed, and bystander CPR was started. 911 was called. The PFD arrived and shocked the patient who was pulseless. His pulse returned. AMT arrived and attempted to place a breathing tube to help the man breathe and protect his airway. For one reason or another, this was not accomplished. Insertion of tubes can be very difficult in emergent situations. The PFD firefighter on the scene was not allowed to attempt the tube-a memo had been released that very morning stating that firefighters can only provide Basic life support even if they are Paramedics. Another firefighter had been placed on a 90 day suspension when he put a tube in another patient several weeks prior to establish the airway for the patient. The patient described above in the restaurant died.

Just think if that man were you or a family member of yours?

Here are questions that the family of this gentleman or anyone with an interest in EMS in Peoria could ask at a neighborhood meeting:

1. Why wasn’t the PFD paramedic allowed to help with his ALS skills in Peoria but can do so in surrounding areas?

2. The family of the deceased man should ask Andrew Rand, Director of AMT, why he stated in a PJS article (Dec. 8, 2002) that they did not want the PFD in the ambulance business for years. (When the PFD shows up earlier than AMT at the scene, shouldn’t they be able to offer the best possible care to the patient?)

3. Miller and Hevesy need to be asked why Joliet, Rockford, and Springfield firefighters can act as paramedics while at work and the firefighters in Peoria cannot.


The next day, July 6, 2005, the following article appeared in the Journal Star:


PEORIA - Criticism of the city's private ambulance service by a former emergency room physician is being downplayed but could still lead to discussion on how to improve the system.

Dr. John Carroll, who worked for 21 years at OSF Saint Francis Medical Center before he was fired in 2001, told the City Council on Tuesday of a recent incident in which a man at a Peoria restaurant went into full cardiac arrest and later died while a Peoria Firefighter/Paramedic on the scene wasn't allowed to try to help save him.

"Just think if that was your family member," Carroll told the council. "Valuable minutes really shouldn't be wasted at the scene" waiting for the city's ambulance service to arrive.

Carroll has been critical of Advanced Medical Transport, the city's only ambulance provider, since at least 2002, but some question whether his accusations are personally motivated by his firing.

"Dr. Carroll has been critical of our operations for some time now. I don't recall ever having the chance to speak with him personally," said Andrew Rand, AMT's executive director. "It's regrettable that these sort of anecdotal references are made that are unsubstantiated."

Rand noted that the AMT was recently given its second perfect score from the Commission on Accreditation of Ambulance Services, making it the only private provider in Illinois thus recognized.

"We have an excellent system," said Dr. Rick Miller, Emergency Medical Services Medical director. An employee of St. Francis, Miller has the responsibility of certifying people as paramedics and EMTs and overseeing their education. If there are any problems and someone has to be reprimanded, he is also involved.

"To say (firefighters) are standing around is inflammatory and an insult to the fire department," Miller added.

Firefighters can perform CPR, control a patient's airway, ventilate a
patient, give oxygen and administer several medications. They can
also use a defibrillator, which could be the most important tool for
a cardiac patient, Miller said.

Those firefighters who are also system-certified paramedics can
also use their skills to assist AMT paramedics if they request help -
a relatively new change allowed by Miller.

It's also an example of what appears to be a sea change in the
relationship between the fire department and AMT. Just a couple years ago, the fire department wanted to get into the ambulance transport business over AMT's objections. But now both sides say they are working together like never before.”


My comments at the time of the article:

This article and Rand and Millers statements are very misleading. If the above "anecdote" did not happen, I am quite sure that OSF and AMT would have let everyone know at the Journal Star. The firefighter felt terrible that he was not allowed to insert the breathing tube as the family watched. (The firefighter had already shocked the patient and he had a heart beat and needed a secure airway.)

The "new change" referred to in the article by Dr. Miller is very difficult to understand. Quite simply, it means that Miller caved in and if AMT ASKS the PFD paramedic to insert the tube into the patients airway, the PFD paramedic can now do it.

What if AMT is not on scene and the patient needs the tube"? Under, Miller's "new change", the patient has to wait. This is unbelieveable. The brain cannot go without oxygen for very long. Also, remember, that the PFD paramedics cannot provide advanced life support at the scene like AMT can and does. (By the way, the same PFD paramedics frequently work outside of the Peoria Fire Department and can insert the tube when needed and can provide advanced life support. Why can't they provide the same in Peoria?)

I do think that the PFD firefighters and the AMT paramedics work well at the scene. But the real problem is behind the scene by the officials and doctors making policy.

And finally, the second "perfect score" by AMT, referenced by the Journal Star, was probably paid for too, as was their first "perfect score".

