County could ask voters for EMS money

Oct. 28--As Baker County Emergency Management director, Jason Yencopal's phone has been on speed dial to the county counsel's office in recent weeks.

That's because he's been busy making inquiries and checking the legalities of procedures needed to establish a ballot measure to help fund ambulance services in the county in time for the May 2020 election.

Yencopal says a new funding mechanism is needed to make up for a shortfall in providing adequate ambulance service to all county residents.

That problem has been -- and until 2021 will continue to be -- alleviated by the Baker City Fire Department's award of a Staffing for Adequate Fire and Emergency Resources (SAFER) grant. The $426,099 federal grant allowed the city fire department to add three additional 40-hour firefighter/emergency services positions. Baker County added a $99,000 match over the life of the three-year grant to fund the positions.

To prepare for the grant to expire, the county, which is responsible for establishing ambulance service areas and choosing allowed providers, sent out letters of interest to 21 potential providers last fall for the Baker service area, which includes Baker City and about half of the county, including Baker Valley.

The Baker City Fire Department is the current provider for that area.

Four agencies responded. And as part of the process, the county sent out requests for proposals seeking bids on the ambulance service contract to those four.

In addition to the Baker City Fire Department, two private ambulance services submitted bids: Med Transport Inc. of North Powder and Metro West Ambulance Inc., a Hillsboro firm. At the advice of county counsel, those bids have not been made public.

According to the schedule outlined in the RFP, the contract, for a minimum of 10 years, is expected to be awarded by June 1, 2020.

In the meantime, Yencopal says he's got a lot of work to do to prepare for that deadline.

He plans to schedule public meetings starting in November to hear what the public is willing to support in terms of ambulance service. The County will entertain any suggestions brought to the table, Yencopal said.

But how that will look, who will be asked to pay, and how much is yet to be determined.

Before the meetings are scheduled, the county will form a seven-member committee (including Yencopal and county counsel as nonvoting members) to work through the contract-award process, Yencopal said.

Baker County Commissioner Chairman Bill Harvey, along with Commissioners Mark Bennett and Bruce Nichols, next are expected to review information gathered in those meetings and from the evaluation committee near the end of January.

Yencopal said information gleaned from the meetings will be used to gauge public sentiment about which aspects of ambulance service are deemed most important.

As part of the consideration, the county will determine whether funding would require voter approval of a bond measure, a tax levy or formation of a special district.

Baker City Fire Chief John Clark wants Baker City residents to pay attention to the process and to let their city and county representatives know their preferences as the process develops. And he will be asking the Baker City Council to chime in as well.

Clark says he hopes Baker City residents, and those who live outside the city limits, appreciate the service provided by the city's professional fire department employees.

About 76% of the fire department's ambulance calls are within the Baker City limits, Clark said. The other 24% of calls are outside the city.

Clark is concerned that if the county should place a ballot measure before only those voters outside the city, they would be making the decision on emergency medical services for everyone.

"City residents need to make their position known and express their concerns," Clark said.

The chief concern is that if the county chose an ambulance provider other than the Baker City Fire Department, the department, due to a significant cut in revenue from ambulance calls, would have to make significant staffing cuts.

As Yencopal points out, decisions are yet to be made, and will take into account comments provided during the public meetings.

In support of his employees, Clark wants residents of the 1,600-square-mile ambulance service area -- slightly more than half the county's area -- to understand that Baker City Fire Department fire and rescue workers live in the community and are rooted here.

"We have a huge community connection," Clark said.

Because his employees are community members, they are involved in organizations such as the Elks Lodge, Boy Scouts and sporting events. And they participate in the Miners Jubilee, rodeos and the Shrine Parade.

"This is their permanent career," he said. "This is the only concern they have: Baker City and Baker County residents."

The level of training and experience reflected in the staff would be hard for a contracting agency to beat, he maintains.

"The average person has been here more than 10 years," Clark said. "They have read through thousands of EKGs and they have had thousands of patient interactions."

And then there is their personal knowledge and experience with the region. They are familiar with remote areas of the mountains, including Forest Service roads, he said.

Plus, the department has fostered relationships with the volunteer departments around the county over the years.

"We work like clockwork," Clark said. "We don't miss a beat."

If an outside company were to be awarded the bid to provide ambulance service all of that would be lost, Clark believes.

While the RFP requires a minimum of four people and two ambulances available per day, the Baker City Fire Department offers five full-time EMT/paramedics, plus Clark, available daily. The department also has a small group of part-time emergency service workers to call in as needed as backup.

Clark said over the past three years, two ambulances were on calls simultaneously an average of 200 times a year. Baker City Fire Department has the ability to cover four back-to-back calls. A contracted service with only two ambulances would not, Clark points out.

The department also provides free training in the community to the quick response and rural fire departments throughout the county and CPR training monthly in the community at no cost.

Ambulance revenue makes up 44% of the Fire Department's budget and assures that current staffing levels can be maintained, Clark said. But that money also funds dual service -- ambulances as well as fire trucks.

"A firefighter paramedic or a firefighter EMT can treat and put out a fire," Clark said.

Without the ambulance contract, the department's staffing likely would be reduced to two people per day, he said.

Four people are required at a fire scene before any of them can go inside a building.

"It's the two-in, two-out rule," Clark said. "We have to have two outside before we can put two inside."

Staff reductions also would likely result in higher fire insurance costs for property owners, he said.

And it would affect the department's ability to provide mutual aid to the rural fire departments.

"Clearly, because of the staffing model we have, we have the ability to help them," Clark said. "If we return to two people in the station, there would be no mutual aid."

The same would be true for fire calls involving vehicles that might include the need for extricating vehicle occupants along Interstate 84.

The city has a contract with the Oregon Department of Transportation to respond to freeway calls between Weatherby and the south Baker City limits.

That practice would end with reduced staffing, he said.

Clark hopes the county will look at all of the examples he has pointed to when awarding a contract for ambulance service.

"We have a good relationship with the county," he said. "We just feel like the public needs to understand where the process is going."

And Yencopal echoed that sentiment from the county's view in a press release about how the county plans to proceed:

"I want to assure you that the County has not undertaken this process due to any issues or hard feelings by any group or jurisdiction.

"This process is to gather information so Baker County residents can make an informed decision about the care they'd like to receive, and the costs of that care."

County Commissioner Mark Bennett said this summer that the city fire department has "provided excellent levels of service" in the ambulance service area and that the county does not intend to harm the department.

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