Which was the bigger consideration, the San Juan Island Emergency Medical Services budget or staff morale and the potential merger with the San Juan Island Fire District? By a 3-2 vote, San Juan County Hospital District #1 Board of Commissioners at a special meeting January 8, 2018 selected the candidate with experience in administration and budgeting to be the interim SJI EMS Chief.
Richard Frazer, a one-year resident of San Juan Island who has decades of experience nationally with Air Methods, was chosen over SJ EMS paramedic Kyle Davies who has worked or volunteered with the SJI FD for 21 years and SJ EMS for 18 years.
Outgoing Chief Jerry Martin, SJ EMS Director of Operations Karl Kuetzing, and Paramedic and Director of Medical Response Weyshawn Koons all urged the board to choose Davies.Kuetzing said, "Let me preface my comments by saying that EMS is not broken. We as an Agency have continued to provide excellent care for our community despite the financial challenges we have faced and in spite of the ongoing requests for justification of what we are doing.. In regard to the process used to choose an interim chief, he said, "In my opinion, this process is objectionable, definitely not open and transparent, and just not right. We need to follow the internal recommendation by the Chief and if that recommendation is deemed unacceptable then the reasons for that determination need to be made known. We then need to follow up with the prescribed policy for opening the process to public per San Juan Island EMS policy, again which has been approved by the Board of Commissioners."
Asked about the process after the meeting, Chair Bill Williams said choosing an interim chief was not subject to the EMS policies. No advertising was done, but an invitation for interested parties to send a letter of interest was extended at a previous board meeting. Williams said he asked Frazer if he would be interested in applying.
Referring to a contract and strategic plan created with the help of a consultant for $57,000, Weyshawn Koons, a member of the agency for 26 years, said, "That compact based on mutual trust, respect and transparency was agreed upon and signed by each board member, Chief Martin and myself. That compact has been violated. Board-approved policies and procedures have not been followed. Chief's job description has not been advertised...I feel you have shown a complete lack of transparency...We all know finances are important. We currently have a Chief Financial Officer Chris Compton who works closely with the chief on budgeting and financials, Tina in the office does our bookkeeping, the county does our payroll, one of our commissioners reviews the financials on a monthly basis, and WA state auditors review our books. In addition to finances, we focus on public access, communications, clinical care, training and education, operations, human resources, medical direction. ...We do a great job on focusing on education and prevention. We use evidence-based medicine and maintain best practices... Based on best practices we have always focused on promotion from within...Kyle Davies has earned the respect and trust of our personnel, staff and volunteers...He has developed close relationships with other emergency services personnel.
Dr. Michael Sullivan, who is the SJ EMS Medical Supervisor, said he could work with either man but had reservations about someone working as a paramedic and an administrator.
Frazer is a friend of both PHD Chair Bill Williams and Dr. Sullivan. He and his wife moved here at the recommendation of Will and Jackie Hamilton who run Island Air.
During the two time periods for questions from the Commissioners during the meeting, Commissioner Michael Edwards noted Davies long experience in EMS and in the fire department. He thought the lack of budgetary experience could be mitigated by working with the CPA. "That's more doable than what Rick faces," he said. Regarding the budget he noted the agency still owns the old Inter Island Medical Center building which is expected to be sold for $900,000 to $1 million.
Commissioner Harrington said. "Responsibility of the board is to make sure the agency has what it needs to be successful. ..When I came into this agency and started looking at the budget and thought do these people in this agency have any idea what will happen if we don't pass this levy? Do they have any idea what will happen if we don't shore up our finances? ...The budget is scary."
She noted that there is a big unknown that could have a significant impact on the budget - the Civil Investigation Demand by the state's Attorney General Office. The results will be shown to two board members and the district's attorney later this month. The CID involves problems from errors in billing Medicaid and Medicare when the agency was running an air transport division.
Commissioner Edwards said the budget concerns were "all the more reason to merge with fire, fast track it." He noted an EMS associated with a fire department has easier access to more grants and also has the potential to raise its tax levy.
