By Sean Pendergast
By Sean Pendergast
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By Richard Connelly
By Jeff Balke
By Casey Michel
By Craig Hlavaty
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Many paramedics who work for companies such as GoldStar don't stick around for long. Kuehner, for example, now makes twice as much money working aboard an offshore seismic ship. Others go on to work for government providers, such as the Houston Fire Department, which on average offer better pay and benefits.
GoldStar exploits poorly educated workers, says the owner of a rival company, who asked not to be named. "The small town, small mentality, big heart, they take advantage of that," he says.
Critics in San Jacinto County are pointing to GoldStar's record in an effort to get authorities to drop the company for a different EMS provider. But making a switch isn't easy.
Part of GoldStar's allure is its ability to offer what looks like a great value to rural counties that are low on cash and manpower. In San Jacinto County, GoldStar charges the Emergency Services District $380,000 a year to provide the equivalent of 2.5 ambulances -- more than twice what the county could man on its own, officials say.
One supporter of the deal is County Commissioner Johnson, the same lawmaker who almost died when GoldStar allegedly failed to dispatch a helicopter promptly to respond to his heart attack. Johnson defends the company's reliance on transfers to supplement its income and believes GoldStar's medics are top-notch. "They are doing a hell of a job," he says. "It's just their [response] times, sometimes."
Clark, the graying head of the emergency services district, has heard "all kinds of accusations going around" about GoldStar but also knows the county has been burned by other suppliers. The county's prior contractor ended the arrangement two years ago after it failed to make enough money. It had replaced a public service in Shepherd that imploded because of unpaid taxes. Prior to that, a volunteer-run system had run out of volunteers.
"I do the best I can with what I have to work with," Clark says. "But if you need a straight out answer, am I satisfied? I'm satisfied that we're getting a service for what we are paying for."
Still, some volunteer firefighters believe a public ambulance service deserves another chance. Nicklas, who is trained as an EMT, says Shepherd's nonprofit service folded because of bad management and could easily exceed GoldStar's coverage and service under new direction.
Of course, given the widespread controversy surrounding GoldStar, the debate in San Jacinto County could climb the ladder to the Bureau of Emergency Management, which could strip the company's EMS license. The bureau has never pursued such a nuclear option against an EMS company, arguing that it would disrupt patient care and create more problems than it solves. Yet the option is considered more seriously for repeat offenders.
Ultimately, the state has limited experience conducting confrontational investigations. In a recent interview, Perkins was unsure whether her agency had the power to subpoena witnesses. She initially stated that the agency didn't have such power, then responded a week later through an employee that she had been wrong -- the agency could subpoena them.
If anybody in San Jacinto County knows what it means to depend on GoldStar, it's probably Nicklas, who sits behind a desk in the one-room office shack of the Shepherd Volunteer Fire Department. A calendar full of accident photos hangs on the wall near a scented candle and a sign that says, "You just can't fix stupid." Nicklas curtly fields calls and works other days alongside GoldStar paramedics as a first responder. But she also knows GoldStar in more personal ways, and it's a relationship that began roughly.
Driving a year ago in her Ford Ranger extended-cab pickup down a two-lane road, Nicklas encountered a dog lying in the middle of the street and swerved -- nothing unusual, she explains. "The dog stays in the road every day. We had an understanding: He just laid there; I went around him." That much went smoothly. But her tire caught on the sharp edge of the pavement as she hooked back onto the road, flipping her truck upside down and sending it skidding across the blacktop.
The wrecker drivers arrived first. Nicklas says she directed them -- from the inverted swing of her seat belt -- to switch on the radio in her pickup and say: " '1606 was in an MVA, is hanging upside down, and it was a 1050 major,' because I did have injuries."
The distress call brought a GoldStar paramedic who parted the crowd and brashly set out to free Nicklas from her dangling captivity. Another EMT offered a cervical collar to place around Nicklas's neck. The paramedic waved it off, Nicklas says. Police and firemen on the scene volunteered to help her remove Nicklas, who is short and stocky. The paramedic declined. Nicklas volunteered this advice: "Don't pop the seat belt; that's the only thing holding me in here."
The paramedic popped it.
Nicklas screamed and landed on her head, wrenching her neck and smashing her back on the truck's door frame.
A doctor at Cleveland Regional Medical Center diagnosed her with a concussion and back injuries, including multiple herniated and broken discs. Surgeons later installed two metal rods and six screws and nuts into her back, fusing them together with a cadaver bone. She still suffers major muscle spasms.
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