Here are questions I asked Drs. Miller, Hevesy, and Andrew Rand on Peoria's Medical Mafia blog after presenting to the Council:

1. Dr. Miller, when you made your policy change during the summer of 2005, did it have anything to do with the man’s death at the restaurant? Why won’t you allow the PFD paramedics to put tubes in people who need them to breathe or protect their airways without AMT having to ask the PFD to perform this service? “A” stands for AIRWAY in the A,B,C’s of resuscitation. What happens if the PFD is at the scene first, which is not uncommon, and AMT is not there to ask the PFD to insert the tube? Why won’t you let the PFD carry the tubes on their rigs in the first place?

2. Are you all against the PFD advancing their status to paramedic? If so, why? What about an Intermediate level of service for the PFD? This only takes about 400 hours of training (instead of 1200 hours for paramedic training) and, Mr Rand, you even stated in the Journal Star in 2002, you would help the PFD advance to Intermediate service if the PFD would not go into the transport business. You suggested that Intermediate service would be more "comprehensive" than the basic service they give now. Why didn’t you help them advance to Intermediate service which could help save lives in Peoria? Because you didn’t get the 10 year contract that you wanted? Dr. Miller, could you have pulled some strings at the “resource hospital”, OSF, to get a good price on training some firemen to the Intermediate level? (OSF and AMT control the majority of the emergency medical technician education in Peoria as well.) Dr. Miller, where are your memos that the PFD should at least advance to the Intermediate level so that they could perform a more comprehensive service? Are you aware of the optional model offered by the Department of Transportation that would allow Basic providers to learn advanced airway techniques like the endotracheal tube and laryngeal mask airway? Some municipal fire departments around the state take advantage of this, why not Peoria? Where are your directives requesting that the PFD become more versed in securing the airway?

3. Dr. Hevesy, where are your memos from all your years as director of the ambulances in the Peoria area that the PFD should be giving basic drugs? Why did you not insist that the PFD give aspirin at the scene to people with chest pain, albuterol spray to people suffering from asthma and emphysema, and adrenalin to people having severe allergic reactions? You let AMT do it. Why not the PFD? Also, where are your memos that the PFD should be shocking people in with ventricular fibrillation? All basic units should have been doing this since at least the early 90’s. AMT was saving Peorians’ lives with this technique. You obviously knew this. Were you an advocate for the PFD using defibrillators and where is the proof? Please don’t say it would be “duplication of services” again because the oxygen starved brain does not care about this concept.

4. Dr. Miller, are you aware that some nursing homes in the area call AMT directly when there is an emergency in the nursing home and that they don’t call 911 first? Does this seem sound to you? What if AMT is tied up on another call and the firefighters get a late call for the geriatric patient and then they arrive late also. Remember, Rick, you won’t let the PFD perform advanced life support for the old person, so what is going to happen some of the time? Do you think the families of these people know that 911 is NOT being called for their mother when they moved her there? I have heard that AMT paramedics will call the PFD for help in situations like this when AMT can’t get there in a reasonable amount of time. This doesn’t sound good, does it?

5. Rick, Andrew, and George, how would the Peoria Area EMS system work in light of a mass casualty? Glad we don’t live on the gulf coast with you guys running the show. A bad tornado in Peoria could be devastating. The PFD could respond but not offer advanced support or transport the patients. Sounds bad, guys.

6. Andrew, is AMT paying Dr. Miller for his services as project medical director? You have been paying Dr. Hevesy for years, right?

7. Do any of you believe the statement of conflict of interest submitted to the Illinois Department of Public Health that states there is not even the “potential” for conflict of interest with Hevesy collecting a salary from AMT? Who wrote that statement and gave that statement to IDPH from the Peoria Area EMS? Was OSF involved with this statement?

8. When I have spoken to different experts around the United States about emergency medical services in Peoria, they all laugh or grimace when they realize that Hevesy has been on the payroll at AMT and the PFD languishes in its basic non transport role. Why the reaction? (The new president of the American College of Emergency Physicians, Dr. Fred Blum, was definitely chagrined with the news when I spoke to him in West Virginia.)

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July 3, 2008:


I submitted the following article to the Journal Star Forum on July 3, 2008.....several days before the Peoria City Council voted to allow the Peoria Fire Department to provide Paramedic services.

The Journal Star did not run this article:

A recent Journal Star article reported an accident in Peoria where a CityLink bus was rear ended by a car. According to the article, at least 13 people were "sent to the hospital" for evaluation. The accompanying photo showed the Peoria Fire Department (PFD) rescue firefighters caring for the injured bus passengers that they had placed on stretchers.

