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Editorial: Take a look back before moving forward

Under a very tight deadline, San Juan Island Emergency Medical Services is grappling with the question: What levy rate should be placed before the voters on the August primary ballot? Another question needs to be answered first. What has changed,  in the terms of services needed from SJ EMS,  now that there is a critical access hospital in Friday Harbor and air transport is no longer part of SJ EMS?

With the expiration of the current six-year levy at the end of this year, employment of a new chief at the beginning of this year, the end of the air division of SJ EMS at the end of March, time is ripe for the organization to take a long introspective look at its operations. Unfortunately, Chief Jerry Martin and his staff and volunteers only have until Friday, April 15, 2016 to produce a balanced, sustainable budget for 2017. That budget will determine the amount of levy that will be requested.

At a Hospital District Commission special meeting April 1, 2016, the draft budget put forth by SJ EMS Chief Jerry Martin was "upside down by $600,000" according to Commissioner Bill Williams and required a 50 cent per thousand dollars of assessed value tax levy rate. The current levy rate is 35 cents per thousand. The maximum under the law for EMS is 50 cents. 

The creation of a new budget is complicated by the fact that Island Air terminated its contract with SJ EMS. 

Revenue from the air transport side of SJ EMS operations subsidized the ground transport according to the consultant retained last year by SJ EMS to help create the 2016 budget.  With air transport revenue SJ EMS employed flight nurses,  a Director of Critical Care and paid for part of the organization's administrative and facility expenses. 

As of April 1, 2016  Island Air, which has always owned and maintained the aircraft and employed pilots, hires its own flight nurses and does its own billing.

With time being so short, the organization needs to find a quick way to sort through all the changes that evolved during the past decade when it added the air division. A quick way to reset would be to dig out the 2006 budget, the last one before air was added.  Obviously prices have changed in the past decade, however, taking a step back to a starting point which isn't cluttered by layers upon layers of changes would be helpful.

With 2006 operations as a starting point, beneficial programs added in the past decade - such as fall prevention, etc - could be discussed, analyzed and written into the budget.  

As to the other big change - the addition of Peace Island Medical Center - there isn't an easy reset button that will answer the following questions.  How has the presence of an Emergency Department on island, changed patients' behavior? Are people driving themselves or their loved ones directly to the hospital? Should they be? Is the old paradigm of calling the Sheriff's Office for emergency medical care in need of modification? Do we need an educational effort to inform visitors and residents of the best, safest action to take when medical emergencies occur? How does this or doesn't it affect the operations of SJ EMS?

This is a trying time for SJ EMS and for the Hospital District Commission. There is a lot of work and a lot of healing that needs to be done. It's unfortunate that some of the EMS staff and volunteer EMTs feel unappreciated. They need to know this community appreciates the work they do, the lives they save, the sacrifices they make. 

Now is the time to look squarely at this challenging situation we find ourselves in, contemplate the changed circumstances and figure out the best route to a sustainable healthy EMS.  We'll all be the better for it. 

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