Monday, July 28, 2014

Chiefs vie to run ambulances

From page A1 | September 06, 2013 |

A meeting last week of the El Dorado County Emergency Services Authority, a joint powers authority, revealed three Requests for Information regarding which local fire department could manage the county’s ambulances.

The proposals were from El Dorado County Fire, Pioneer Fire, El Dorado Hills Fire and Cal Fire, which runs the Cameron Park Fire Department.

Chief Michael Hardy was first to present his proposal for County Fire. He noted that they had been “proactive in the (emergency medical services) system from” the infancy of the department, after departments were combined to form the county-wide department in 1991. He noted all of the firefighter/paramedics had gone to the Sacramento City Fire Academy and had minimum standards for rotations on engines and ambulances.

In all, he said, it would cost an average of about $847,000 per ambulance unit annually — a bit less than $7 million to operate eight ambulances, what JPA Executive Director Marty Hackett had asked the departments to project.

Cal Fire Unit Chief Kelly Keenan took over for Division Chief Dave Teter, who sits on the board, noting that Cal Fire would pay for personnel, while the JPA would pay for the equipment and handle the business end under their proposed plan. The benefit of this, Keenan said, would be that after five ambulances, there would be “efficiencies for cost-saving up to eight units” due to the number of hours worked and shift rotation.

Due to Cal Fire policy, the RFI was generalized and non-specific, only specifically noting cost per unit up to eight medic units, which would cost $6.7 million.

Although the Pioneer Fire Protection District prepared a proposal, due to the department undergoing a change in chiefs, the department declined to be heard and took themselves out of the running to take over the medic units.

The last RFI was proposed by Chief Dave Roberts of the El Dorado Hills Fire Department. Roberts suggested a reorganization of how the medic units are handled, reporting through only one agency rather than through the JPA and employing three shift supervisors covering every hour of every day so details of what happens with the units won’t “get lost in the minutiae” of day-to-day work. The shift supervisors, he said, could “jump up and fix problems” in that regard.

To that end, they would create a JPA within the department and would be able to meet all the requirements set out by Hackett with little difficulty with fully trained firefighter/paramedics.

Though he said they would be able to do “apples to apples” and have eight units, he proposed a different scenario: Daytime coverage would see 10 ambulances while there would be six ambulances during the night. This would increase service and create more efficient delivery of patients around the county. The project cost would be about $10.7 million, which would save about $1 million a year from average medic unit costs. This would allow the county to begin finding replacement equipment and pay back the deficit the JPA owes. From there they would be able to increase wages and benefits. Under questioning from Diamond Springs Fire Chief Robert Combs, Roberts noted that money was set aside to house the personnel, and it would cost less to house for six units than eight.

Combs, however, noted that the cost for the administration for the JPA under that plan would jump from $160,000 to $992,000 in order to have the three supervisors, a battalion, a human resources rep two days each week and a full-time admin. Roberts countered by saying this would allow there to be direct supervisors over the ambulances, as there is currently no “real measure of coordination” with five separate agencies overseeing the ambulances.

Under the proposed plan, Combs confirmed with Roberts, the current staff on the ambulances, who are tenured and some who have been employed with the agencies for 20 years, would have to be rehired with wages cut to $15 or $18 per hour. “I don’t see how we are achieving efficiency except (adding) bureaucracy and cutting wages to the bone,” Combs said.

The extra admins and supervisors, Roberts said, would ease the “concern of where the ambulance is” during the day. Combs fired back, saying that with their medic unit, “We keep pretty close tabs.”

Hardy redirected the meeting back to the proposed staff situation, noting there were about 25 tenured staff, and as they would not be absorbed into the proposed new JPA, they would instead be rehired at a medical technician rate, a “significant cut in pay and a slap in the face,” also wondering what the union would say.

Combs added that the staff would “lose their homes, go bankrupt,” and that the entire situation would be “absolutely wrong.”

In regards to the current JPA, Roberts posed the question, “What happens if it fails, goes away?” Combs replied, that is “Not an option.”

Comparing the JPA to a cruise ship rather than a sports boat, Combs pointed out that despite a large deficit, they were successfully cutting costs and restructuring departments, increasing efficiency while receiving less money to do so. To fire and rehire staff at “substandard  rates” to get the budget even more in check would be “ludicrous, throwing the baby out with the bath water.” He concluded it was “inappropriate.”

“I agree to an extent,” Roberts conceded, but said that there needed to be a positive control on the budget.

Hackett pointed out that the JPA would come in under the budget for the 2013-14 fiscal year by about $900,000 of its $11 million budget, and expenses would come in “right around” the revenues. “There’s always room for more cuts,” he said, but there are still some sources of revenue that remained unknown.

Rescue Fire Chief Thomas Keating said that it was “hard to make a decision for now.” He posed the question of whether full Requests for Proposals should be obtained. Combs said no, as the county was already in danger of losing the JPA’s exclusivity on ambulances after the state denied their emergency medical services plan and that they “don’t have any latitude” to do RFPs. Additional meetings to discuss plans and hopefully streamline the current process would be needed.

“We are much closer to being solvent” than originally though, Combs said, as they were projected to lose $1.4 million, but were “still $35,000 in the black as of June 6.” He suggested the board “Take a deep breath.”

After discussing the Board of Supervisors, Roberts said that the JPA had violated its contract with the board by going over budget three years in a row and the board “can say we’re done any time.”

Ultimately, it was decided to shelve the RFIs for another meeting, with Keating suggesting the September or October agenda, likely holding off until October.

Contact Cole Mayer at 530-344-5068 or Follow @CMayerMtDemo.





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