Some officials with Lewis County Medic One are concerned not enough forward motion is being made to reform the agency and have approved the laying off of two paramedics by July 1 if outstanding issues remain unresolved.
Though representatives from the districts served by Medic One had supported a new revenue plan last month that would eliminate projected deficits, one of the six districts has since rejected the proposal and another has expressed concerns with the contract codifying the plan, and the layoffs were proposed as a way of preparing Medic One for the potential need to slash its budget.
"Let's say we're sitting here in the meeting in June and we're still at this impasse," said Terry Williams of Cowlitz-Lewis Fire District 20, who put forward the motion for the layoffs during the April 21 meeting of the Medic One Board of Directors. "We've got to make a decision by then...If we are at this same position in 60 days, we are in dire straits."
Medic One has been struggling to address significant revenue shortfalls since last October, when it was predicted drops in call volume and per-patient revenue would lead to a $90,000 deficit for this year. Lewis County Fire District 5, in Napavine, then opted to use American Medical Response instead of Medic One starting Jan. 1, increasing deficit projections by roughly $200,000.
In February, the board proposed a cost-sharing plan for the remaining districts (District 20, in Vader and Ryderwood, and Lewis County Fire Districts 1, in Onalaska, 3, in Mossyrock, 8, in Salkum, 15, in Winlock, and 2, in Toledo) to divide total costs to run the agency based on the percentage of paramedic calls within each district, with costs budgeted this year at $820,825. Officials attending the board's meeting on March 17 said they were in agreement with the proposal, though their individual boards of commissioners would still have to ratify it.
(It is worth noting at this time Districts 2, 15 and 20 own Medic One through an interlocal agreement, while Districts 1, 3 and 8 contract for services.)
Since then, all districts have approved the revenue plan except District 3, with Chief Doug Fosburg stating his commissioners felt the amount Medic One was asking for--even at 4.46 percent, or $36,612--was too great, essentially doubling what they paid Medic One last year.
"$1,200 a run is just not cost-effective," Fosburg told the Board April 21, referencing the approximate cost per call for their percentage. "The most I can bill for a call is close to $1,300 and, when I'm only collecting 45 percent, $1,200 is going to put us in the poor house."
Fosburg did say his commissioners would respond to any financial concessions the board was willing to offer. He pointed out costs in Medic One's budget for supplies and housing that directly benefited just the interlocal districts and asked if the board would consider paying similarly for costs incurred by his district, which the board said they would be open to.
"I just need something I can negotiate with," said Fosburg, indicting the matter would again be brought to his commissioners for a vote.
And while District 8 did agree to the proposed revenue plan, they have requested changes to a contract defining the new plan, asking interlocal districts to be held to the same standards they are.
"We've got to be everybody equal doing everything the same way," said District 8 Commissioner George Kaech, stating he was concerned about "loopholes and open spaces" contained in the current version of the contract.
One concern outlined by District 8 was how the contract did not define the obligations of interlocal districts to pay their portions of the budget, stating he would like to see similar language developed by which Districts 2, 15 and 20 could be held accountable. Medic One Business Manager Diane Wallace noted their obligations to pay are already outlined in the interlocal agreement that formed Medic One.
Kaech also called for representation on the board for contract districts, stating he was frustrated three districts are making decisions for the whole group, and pointed out District 20 bears less than half of the financial responsibility of District 8 (9.06 percent compared to 22.16 percent, respectively) but still has a seat on the board.
Members of the board offered mixed responses to Kaech's plea for representation, with District 15 Commissioner Grant Kistler stating his district was "adamantly" opposed to expanding seats on the board, stating too many voices would lead to too little decision-making. Williams said, though his district has not developed an official position on the issue, he believed they would support a non-voting seat on the board to represent the interests of all contract districts. District 2 Commissioner Dave Beal, who was not a member of the board, said he believes his district is open to the idea of expanding board representation.
District 8 Commissioner Anne Piper indicated she would be willing to see a non-voting representative for the contact districts, if only as a starting point, and members of the board said they would take the matter back to their individual districts.
Despite some progress on the financial and contractual issues brought before the board, Williams put forward his motion to lay off two paramedics by July 1, including a provision to have contract districts, after that date, serviced by a paramedic in a sprint vehicle, rather than an ambulance, at $1,181 per call.
"I'm not trying to shove this down anybody's throat," he said, stating he remains open to seeing the outstanding concerns resolved, and included language in his motion to prevent the layoffs if agreements could be reached.
When the matter came to a vote, Williams and Kistler were in favor, with Kistler having been prepared to propose a similar plan suggested by his district but with a shorter timeline, while Board Chair Dale Nielsen, of District 2, was opposed. Nielsen later stating he felt the move was unnecessary given how much progress had already been made.
"I think we're so close, we don't need to go in that direction," he said.
Nielsen stated the unresolved matters before Medic One are now in the hands of the boards of commissioners for each district, and their desires for the agency will determine where Medic One goes next.
A motion was also approved by the board to authorize Wallace to begin billing the interlocal districts for their percentage of the budget, retroactive to Jan. 1. This was done to increase the operating capital of the agency, as expenses have been outpacing revenue since the beginning of the year, and Wallace had otherwise been prepared to ask the board which bills she should stop paying, as the amount left in their general fund at the time would have been insufficient to cover all costs to date.