The commissioners from San Juan County Public Hospital District #1, San Juan Island Fire & Rescue Dept met along with Town of Friday Harbor Administrator Duncan Wilson and Mayor Farhad Ghatan for two hours Wednesday, April 4, 2018 to discuss the potential merger of San Juan Island EMS with the fire department. Since 1994, the PHD has overseen SJI EMS. Prior to that it was part of the fire department.
After two hours of discussion both boards passed a motion to continue evaluating consolidation. A citizens advisory board made up of one person selected by the Town, one by the fire district and one by the PHD will be established. The three people will then select two more to join the committee. There will be a total of five people on the committee.
Information on how citizens can apply will be forthcoming. The selections are to be made by the next meetings of both the fire (May 9) and PHD (April 25, 2018).
Fire Commissioner Bob Jarman has been meeting over the past several months with two of the hospital commissioners in a series of meetings that were not open to the public. The April 4 meeting was the first time, the topic was discussed by both boards in an open public meeting.
The discussion started with a focus on the benefits of consolidation of the two agencies.
Hospital Commissioner Dr. J. Michael Edwards said, "FIrst item, maximize effective use of scarce resources. There is currently a small number of cross trained. Consolidation will increase the number of cross trained responders and thus will increase the number of qualified responders for either fire and/or San Juan Island EMS.”
Fire Commissioner Frank Cardinale said, "We have firefighters, we have firefighters who are EMTS or paramedics, we have EMTs and paramedics who are also trained to be firefighters. Where do you see that number increasing by a merger?”
Edwards replied, "With consolidating, desirability of being cross-trained particularly would be enhanced. It would be desirable for both entities."
Cardinale said, "Personally I don’t see a lot of our members who want to be cross-trained at this time or see a desire to be cross-trained. If they wanted that they would already be doing that. I disagree with that first benefit as far as maximizing resource... I really don’t think it would make a difference. Really don’t see an incentive for them to be cross-trained."
Fire Chief Brad Creesy said that 20 percent of the current firefighters are cross-trained.
Fire Commissioner Albert Olson said, "What brings the board to us at this point? Why a merger now, what brought this on?. Financial, what is it?
Edwards said, "I think it is some of the things we can talk about in terms of benefiting the community, there is a financial component. Not that San Juan EMS is terribly hurting in that regard, but we are low in reserves. We have significant capital expenditures pending in the next three or four years... That is a motivation from our side of the fence."
Olson referenced news articles which quoted Chief Jerry Martin as saying "Reason we are looking at fire, they can ask for more tax money."
Martin said, "When the initial question came up. I suggested to one board member eliminate my position, take the money and move it to reserves...To the question of benefits of paid and volunteers. Volunteerism is going down. fires are going down. EMS calls are going down. If we had aid car on north side...we would be doing a great service, fast response."
Cardinale said, "Can we show that we could deliver improved response time? We’d have to have fire stations staffed. Don’t see how we can improve that without paid staff in those areas...Merger is not going to change that. I think that you are going to have a hard time selling the public... City of Friday Harbor folks will say what is my benefit. I get great service here... What is my benefit? Why will I have to pay more money to continue getting what I am getting now? .. If there are problems and issues that need to be addressed then they need to be taken care of. Whether we go ahead with a merger in the future or not, we don’t want to take on somebody else’s debt or somebody else's problem. We aren't the cash cow. We are not the Mister Fix It to make sure, don't worry, can come to fire has lots of money lots of people we can solve your problems. That is not how this works. Has to be two equals coming together. I don’t want to be the organization that loses out on some of the things that we are looking for in the future because we can no longer afford to do those things because we had to bail out a different organization... If we come in as equals,OK, let's take a look at that. But if we're not coming in as equal partners, I have a problem with that."
Dr. Warren Appleton, who lives part-time on San Juan Island and part-time on Mercer Island, suggested improving dispatch would improve response time. He talked about a computer program used by King County which determined if a call needed BLS (basic life support) or ALS (advanced life support). It improved response time there.
Paramedic Weyshawn Koons said EMTS have BLS equipment with them and are able to respond before the ambulance gets there.
The conversation touched on how the operations would be headquartered if there was a merger. Expanding the current Mullis Street Fire Station to squeeze in EMS was one option.
Edwards said Peace Island Medical Center might be interested in purchasing the current EMS building but that it would be too early to discuss that with them.
Olson noted that the PHD has a $1.4 million balloon payment on that building coming up in 2020.
Edwards said the PHD still has the original EMS building as an asset. It is valued at $950,000 and has been on the market for five years.
Wilson asked, "Has anyone talked about doing an economic study of the condition of the fire service and the condition of the EMS and come back and give us a report from a consultant that looks at these numbers and actually says 'Yes' or 'No' there are savings with a merger. Then you have actual numbers to turn over to a citizen committee."
Commissioner Anna Lisa Lindstrom said, "I have two questions. Does this enhance service to the community? Does this have financial benefits to the community?
Martin said, "In regards to cost of service, people I’ve talked to, there is no guarantee we will be cutting costs on this merger...That would be a terrible message to say, that we are doing just for cost savings. What we are doing this for is for efficiency, patient care is really truly what we are doing this for. Making sure we are working for the best services for the people we serve."
Commissioner Rebecca Smith emphasized the role strategic planning is playing in consideration of consolidation. She said fire and EMS services are changing and encouraged everyone to think longterm.
Motions passed by both boards included $5,000 from each entity for the advisory committee to use for legal and accounting expertise.
Mark Fishaut Mark Fishaut MD FAAP Friday, 06 April 2018 08:35 Comment Link
"Not that San Juan EMS is terribly hurting in that regard, but we are low in reserves."Report
"Edwards said Peace Island Medical Center might be interested in purchasing the current EMS building but that it would be too early to discuss that with them"
Res ipsa loquitur
Edwards must resign