June 12, 2008 in Voices

Ambulance agreement discussed

By The Spokesman-Review
 

Districts involved

An interlocal agreement is being circulated among the Spokane, Airway Heights, Cheney and Medical Lake city councils and among commissioners of Fire Districts 3, 4, 5, 8, 9, 10 and 13 and of the Spokane Valley Fire Department.

Fire districts and departments throughout Spokane County want to find out whether there’s strength in numbers when it comes to ambulance service.

They’re forming a consortium to negotiate an ambulance contract that would set prices and service levels everywhere in the county except in Deer Park and Fire Districts 2, 11 and 12 in the Rockford, Waverly and Fairfield areas, which are served by volunteer ambulance groups.

“It’s probably about 90 percent complete,” said Mike Thompson, chief of the Spokane Valley Fire Department, which is taking the lead.

Thompson said officials hope to form the consortium and have a board of directors in place by the end of the month and an ambulance contract in effect by Jan. 1.

An interlocal agreement is being circulated among the Spokane, Airway Heights, Cheney and Medical Lake city councils and among commissioners of Fire Districts 3, 4, 5, 8, 9, 10 and 13 and of the Spokane Valley Fire Department – which actually is a free-standing fire district.

The Spokane Valley Fire Department, more properly known as Fire District 1, serves Liberty Lake, Millwood and unincorporated areas as well as Spokane Valley. The district’s three commissioners, not the cities, will decide whether to join the consortium.

Thompson said the project grew out of discussions his department began a couple of years ago with American Medical Response, a private ambulance company that already serves most of the county without a contract. Several smaller fire districts asked to join the negotiations, and the Inland Empire Fire Chiefs Association got involved, Thompson said.

The hope, he said, is to get “at least three to five bidders” and drive down costs through competition.

So far, Thompson said, American Medical Response and another ambulance company, Rural/Metro Corp., have expressed interest in bidding.

“It has the potential to at least control or stabilize the cost,” Thompson said. “At this time, they can charge whatever the market will bear or whatever they deem is appropriate.”

John Serben, business development manager for American Medical Response in Spokane, said he sees no major advantages or disadvantages for his company.

“It will just be a different way of negotiating,” he said. “We have a diverse county with a lot of different needs, so it will be a matter of sitting down and figuring out how we’re going to be able to meet all the needs.”

Only the Spokane Fire Department and a handful of fire districts – including the Spokane Valley Fire Department – now have contracts with AMR. While Spokane’s contract spells out the service AMR must provide and the prices it may charge, the Spokane Valley Fire Department’s agreement provides only that AMR will station an ambulance in Spokane Valley.

Fire District 9, which serves areas immediately north of Spokane and Spokane Valley, has only an informal understanding that the AMR will position an ambulance at the North Division Y during peak hours.

Chief Bob Anderson likes the idea of a countywide contract, at least in principle. If only some cities and districts negotiate contracts, “you end up with the haves and have-nots,” he said.

“Until you see it, you don’t know,” but a countywide contract “would appear to be in the global best interest of the citizens as a whole,” Anderson said

Spokane Fire Chief Bobby Williams agreed. Williams said he and Mayor Mary Verner support countywide negotiations because the extra bargaining power may give the Spokane residents a better deal.

Still, Spokane has the most to lose if the bids don’t come in as expected. So Williams suggests a request for two bids: one with everyone and one with everyone except Spokane.

A shared contract must serve Spokane residents at least as well as the city’s current contract does, Williams said.

But, he added, “Until bids come in and we have something to evaluate, why would we take away our chances to see if there is something that could be better for our citizens?”

The interlocal agreement wouldn’t force any jurisdiction to sign a contract it doesn’t like.

Once they sign, though, cities and districts would need the consortium’s permission to withdraw from a contract before it expires. They also would have to reimburse the consortium for any expenses created by the withdrawal.

Anderson envisions a system that would set performance standards according to population densities.

“Obviously, at the top of Mount Spokane, you can’t expect the same response time you would have at Riverside and Browne,” Anderson said.

He and other chiefs want flat rates throughout the county, with a mileage charge to account for longer distances. A bill could vary according to whether basic or advanced life support is provided, but there would be no itemized charges for things like sheets, bandages and drugs.

However, the contract would apply only to emergency transportation in response to 911 calls.

The number of emergency transports in each district and department would determine the composition of the eight-member Ambulance Service Board.

The four districts or departments with the most transports would each get a seat on the board.

There is general agreement that Spokane and Spokane Valley each would get a position, and Anderson thinks Fire District 9 would get a seat. Speculation also focuses on Districts 8 and 4, but no one will know for sure until an ongoing analysis of ambulance transports in 2005 through 2007 is completed.

The first representatives of large “participating local governments,” dubbed PLGs, would serve until Dec. 1, 2010. After that, they would receive three-year terms according to the number of 911 transports in the previous three years.

Representatives of smaller PLGs would be elected to two-year terms by their small-group peers.

The entire Board would elect a chairman annually.

As proposed, the directors would be fire chiefs or their designees.

Initially, at least, the Spokane Valley Fire Department would administer the contract and the board’s treasury. Money to hire an administrator and cover the board’s other expenses would come from a fee the ambulance provider would be required to pay.

Williams said he is comfortable with Spokane’s proposed representation on the board and with having a smaller organization administer the contract. Those are “significant issues” for the city council, but “if they don’t approve the interlocal, we’ll never have an opportunity to know if it could have been better for us, and I think that’s Mayor Verner’s point.”

Also, Williams said, major fires, storms and shootings in recent years have shown the need for more cooperation among emergency service organizations.

He noted that Spokane County had four fire dispatching centers in the late 1990s, each with vested interests, but they were consolidated into a single system administered by Spokane.

“All of us took a risk in going to that larger system for what we felt was a betterment of the whole,” he said. “Sometimes you have to step out on that plank a little bit.”

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