The University of Mississippi Medical Center in April laid off seven specially trained medical providers who transport children and babies in need of critical care from hospitals around the state to Jackson.

The cuts brought the total number of staff on the pediatric and neonatal transport teams from 21 to 14.  

UMMC officials said the reduction was the result of a routine evaluation looking for operational efficiencies.

The transport teams offer timely, hospital-level care in a specialized ambulance for critically sick or injured children and babies. The teams are made up of specially certified paramedics, nurses and nurse practitioners, and the ambulances house more equipment and medicines than regular ambulances – “more than … most rural hospitals have,” according to a January 2023 UMMC press release highlighting a pediatric transport team member.

The teams can also provide care in a hospital’s emergency room before transporting the patient to Jackson.

Prior to the layoffs, the Mississippi Center for Emergency Services, which oversees the transport teams, housed one pediatric critical care ambulance and one neonatal critical care ambulance. Two of each provider plus a driver would go on each ambulance to respond to each call.

A former employee says both teams were “already strapped” to respond to the calls that came in before the teams were reduced and combined into one.

Further reducing their ability to respond to these calls, the employee said, “is a real disservice to the children of Mississippi.” The person spoke to Mississippi Today on the condition of anonymity out of career concerns.

UMMC did not answer questions from Mississippi Today specifically about how the decision to cut the teams was made or address what kind of impact it will have on children in need of this care in remote areas of the state. 

“Medical Center units routinely evaluate their operational models to identify efficiencies. A thorough review of our transport programs revealed that we could redesign models for some teams and continue to fulfill responsibilities,” said Patrice Guilfoyle, a spokesperson for UMMC, in an emailed statement. “Appropriate allocation of resources allows for investment in more areas that address the needs of Mississippians.” 

After the layoffs, however, there is one truck for both teams, and one pediatric and one neonatal provider total to respond to calls.   

Neighboring Arkansas – which also has one children’s hospital in the state – has a similarly modeled transport team. It is cross trained for both pediatric and neonatal transports, according to a spokesperson with Arkansas Children’s. 

“All Angel One transports are staffed by a nurse and respiratory therapist with support from medical control, an intensive care specialist from our Neonatal Intensive Care Unit or Pediatric Intensive Care Unit who can provide specialized guidance,” spokesperson Hilary DeMillo said.

UMMC’s chief financial officer said in May that the medical center is experiencing “very strong revenues” for both May and the year to date. In April, she also reported revenues of $177 million, or $16 million over budget.

“I do expect this year to be even better than this,” she said of future financial projections.

Transport volume numbers for the months of May and June – the two months following the layoffs – were at their lowest in a 12-month period for the pediatric transport team, according to records obtained by Mississippi Today through a public records request. The numbers for the neonatal team in May and June did not see a noticeable decrease.  

Marc Rolph, executive director of communications and marketing for UMMC, said there was a two-week staff training period in May that “temporarily limited our operational capabilities.” 

Rolph did not answer why the numbers were lower in June or how they compared to the same months’ numbers in previous years. 

Mississippi Today also requested the number of missed calls – or requests for transports that came in and were not fulfilled – for a 12-month period beginning in June 2023. UMMC responded to the request that there were no such records.

Most Mississippi hospitals contacted by Mississippi Today declined to weigh in on the impact of the changes. 

UMMC has the state’s only children’s hospital and the highest level neonatal intensive care unit and trauma center. 

The hospital’s transport teams are voluntarily accredited by the Commission on the Accreditation of Medical Transport Systems and have been since July of 2015, according to Jan Eichel, the associate executive director of the organization.

The accreditation standards require two critical care providers per vehicle.

“It’s not uncommon to have a cross-trained team” like the new combined pediatric and neonatal transport teams at UMMC, she said. “They should be very proud that they are adhering to the highest standards in patient care and safety.” 

Editor’s note: Kate Royals, Mississippi Today’s community health editor since January 2022, worked as a writer/editor for UMMC’s Office of Communications from November 2018 through August 2020, writing press releases and features about the medical center’s schools of dentistry and nursing.

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