Commentary by Samuel Strait – July 27, 2022
While there has been much to say already about the recent request by Del
Norte Ambulance to become Del Norte County’s sole and exclusive provider
for services, obscured in the verbiage is the basic importance as to
what is best in the current circumstances for Del Norte County
residents. In an effort to clarify that particular question following
my attendance of the meeting of the County’s Board of Supervisors, I
read the Ad Hoc Committee’s report, spoke at length with Del Norte
Ambulance’s, Ron Sandler, continued with a thorough questioning of
Supervisor Valerie Starkey, member of said Ad Hoc Committee, and
acquainted myself with several articles pertaining to both Del Norte
Ambulance and its history of service to the County’s residents.
Before we get to the merits or lack there of where granting Del Norte
Ambulance an Exclusive Operating Agreement (EOA) to provide service to the
County, it is important to understand the available options for the BOS
to consider. They are three in number, none of which would exclude Del
Norte Ambulance from being our ambulance provider. The first, is to
continue the current arrangement with Del Norte Ambulance until their
contract with the County to provide universal service to all needing its
services until the contract expires in 2027. The second is to allow Del
Norte Ambulance an exclusive operating agreement with the associated
enhancement of oversight that accompanies such arrangements. The final
option is to offer competitive bidding to other ambulance service
providers including Del Norte Ambulance in a bidding process at county
expense. It was the Ad Hoc Committee members preferred choice that an
EOA was the most reasonable option.
The reason given for the choice was cost, increased oversight,
accountability, stability, and success in other local jurisdictions.
The negatives were listed as it being a monopoly, quality of past
service, and the risk factor to the County of it being an exclusive
service should Del Norte Ambulance not live up to expectations. What is
notable about the negatives is that Del Norte Ambulance, due to the
limited nature of service requests, is already a monopoly without the
constraints that an EOA would provide. As to quality of service, with
the exception of Fire Service Personnel, no other reporting service,
members of the public, or first responders had issues with Del Norte
Ambulance’s level of service. And finally, just as with any other
private entity, an EOA, provides no substantial risk to the County as it
can be terminated at any time should Del Norte Ambulance not live up to
its commitments.
A further examination of the “complaints” submitted by fire personnel
appear to reveal an ongoing sense that fire personnel and ambulance
personnel are at odds in some emergency situations where ambulance
personnel should be the primary medical service provider. Many of the
“complaints” appear superficial and without serious merit. Those that
have come to the attention of the North Coast EMS director, Larry
Karsteadt, have been satisfactorily remedied and Del Norte Ambulance was
recognized as being in compliance and cooperative. While it is
relatively easy to infer motive for the level of complaint from fire
service responders due to recent activities of its retired Chief, Bill
Gillespie, in taking steps to move toward permanent hired personnel and
the comments offered via zoom at the BOS that ambulance service should
become a “public service”. It should be noted that this is also an
expensive alternative and would be an ongoing expense to this
community. We are not a huge population with a great demand for
ambulance service necessitating a change to public service.
Clearly the notion that Del Norte Ambulance service is less than a
quality service must be taken into account, whether allegations by fire
service personnel of inadequate service is the case, and whether
“statistics” can possibly shed light on this charge are unlikely. It
is none the less curious as to why County and City fire services would
be the only shade on the proposal. Testimony of the majority of those to
the Ad Hoc Committee and the recommendations by North Coast Medical
Services to proceed with what is already a sensible option of granting
EOA to Del Norte Ambulance comes with very few uncorrectable risks to
the County. I fail to see the need for hesitation on granting Del Norte
Ambulance’s desire to be exclusive and protect as any “good” business
venture would its value and its value to its consumers.
As with the ambulance service, it may behoove the County to take a close
look at what is being offered by local Fire Protections Services as a
necessity for Del Norte County. What has been recommended by retired
Fire Chief, Bill Gillespie, and current Fire Chief, Kevin Carey as
“corrective measures” for Del Norte Ambulance personnel, perhaps should
be also something Fire Service personnel need to be acquainted with as
well. Having “pissing contests” at the scene of an emergency does not
reflect well on those that are involved. There are unavoidable mistakes
enough at all levels of emergency services, certainly an untucked shirt
or disheveled uniform does not merit the level of a “complaint”.
Similarly, feelings that lack of trained or “proper” personnel or
“failure to engage” make no difference to the person in distress when
all that is required is the best service under the circumstances. In
any event, none of this past history of dubious complaining should be
involved in determining what is best in the present circumstances for
the public. In the eyes that oversee its operation, Del Norte Ambulance
has had few complaints from those it services for many decades. Hence,
Board of Supervisors, where do you go from here?
Please explain how this competition for service is meant to work in Del Norte County where ambulance service averages fourteen calls in a twenty four hour period and a fully equipped ambulance costs $500,000 per year to operate. More than one ambulance in operation, say three, increases the cost accordingly. Del Norte Ambulance operates three currently and would go to four in the EOA, or two million dollars per year. If your reimbursement cost is $135.00 for much of its transports, those that have no or limited insurance coverage, the remainder being covered by those with insurance, where is the motive for other ambulance companies to provide the competition and be able to offer that “quality of service” you think is out there? Similarly, if another service were to take the financial risk and be competitive, will they be required to take all transports regardless of ability to pay? Please explain what all this “competition” will look like in Del Norte County where most transfers do not even cover the cost of the transport. And, no, I do not work for Del Norte Ambulance, or know anyone who works there. There is simply not the population in the County to support another ambulance service or many other specialty services for that matter. It unfortunately is a fact of life when living in a rural setting, otherwise we would have two hospitals or more in your world? The list is infinite.
You are so correct. Where I was, was on the I-5 corridor and the ability to collect for services was a big issue for medical. For Fire, it was the expense of equipment and supplies. Fire funding was from a tax base.
The problem with the ambulance service and lack of is outrageous. The ambulance service double dips. They charge for insurance and get paid from your medical insurance, the county, and the insurance they collect from a separate entity. Is this a non profit business?
Additionally, their service to this community is below standard regardless that Commander Depee passes their inspection. They have no ALS crew members and most their employees are trained as BLS
The Fire district should take over. The Fire district should train their people as ALS(advanced life support) since the ambulance can’t get their asses off their chair and respond. Due to Ad Hoc committee report we would be better off paying the additional tax to get the firemen trained as ALS.
And there you have it, the reason the fire district is the only group complaining about the “ambulance service”. They don’t fight fires much anymore and need to justify their expense to the community, so “let’s take over the ambulance service” and let the public foot the bill. Have you ever heard of a publicly funded service that actually provided “a better service” to the public? Sounds like something a progressive Democrat would say. Might as well have everything provided by government in your world Linda. How is that working out for you at the jail, the court house, or in front of the BOS? Anywhere? Is each fire station going to provide for an ambulance or two, trained crew? Ten stations, twenty four seven three hundred sixty five days at a cost of $500,000.00 per year per ambulance. My feeble math skills say $10,000,000.00 per year or a pretty hefty price tag. No wait three ambulances per year per station, government provided, and regulated. Trained crews of I know not where they are to come from. Likely out of the area to go scurrying back from whence they came from after a couple of years of expenitence to “higher paying” situations. What world do you live in anyway?
Never sign an exclusive, dummies. Competition is needed for quality of service. Dummies. No competition in this County is already a problem across the board of services.