October 22, 2001
Medic One: the ride of your life
by Jeanette Knutson
Citizens have come to rely upon an invisible safety net of sorts ‹ Medic One ‹ to deliver them from harm's way in moments of personal crisis. For two decades Medic One paramedics ‹ one layer of our regional emergency medical system ‹ have rushed to the aid King County citizens at crucial crossroads of their lives. Ask any car crash victim, any stroke or heart attack victim, any man who's fallen backwards off his roof and has had one of those red and white Medic One ambulances come to the rescue.
It's nice to know that men and women with a very high level of medical emergency training are at ready to be dispatched at three keystrokes of your phone pad, 9-1-1. But the fact of the matter is, the Medic One program needs to be paid for. And on Nov. 6, county citizens will be asked to renew an existing property tax levy to keep Medic One alive.
Terms of the levy call for $.25 per thousand dollars of assessed valuation on all taxable property within the county for six consecutive years, with collection beginning in 2002. That amounts to roughly $50 a year for a $200,000 home, $75 a year for a $300,000 home. The current levy calls for $.29 per thousand dollars of assessed valuation, so the new levy is slightly lower than one set to expire at the end of this year.
Sixty-two percent of the levy money collected will go to support the paramedics, the "advanced life support" tier of the emergency medical system. It costs $1.2 million to run a single paramedic ambulance per year and there are 22 such rigs throughout the county.
According to Fire Chief Steve Smith of the Woodinville Fire and Life Safety District, "That money covers staffing 24 hours a day, seven days a week, 365 days a year; in addition, it pays for rig upkeep or replacement, and the replenishing of drugs and supplies that the units carry.
"Woodinville has one Medic One unit at Station 35, located at Avondale and the Woodinville-Duvall Road," said Smith.
Others in the area include one in downtown Redmond, one in downtown Bothell and one at Evergreen Hospital Medical Center, he said.
This money will also pay for new paramedic services planned for the next six years, said Tom Hearne, manager of King County Emergency Medical Services.
Twenty-six percent of the proposed levy money will fund the "basic life support" tier of the system, "... the emergency medical technicians (EMTs) trained to sustain life, to stabilize the patient, until the paramedic unit gets there," said Hearne. "This money will be allocated to the 34 fire stations throughout the county."
"This will mean roughly $253,000 for our district's basic life support services," said Woodinville's Chief Smith.
Fire Chief John Lambert of Fire District 45 in Duvall is also counting on the $110,000 the levy will provide for his district's local emergency medical technicians. "If the funding were lost, it would have a significant impact on our district's basic life support, our aid cars," said Lambert.
Twelve percent of the levy money will go "to 'support' costs," said Hearne. "In that we include training costs for EMTs and dispatchers. This training is of a uniform and very high standard throughout the county. [The support costs also include] medical control; by this I mean the physician-oversight component [of the system]. ... Physicians must OK the training, OK the types of things they can do in the field. ... [And finally,] support costs cover the regional collection of data. We use this information to determine where we need additional services," said Hearne.
Since the inception of the countywide Medic One program in 1979, regional paramedic services have been supported primarily by property taxes. Four years ago, however, the Medic One levy failed to get the required 60 percent voter approval. The failure spurred a vigorous campaign for a three-year interim levy, which passed with overwhelming approval three short months later.
Then, elected officials got involved. Two task forces over three years earnestly looked into finding a stable base for funding such an important county program.
Said Hearne, "The first task force really looked at EMS (emergency medical services) in great detail ‹ operations, efficiency, funding options. It was unanimous that we had a strong regional system, that a person could get the same level of care where he lived, say, in Woodinville as he would where he worked, say, in downtown Seattle. If something happened, he'd be assured of the same level of service no matter where he was in the county.
"This task force compared our system to other systems, Boston, Dade County, for example. What they found is that we are very, very efficient. You'll notice our paramedics only respond to roughly one-third of the calls. They are going to the most severely injured, the most severely sick. [In the year 2000, EMTs answered 148,474 calls; paramedics answered 49,662.] Other systems send paramedics on every single call. They found that our system is much more cost-effective and that it worked very, very well.
"This group also looked at 12 funding options," said Hearne. "But the basic themes that they kept coming back to, were that the funding options didn't raise enough money; or that [implementing a particular option] required substantial changes in state law. It was very reluctantly that this group concluded that the best way to fund Medic One was with the levy tool. They concluded that levies for this program were worthwhile and effective.
"The second task force looked at the operation facet [of a levy], how long the levy would be ‹ for six years, 10 years or should it be permanent. Now this was a bipartisan group, and they decided that a six-year levy was best, that taking it back to the voters every so often was the best thing to do," said Hearne.
"One funding option they're looking at," continued Hearne, "is the feasibility of charging people for paramedic transports. But large questions [loom], with large implications: What kind of revenue would this produce, what are the pros and cons, would charging for service be a barrier to care? This will be reviewed during the next six-year period."
"It would be nice if there were a source of money that would be there year after year after year," said Chief Smith. "... But I know they looked at it closely and they just couldn't find a [steady] revenue source. It appears the excess levy is the only way to acquire the funds."
Duvall's Chief Lambert agreed. "There was extensive study of the different options. What they came up with was that the best way to give secure funding to the program was the levy system. This way the money can only be used for Medic One. If it came out of the county's operating budget, it could get cut."
"Medically," said Hearne, "this system is tremendously effective. We have the highest survival rate from cardiac arrest anywhere. It's region-wide. No matter where you travel in the county, you'll get similar service. All our paramedics are trained at Harborview and all get the same high level of training. It's quite a bargain. If you think that the average home is worth $200,000, this levy will cost you $50 a year. For that you can get CPR instruction over the phone from a qualified dispatcher, an EMT at your door in four to six minutes, and the highest trained paramedic not far behind. That's a good deal," he said.