January 14, 2002
Medic One biz plan continues to evolve
by Jeanette Knutson
A year ago, with the bottom line in mind, Andrew Fallat, the former chief executive officer of Evergreen Hospital Medical Center, reluctantly suggested that Evergreen relinquish its lead role in delivering emergency medical services to the Kirkland, Redmond, Woodinville, Bothell and Duvall area. The hospital had been contracting to provide Advanced Life Support services for over 25 years. But funds allocated through the Medic One levy weren't covering the hospital's costs. Shortfalls were mounting up to the tune of hundreds of thousands of dollars.
So, in a letter written to Dr. Alonzo Plough, director of Seattle-King County Public Health, Mr. Fallat said, "... (W)e are prepared to work cooperatively with all interested parties to manage a smooth transition to another contractor."
Those were sweet words to area fire departments, which were eager to take over the Advanced Life Support management role.
"It was as if a door opened up," said Woodinville Fire & Life Safety District Fire Chief Steve Smith at the Jan. 7 Woodinville City Council meeting. Fire Chief Smith appeared before the council to provide a Medic One update.
Shortly after hearing of Mr. Fallat's dropout proposal, a number of stakeholders came to the table. They formed a consortium whose goal was to craft a business plan, integrating Basic Life Support, Advanced Life Support and fire services, all of which would result in improved services to the community, the consortium felt.
But coming up with a business plan "turned out to be a longer process than we anticipated," said Fire Chief Smith. Along the way, moreover, the group has broken into two consortiums, he said. As it stands now, there is the Redmond, Kirkland, Woodinville, Duvall, Evergreen consortium and the Shoreline, Northshore, Bothell consortium. Evergreen wishes to remain part of the consortium, just not as the lead agency. It would, however, like to continue to provide medical control.
Redmond would like to act as the lead agency for the consortium to which it belongs. Woodinville would be the backup lead agency should the Redmond City Council not support a Redmond lead position, said Chief Smith. Shoreline would like to act as lead for its group. Yet all these roles hinge on the approval of the governing bodies of each of these agencies - the city councils of the participating cities, the boards of commissioners of the participating fire districts and the King County Public Hospital District No. 2's Board of Commissioners for Evergreen.
As to why the initial consortium split into two, Redmond's Fire Chief John Ryan said in an interview last week, "Geographically, it's a big area from Shoreline to below Redmond. Shoreline has some Medic One units but adding another three and a half would have been more than they wanted to take on." By the same token, Chief Ryan said he would be happy to keep the Redmond group at a manageable size, as well. "This way both consortiums can take a good look at what they have and how it works," he said.
King County EMS (Emergency Medical Services) will probably sign a contract with Evergreen to deliver emergency medical service through August. But when the business plan is complete, when all parties are in agreement, and all governing bodies have signed off on the plan, the consortium lead agencies will pen their own contract with King County EMS. Then the lead agencies will subcontract with consortium members to provide services.
"We should see the transition by July or August," said Chief Smith.
So what's the holdup? Why is this biz plan taking so long to draft?
Chief Ryan explained, "A lot of it has been the mechanics. Will it work? It seemed logical in the beginning, but we had to put a lot of work into it.
For one thing, there was a lot of data collection to be done. Also, there were a lot of interests at the table. Evergreen had its patients in mind. It wanted to make certain the high quality of service was maintained.
"In addition, every fire chief at the table had interests of his own. Would his district get the same degree of service it had before? Labor brought its concerns as well. The Evergreen paramedics didn't want to be left behind. The firefighters wanted the opportunity to become paramedics when openings occurred. With every issue, we had to weed through the data, discuss it and reach consensus," said the Redmond fire chief.
All the paramedics that work for Evergreen Medic One will be absorbed into the consortiums, Chief Smith said, some joining the Redmond consortium, others, the Shoreline group. Some may be eligible for retirement, having been with Medic One since the beginning. But all are welcome to become a part of the new configuration.
In the future, said Fire Chief Smith, firefighters will become the paramedics. They will undergo the rigorous nine-month paramedic training, ultimately playing a dual role for the new organizations - firefighter/paramedic. In that way, he explained, the consortiums can better control costs. They believe they can obtain certain economies, he said.
"It's really important to consolidate emergency medicine," said Chief Ryan. It's going to be good for our citizens who need trauma and illness and transportation services. Evergreen has provided excellent service in the past. We're going to see if we can take it to an even higher level."