By Jim Johnson
Monterey County Herald
Copyright 2007 Monterey County Herald
MONTEREY, Calif. — With an ambulance system redesign still developing, county supervisors must choose between continuing a subsidy to its ambulance provider or reduce service levels beginning in March, say county officials.
Emergency Medical Services officials, who are set to deliver a report to the Board of Supervisors on Tuesday, said a task force working on a system redesign proposal won’t be done in time for a new contract to be in place by the end of February.
That’s when the county’s current subsidy to Westmed Ambulance Inc. expires. The county is paying Westmed nearly $1 million to maintain pay for area paramedics and other ambulance system employees, as well as keep a fully-staffed ambulance in Big Sur, while the task force completes its work.
Carmel Valley Fire Chief Sidney Reade, chairwoman of the task force, said the report to the board will include an update on the system redesign work and a discussion of how to finance the system, including a possible tax measure.
Reade and EMS Director Tom Lynch will present the report to the board.
Reade said the report will stress the urgency of getting the system redesign finished, and estimated that the task force could complete its work in the next two months.
She said the task force is continuing to develop a more comprehensive emergency response system that will take more time than simply reworking the ambulance system. That will ensure that the county doesn’t end up with another dysfunctional system as in the past, she said.
“There are a whole bunch more pieces than just where to put the ambulances,” Reade said. “It’s not just about the transport system.”
Originally, supervisors had asked the task force to complete the redesign, and a new request for proposals, by this summer and had planned to have a new contract signed by October. But the task force, convened in February, asked for three more months in June, and will apparently need more time beyond that to complete its work.
If the board chooses to continue the subsidy to keep Westmed operations at status quo, Lynch said, it would theoretically last until a new revenue source is identified or a new contract is in place.
If the board chooses not to continue the subsidy, Lynch said, Westmed has indicated it would be forced to cut back to as few as eight ambulances on the road — it now has as many as 12 on local streets — and response time goals would increase. For instance, response time goals for areas designated as “rural” zones would increase from 12 to 16 minutes to up to 20 minutes.
Lynch said the EMS Council has indicated that would be an unacceptable reduction in service.
Jeremy Lyon, IAFF 4513 paramedic union spokesman, said it would be a “very bad thing” if the board chose to cut back on ambulance service, adding that he doesn’t think the board will choose that option.
“I don’t think the board wants to continue the subsidy, but it also doesn’t want to put public health at risk,” Lyon said.
Lyon placed the blame for the delay and the necessity for the continued subsidy on the task force, calling it a “waste of time” and replete with “hidden agendas.”
Reade said Tuesday’s report will also include options for securing new revenue sources, including a new property tax to augment the Community Services Area 74 fund, which currently pays for ambulance service.
She said it has become clear that the county’s current financing structure can’t sustain its “Cadillac” ambulance system, even as it was amended to include increased response time goals earlier this year.
But Reade said any new tax measure would need full support from the community.
“If we go after new money, we all have to be standing side-by-side and we have to agree on how to spend that money,” she said.
Lynch pointed out that the earliest the county could ask voters to approve a new tax measure would be June next year. Any increase to the current CSA 74 assessment would require a two-thirds approval, he said.
After taking over the county’s ambulance service under a five-year contract, Westmed announced in January that it had lost more than $2 million during its first year. Westmed officials suggested the company would have to leave its contract unless the county could provide financial assistance.
Supervisors agreed to loan Westmed up to $1 million and allow longer response time goals in an effort to help the company recover financially. The board also later agreed to the $1 million subsidy, in addition to the loan, in an effort to avoid additional cuts.
Westmed officials have since reported that the company has begun making money and paying back the loan.