Will Evergreen opt out of Medic One system?
by Jeanette Knutson
Not many know that Medic One units in northeast King County are manned by Evergreen Hospital Medical Center employees. The paramedics in these red-and-white rigs work in conjunction with local fire departments, hospitals and King County and have quite an interesting chain of command.
Seattle-King County Department of Public Health is the umbrella organization under which the Medic One program falls. King County Emergency Medical Services (EMS) is a division of Public Health that oversees the funding implementation of the program, makes sure the standards of medical care are maintained and helps determine where the paramedic trucks should be placed. Evergreen Hospital Medical Center is the agency that contracts with King County EMS to deliver the emergency medical service for the Kirkland, Redmond, Woodinville, Bothell, Duvall area. And they've been delivering it for close to 28 years.
This year, however, Evergreen is considering dropping out of the Medic One system. The reason? They're losing money. Funds allocated through the Medic One levy aren't covering their costs.
Last year, according to Kendra Weil, hospital spokeswoman, the Evergreen Medic One program received $3 million from King County to fund the program. The actual cost to the hospital was $3,075,000. This year projections indicate a $250,000 shortfall beyond the $3.15 million budgeted.
"With regard to 2002 and beyond, we will be willing to contract to provide Advanced Life Services only if our reasonable full costs of operation can be covered by our contract with King County," wrote Evergreen's chief executive officer, Andrew Fallat, in a Dec. 19 letter to Dr. Alonzo Plough, director of Seattle-King County Public Health.
Fallat continued, "In the event that King County is unable to fully fund the cost of Medic [One] services, we are prepared to work cooperatively with all interested parties to manage a smooth transition to another contractor."
Tom Hearne, manager of King County EMS, is hopeful Evergreen remains in the system. He cited their long history with the program, a program that created a model used by emergency response providers worldwide.
Hearne also insisted that if the hospital decides to discontinue their paramedic program, "the service is not going away." Nor will it be substantially different if another provider takes over.
Area fire chiefs have expressed interest in picking up the program.
On Jan. 12 fire chiefs from Bothell, Kirkland, Redmond, Shoreline, Northshore, Eastside Fire & Rescue and Woodinville Fire & Life Safety, along with a representative from King County EMS, met to discuss the topic. It was the consensus of the group, according to a statement issued after the meeting, that Advanced Life Services for this area should be operated by the fire service. The chiefs met again on Jan. 30 and continue to work on a business plan to deliver emergency services should they be called on to do so.
Fire Chief Steve Smith of Woodinville Fire & Life Safety said they believe they can obtain certain economies if they form a consortium to deliver the paramedic services.
Fire Chief John Lambert of Fire District 45 in Duvall agreed. "Fire chiefs are taking the opportunity to look at the program to see if they can make it more cost effective, more efficient." He emphasized, "It's not a situation where the services will just disappear."
But the fact remains that the Medic One program is underfunded. Right now the county is funding roughly 87 percent of the cost. And whether Evergreen or the fire service consortium or someone else delivers the service, costs need to be met. The county has assigned a task force to look into how best to provide stable funding for the system. Its final report may come in March. After that, their recommendation needs to be approved by the county council and by certain cities as required by law. Only then can it be put on a public election ballot in the form of a levy.
Meanwhile the paramedics are committed to "quality care, uninterrupted and undiminished," said Mark Brownell, president of the Paramedics Union Local 3611. All paramedics, said Brownell, have to go through paramedic training at the University of Washington and Harborview Medical Center. They train shoulder to shoulder with some of the best cardiologists, neurologists and ER doctors in the world. "For the paramedics," he said, "it's not just about a paycheck. Their primary concern is for the patients, that they continue to get the best service possible with no interruption of care."
Nevertheless, these paramedics' livlihoods rest with the decision-makers.
City of Bothell Fire Chief Marcus Kragness feels, " ... the consortium should honor the commitment and service of the current paramedics in the Medic One program and absorb them into the consortium."
In Fire Chief Smith's opinion it is the intention of the consortium [should it eventually sponsor the program] to take into the consortium "any and all Evergreen Medic One paramedics that want to come."
So, too, will the citizens of northeast King County have a chance to weigh in on this issue when they vote on the next Medic One levy later this year.
In the meantime hospital spokeswoman Weil confirmed, "There will be no interruption in the Medic One service through the discussion process this year. Medic One is not going away. It is going to continue. It may just transition to another provider."