Civic Agenda: Take time for long-term EMS solution


For many years Whatcom County has been served with excellent Advanced Life Support ambulance services provided by the medics of Bellingham Fire Department's Whatcom Medic One. In 2005, due to increased call volumes and increased costs, a county-wide plan was adopted that addressed the future financial and operational needs of emergency medical services.

Major components of the plan included a voter-approved increase in sales tax of 1/10th of 1 percent, asking the county fire districts to increase Basic Life Support services, and adding additional ALS units in fire districts outside of Bellingham when service demands required expansion.

The implementation of the EMS plan and the addition of an ALS medic unit in Fire District 7 (in the Ferndale area) created labor issues with the union representing Bellingham firefighters. Increasing costs of the Whatcom Medic One service, along with substantial decreases in Medicare and insurance reimbursement and the perceived lack of a meaningful voice in the decisions being made through the existing contract resulted in the Whatcom County Council sending notification to the city of Bellingham to terminate the long-standing contract at the end of 2013.

Mayor Linville and I were elected to our positions in 2012, and we both felt it imperative that Whatcom County and Bellingham be served with a collaborative system - having two separate ALS systems in the county was not productive. Therefore we presented our councils with a resolution outlining a path forward to keep a unified system based roughly on the 2005 plan. The resolutions were passed unanimously by both councils.

Progress has been made in the last year working with Bellingham and Fire District 7 to achieve the goal of a unified system as outlined in the resolution. Not all of the mandates of the resolution are feasible at this time, including the goal of a unified administration overseen by the city of Bellingham.

Another critical point in the progression of the agreements came late in 2012 when it became evident that the system was continuing to expend more reserves than anticipated, with further increased costs by Medic One and decreased reimbursements from the federal government. The frustration that was expressed in 2010 was revisited by the Whatcom County Council during the 2012 budget proceedings, but the council decision was to honor the contract and work toward a fiscally responsible system in 2013 while maintaining an appropriate level of service.

This May, I presented the Whatcom County Council with a plan that I believe reflected their desires as identified in the 2010 resolution, and as expressed by them in the 2012 budget deliberations. The plan calls for validation of Fire District 7 as a full-time ALS unit in the system, while reducing the Bellingham Medic One units to three full-time units. I'm convinced this is a responsible plan providing for the emergency medical needs of our entire community, based on the excellent work of the fire districts providing BLS coverage, and the commitment from Bellingham to provide extra surge capacity coverage in the event of a major emergency.

This plan would be implemented incrementally in 2014, reducing the annual deficit from $1.15 million to $375,000. It also would give Whatcom County and their fire districts a stronger voice in the administration of the system through the creation of a Medic One Oversight Board and a Technical Advisory Board.

Since May, I've met with labor groups, fire commissioners, fire chiefs and interested citizens concerning the proposal. These groups and citizens also have met with some council members. Most, if not all, are concerned about a perceived reduction in service and the impact that it may or will have on their organization and on the community at large. I respect their concern and appreciate their input.

Because of these concerns, and my desire to work with our council on an appropriate resolution to this issue, I have asked the Whatcom County Council for their guidance pertaining to the proposal. It was discussed on July 9 and will be again on the council committee docket for July 23.

It is my desire that Whatcom County, city of Bellingham and Fire District 7 accept this proposal as a medium-term solution to the financial realities we have. The plan as presented is feasible without the loss of jobs, other than retirements, and is operationally and financially prudent, as identified by the current service data. The savings we would experience would give us three to five years to engage the community in finding a long-term funding solution, using the reserves we currently have to bridge the gap.

The long-term solution I propose is to review and update the 2005 plan based on current data. Using up-to-date service and financial information, we will be better able to determine the need and path forward, which may include requesting voter approval of appropriate funding. The plan should accurately reflect the synergy developed between the BLS, ALS and emergency dispatch components of system delivery. It needs to be vetted by all of the elected officials throughout Whatcom County, including fire commissioners, councils and mayors. We also need community input to guide us in the decision-making process. I estimate that it would take 18 to 24 months to accomplish this task comprehensively. My personal goal would be to explore the idea of a county-wide Ambulance Authority that would self-regulate and self-manage the system with dedicated funds.

One of the options being discussed by Whatcom County Council on Tuesday is extending the present service level for one more year, with the understanding that the Council would ask the voters for a 1/10th of 1 percent tax increase in 2014 to cover the additional monies needed to operate the system at its current service level.

If this option prevails by the council, of course I will be supportive of facilitating their efforts. With that said, I believe the decision would derail the opportunity for us to augment the financial commitment to the program through assessing and planning for a long-range solution as described above that would provide a funding package and operating agreement to finally solve the system's existing challenges.

This is an important issue for everyone in Whatcom County, as it is imperative that we provide the best service possible for pre-hospital emergency health care response and continue to build this program in an operationally and fiscally responsible manner for this essential service for years to come.

Thank you for the opportunity to serve you as your Whatcom County executive. If you have specific questions or comments pertaining to this subject, or any subject for that matter, please contact me at: or 360-676-6717.

This is one of a series of monthly Civic Agenda reports The Bellingham Herald invited Whatcom County Executive Jack Louws to provide to share updates about Whatcom County issues and projects.

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