Commissioner Lindstrom said, "Of course I am concerned about EMS and our volunteers and how our organization runs, but I am still stumped about why we are talking about a merger with fire when our EMS budget is in the state it is in." She emphasized the need for transparency and better communication."
Commissioner Williams said, "I understand people who feel like they don't want change or afraid of change or concerned about some hidden motive. There is no plan, we're exploring a merger with fire... I don't think we've done anything to show that the board has anything but your best interest at heart...What we need desperately is the support to do what we are trying to do."
Board members Bill Williams, Monica Harrington and Anna Lisa Lindstrom voted for Frazer. Mark Schwinge and J. Michael Edwards preferred Kyle Davies.
Francis G Smith Thursday, 11 January 2018 12:27 Comment Link
In follow-up to my letter regarding the appointment of Mr. Frazer as the new EMS Chief, I am happy to see that Dr. Sullivan has agreed to return to his previous post as the direct medical supervisor of San Juan Island EMS. This is one bright spot in the recent cascade of events. Dr. Sullivan is an exceptional emergency physician and a gifted educator. Bravo.Report
San Juan Island EMS
Francis G Smith Wednesday, 10 January 2018 16:28 Comment Link
The PHD board is correct to position themselves as the financial watchdog for San Juan Island EMS. No one seriously disputes that obligation. Financial concerns, however, are only ONE factor that will affect the ability of the agency to accomplish the mission. Repeat - it is ONLY ONE factor. What has never been understood by 3 of the board members, including the Chair, is that they are equally responsible for oversight of the FUNCTIONAL PERFORMANCE of the agency - the technical ability of the agency to provide emergency medical and trauma care to our citizens and visitors under any and all circumstances, including increasingly common active-shooter incidents and mass casualty incidents.Report
As Captain Kuetzing said in his remarks to the board, “This agency is not broken”. San Juan Island EMS has continued to provide documented top-level pre-hospital care to the residents and guests of this island for two decades. During recent years, the people at the pointy end of the stick - the career medics and volunteer EMT’s -have managed to maintain this national-level level of performance in spite of being poorly served by top-level management, including the current PHD board. We have operated for prolonged periods with no Chief, following the departure of Chief Cole. We have functioned without access to local medical officer training and supervision following the decision of Dr. Sullivan to drop his San Juan Island EMS supervisory role. Our present, well-qualified and soon to depart Chief, has encountered such hostility from the Chairman of the PHD that he has decided that the relationship is untenable.
Now we find ourselves with a new “interim” Chief, Rick Frazier, a personal friend of the Chairman Bill Williams, who has no 911 experience whatsoever. Many observers regard the appointment as a blatant example of cronyism. With all due credit to Mr. Frazier for his work at Island Air Ambulance, we do not need another financial manager, we already have a financial expert on board - Mr. Chris Compton. What we need is a seasoned Fire/EMS Chief who can direct our field operations. Mr. Compton has a firm hand on the agency’s financial health.
San Juan Island EMS does not sell widgets. What we do is to show up for our island neighbors on the worst day of their lives to step in and handle their medical or trauma situation. Much of the ability of SJIEMS to continue to carry out this mission is dependent on having the best possible Chief in place to supervise, train, guide and provide support during incredibly difficult and stressful situations. We cannot afford this management misstep to degrade our performance.
With this concern in mind, it is imperative that the initiative to fold SJIEMS into District 3 Fire be given 100% support. The notion stated by the newest member of the PHD, Anna Lisa Lindstrom, that the merger cannot be considered until “the agencies financial house is in order” is nonsense - District 3 Fire Board will make that determination. The PHD has no basis in fact to oppose this proposed merger. The vast majority of all EMS services in the US are Fire Department based. Once the merger is completed, an appropriate EMS Chief officer could be recruited and installed and this unpleasant and dangerous episode could be put behind us.