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Idaho county seeks to overhaul ambulance service

By Cynthia Sewell
The Idaho Statesman (Boise)
Copyright 2006 The Idaho Statesman
Distributed by McClatchy-Tribune Business News

Ada County has a goal to overhaul its ambulance service ordinance, which has not been updated since 1975.

The county wants to standardize ambulance operations throughout the county and establish new licensing guidelines for ambulance personnel.

“The current ordinance is 17 years old. The medical field is much different today and we need to modernize the language to make sure patient care is a priority,” Ada County Paramedics Director Troy Hagen said.

The county commissioners will consider the new ordinance Tuesday morning at a public hearing.

County officials said the proposed ordinance will not eliminate or change the current delivery of 911/ambulance service, nor will it impact the delivery of any emergency medical care that first responders provide at an accident scene or during an emergency.

In addition to updating language and guidelines, though, the county is considering further revising its emergency medical services ordinance once a judge decides how much authority the county has over 911/ambulance providers.

This has local fire departments concerned because it could prevent them from owning and operating ambulances. Kuna Rural Fire District Chief Doug Rosin said he thinks the county wants to put Kuna’s ambulance out of business.

“The county said at our first meeting (about the proposed ordinance) that this is about dollars and cents.” If the county could get Kuna’s ambulance calls it would get more revenue, Rosin said.

Ada County Paramedics receives 70 percent of its revenue from fees charged to patients and service contracts and 30 percent of its revenue from property taxes via a countywide EMS taxing district.

Presently, the Kuna Rural Fire District, one of seven fire districts in Ada County, provides 911/ambulance services within its jurisdiction. Kuna has been providing ambulance service since the early 1960s — prior to Ada County establishing its own 911/ambulance service in 1975.

The county said this creates a duplicate service area, and possible confusion, with two 911/ambulance providers covering the same area. It also is double taxation, Hagen said, because “property owners within the fire district would pay both the rural fire district tax and taxes levied by (Ada County’s) EMS taxing district.”

“This EMS taxing district means we are required by law to respond to every emergency medical call no matter where it is in Ada County,” Hagen said.

The county will ask a judge to determine if state law allows both a county and fire districts within the county to provide 911/ambulance service, or if the county has the authority to declare itself the sole operator of all 911/transport ambulances in the county, thereby putting Kuna Fire District’s ambulance out of commission and preventing future fire districts, like Star, from establishing their own 911/ambulance services.

“This is the second time in three years the county has tried to do this to us,” said Rosin, who has been Kuna’s fire chief for three years. “If it takes going to court to get it resolved once and for all, then get it done. My (fire district) commissioners agree. We’ve got more important things to concentrate on than this. ... I would like to see us be more concerned about patient care than a turf issue or dollars and cents. It’s a paramedic service whether it comes from us or from Ada County. We need to concentrate on patient care, not on who is providing the transport. With the growth in the valley there’s more than enough emergency medicine that needs to be provided for both of us.”

Kuna has a paramedic and ambulance available around the clock every day, Rosin said. Ada County stations a paramedic and a Suburban at the Kuna Fire Station. When an emergency call comes in both Kuna’s ambulance and the county’s Suburban respond. If hospital transport is required, Kuna takes care of it.

“Ninety percent or better of the time we cancel their medics because our medic can handle it,” Rosin said. “Star and Eagle don’t have a 24-hour paramedic. Mine are 24/7 plus the Ada paramedic they put here as well. Put that medic in Star or Eagle 24 hours a day because we’ve got our end of the county covered.”