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Medic One opts for seven-medic system in 2015 budget

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Lewis County Medic One has approved a 2015 budget providing full-time services to all participating districts, though with a need to compensate for a potential deficit of roughly $300,000, at projected income levels.

Approved by the Medic One Board of Directors in a 2-1 vote during a special budget meeting held Nov. 20, the budget reflects a desire by all districts involved to continue providing current levels of service, while attempting to compensate for recent decreases in patient revenues as well as the potential departure of Lewis County Fire District 5, based in Napavine, who had provided the bulk of funding necessary to serve the northern group of districts.

The board had originally been considering a budget allowing only four paramedics covering all districts and, while this budget would have been balanced, it would have resulted in an estimated 30 percent reduction in responses to contracted districts in Mossyrock, Salkum and Onalaska, as well as an increase in response times to those districts as the paramedics would be based in the Winlock area.

Members of the board, made of representatives from districts in Winlock, Toledo, Vader and Ryderwood, had originally argued the four-paramedic budget was their best strategy given the funding levels they would be expected to work with next year. However Chief Doug Fosberg, of Lewis County Fire District 3, in Mossyrock, pointed out Medic One is contractually obligated to provide 24-7 response coverage to its northern districts from Medic One's secondary station at Mary's Corner and, without choosing to withdraw from their contract, a budget providing less than what had been agreed to would not be acceptable.

In response to this, board member Ken Miller, representing Cowlitz-Lewis Fire District 20, in Vader and Ryderwood, declared he felt the solutions to Medic One's problems were being over-complicated and said simpler steps should be taken toward preserving the system as it stands today, utilizing two four-person teams at Winlock and Mary's Corner.

Miller said Medic One has resources such as an unused ambulance it could sell to help cover projected deficits, while the districts involved should consider expending the funds necessary to sustain the agency one more year while time is spent during that year to re-work Medic One into a solvent program.

Operations Chief Grant Wiltbank said, in the interest of changing the way Medic One operates, he is intending in the short term and long term to explore additional funding sources and has contacted Morton General Hospital with the hopes of again performing their inter-facility transports, and said Medic One may also be available to seek out transport services for Providence Centralia Hospital if they are in the market for an alternative to American Medical Response (AMR).

Wiltbank clarified, if the board were to pass a four-medic budget, these would still be his goals, as the strategy would then be to work within Medic One's projected means and seek to expand those means back to previous levels.

Commissioner Anne Piper, of Lewis County Fire District 8, in Salkum, said her district would be willing to encumber greater expenses to continue receiving full-time coverage, while fellow Commissioner George Kaech said they would likely consider proposing an EMS levy next year to bolster their ability to remain involved.

Feedback from District 3 and Lewis County Fire District 1, in Onalaska, was unavailable as District 1's commissioners held their regular meeting on the same night, and District 3's representatives had left shortly after Fosberg's statement, with Fosberg adding on their way out they had said all they intended to on the issue.

As far as feedback from local districts, Miller said, if the districts involved are to be asked for direct contributions to make up the deficit within Medic One, he expects they would be made based on a proportion of annual responses from within those districts, as had been used to calculate contributions from southern districts made last year.

Commissioner Randy Pennington, with Lewis County Fire District 15, in Winlock, said, from what he understands of his board's perspective on direct contributions, they may be unlikely to support using their funds to make up for the projected shortfall, as they are uncomfortable paying for what they feel may be services subsidized for contract districts. (Districts in the northern group contract for services from Medic One while districts in the south own Medic One through an interlocal agreement.)

Along that same reasoning, District 15's board had voted unanimously on Nov. 13 to withdraw an annual contribution of up to $50,000 per year they had agreed last November to give Medic One through 2016. The contribution had been intended to support a ninth paramedic position and, since the position was eliminated in July, District 15 said they felt the funding is now being used to defray costs for contract districts.

Representatives from Lewis County Fire District 2, in Toledo, indicated their district would also be open to discussing payments made on a proportionate basis, but did not speak directly about their intentions to make contributions to cover the deficit.

When voting to accept the seven-medic budget, Pennington and Board Chair Dale Nielsen voted in favor of the proposal, while Miller voted against, having stated his support of a budget maintaining the current eight medic positions.

The board also approved, unanimously, a decision to begin drafting policy allowing contracted districts to be represented on the board along with interlocal districts so they would have a vote in how the agency is operated. Included in the motion was a stipulation that only representatives from the interlocal districts would make decisions regarding equipment and resources acquired or contributed by interlocal districts.

It is expected such representatives will begin participating in board meetings starting in January and will take part in restructuring how the agency is to be operated long-term.

Until then, the current board is expected to again consider the 2015 budget during their Dec. 16 meeting, this time accounting for potential contributions from districts involved as well as other funding sources, while it is also expected more complete revenue figures for this year will be available for the board to make clearer projections for next year.

At the end of the Nov. 20 meeting, the board met in executive session to discuss a complaint brought against Wiltbank by the paramedics' union, in which the union had cast a vote of no confidence in Wiltbank. The union alleged Wiltbank had disenfranchised District 5 and contributed to their decision to look elsewhere for services, as well as fostered poor communication between districts. After their executive session, the board took no action and made no statement in regard to the complaint.

Though District 5's commissioners had unanimously chosen to ask for a contract from AMR during their Nov. 13 meeting, they have indicated, until they accept such a contract, which could be discussed during their Dec. 11 meeting, they have not officially chosen to accept an alternative to Medic One.

During the Nov. 20 meeting, Wiltbank said he would be willing to entertain offering District 5 a reduced rate compared to other contract district as a way to encouraging their support of the program, stating multiple times the task of providing adequate services and balancing the budget would be considerably easier if District 5 decided to remain involved. Wiltbank said an offer of a lower rate could be justified because the station at Mary's Corner is within District 5 and ambulance staff travel shorter distances to respond to Napavine calls than to other calls within northern districts.

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