According to the article accident victims sat on the sidewalk waiting for additional Advanced Medical Transport (AMT) ambulances to arrive. The reason these people had to wait, is that the PFD is not allowed to transport emergency patients. The PFD had their own rescue vehicle several years ago but were not allowed to use it for transport…so they sold it.

What was not reported in the article was that AMT asked CityLink to help out. CityLink graciously sent a van and transported injured victims to the hospital.

Isn't this amazing when CityLink needs to transport patients who may have broken necks while the PFD cannot? And unless the policy has recently changed, if any of the bus accident victims were seriously injured at the crash scene, the PFD paramedics could not have provided paramedic support for the victims if AMT was not present.

As reported by the Journal Star a couple of years ago, when no other transport agency was quickly available, the Dunlap Fire Chief transported one of his own Dunlap firefighters who had lost consciousness at the scene of an emergency. To protect his firefighter, he had used common sense but crossed the powers that be who control our local Emergency Medical Services. Because of his action the Dunlap Fire Chief came very close to losing his job.

Something seems wrong here.

The paramedic and ambulance transport monopoly in Peoria, fueled by conflict of interest and the mighty dollar, is not patient friendly. This bus accident helps show Peoria is not ready for a more serious mass casualty.

John A. Carroll, M.D.


July 7, 2008

The Peoria City Council voted unanimously last night to OK the new Peoria Fire Department contract.

For the first time ever, the Peoria Fire Department firefighters will be able to act as paramedics (without the oversight of Advanced Medical Transport) and provide advanced life support at the scene of a medical emergency.

Over the last few years the Peoria Medical Society told me that they did not see a need for this change to be made in Peoria, the Catholic Diocese of Peoria referred me to the Pope regarding Advanced Medical Transport and their "alleged monopoly" of local pre hospital care, and the OSF Corporate Ethics Committee and the OSF Compliance Officer refused to hear my concerns over this dangerous issue. And Dr. George Hevesy, who was receiving salaries from OSF-SFMC and Advanced Medical Transport when he was director of ambulances (Project Medical Director), told the Peoria City Council years ago that allowing the Peoria Fire Department to get involved with advanced life support was "duplication of services".

Many patients that have called 911 in Peoria and had to wait long periods of time for paramedic care probably would disagree with the above statements.

Obviously everything is not transparent here and OSF and their present Project Medical Director (who works under Dr. Hevesy in the OSF Emergency Department) had to agree with this policy improvement, or it would not have happened.

The Peoria Fire Department still cannot transport patients to local hospitals, so Advanced Medical Transport will not lose their income in transportation.

And most importantly many patients will be treated earlier when precious minutes can mean the difference between life and death. Too bad this common sense decision took so many years to occur.

Recommendations:

When people call 911 for a medical emergency they are frequently distraught. Something bad is happening to someone close by. It may be a family member or someone they don’t know. They just know that someone needs help right away.

These people who call are usually very happy to have ANYONE come and help.

Peorians need to be able to trust the professionals who set policy for 911 response.

Just imagine how enraged Peorians would be if they knew that for the past decade that when the PFD arrived with a Paramedic/Firefighter, that he/she was not allowed to provide advanced life support for the victim. Who would even believe this scenario?

New England Journal of Medicine, August 19, 2003:

“A conflict of interest is a set of conditions in which professional judgment concerning a primary interest (such as a patient's welfare or the validity of research) tends to be unduly influenced by a secondary interest (such as financial gain). Conflict-of-interest rules, informal and formal, regulate the disclosure and avoidance of these conditions.”

My question is: Did Drs. George Hevesy and Rick Miller avoid these conditions? In other words, did accepting a salary from Advanced Medical Transport lead one to believe that Dr. Hevesy was “avoiding these conditions”. Many people I have spoken with over the years would say no.

The New England Journal of Medicine continues:

“The primary interest is determined by the professional duties of a physician, scholar, or teacher. Although what these duties are may sometimes be controversial (and the duties themselves may conflict), there is normally agreement that whatever they are, they should be the primary consideration in any professional decision that a physician, scholar, or teacher makes. In their most general form, the primary interests are the health of patients, the integrity of research, and the education of students.”

Were EMS patients the primary concern in Peoria for the past 15 years?

My recommendation would be that Drs. Hevesy and Miller be reviewed by the University of Illinois Ethics Group and by the American Medical Association Ethics Group to see if they have complied with medical ethics standards of these two institutions. If Drs. Hevesy and Miller have not followed ethics protocols or if they have obstructed care to 911 patients in any way over the years, I believe their medical licenses should be revoked.