North Valley Hospital hopes to step in

“The need for a decision is coming fast…. Without a strong EMS system people will die. I truly believe NVH has the opportunity to not just keep it running but to continue to provide opportunities to these EMTs in the hospital, which will improve their performance.”

Mike Zwicker, CEO

North Valley Hospital District

OKANOGAN – Okanogan County Commissioners issued a Request for Qualifications from potential vendors to take over Tonasket Emergency Medical Services (EMS), with plans to put it out to bid June 17.

North Valley Hospital CEO Mike Zwicker approached the Board of Directors Thursday, June 9, for permission to respond to the Request for Qualifications to take over running the ambulance service.

“The need for a decision is coming fast, as the commissioners want to put it up for bid June 17,” said Zwicker. “Without a strong EMS system people will die. I truly believe NVH has the opportunity to not just keep it running, but to continue to provide opportunities to these EMTs in the hospital, which will improve their performance within the community and make them more efficient out in the field. We have a great EMS crew and I feel it is an obligation to keep them.”

Attending the board meeting were Tonasket EMS Interim Director Wendy Burks and EMTs Jackie Daniels, Glenna Brown and Chris Allen. When board member Adam Tibbs asked the EMTs in attendance if this was something they wanted, they unanimously responded, “Absolutely.”

Tonasket EMTs were sent a letter dated May 25, 2016 informing them of the commissioners’ intentions, with a date of separation of service slated for anytime after June 30, 2016.

The move comes following an Accountability Audit Report of the Tonasket EMS by the Washington State Auditor’s Office. The audit, published March 7, 2016, covers the period of January 1, 2012 through December 31, 2014. The audit summary recommends the Board of County Commissioners and Advisory Board establish internal controls over financial operations of the EMS District, with the suggestion the control structure “be adequate to facilitate retention of adequate documentation to support the validity of transactions, monthly reconciliation of the payroll imprest account, proper handling of donations and approval of time sheets, and to ensure all activity is performed under the governance of the Board of County Commissioners.”

“We have the personnel, billing talents and administrative ability,” said Zwicker.

A move was made by Tibbs and seconded by Board Member Herb Wandler to draw up the qualifications to present to the commissioners.

Patrick Plumb, who served as an EMT with Tonasket EMS for six years and works in the business office of NVH, said he was glad to hear the hospital was considering the contract. “I truly believe that Medicare rules are going to have ambulances and hospitals working a lot more together than they have in the past,” said Plumb.

Allen, who founded the non-profit ambulance service North Star Medic last August after Oroville’s EMS was taken over by Lifeline, said the only three prospects to take over the ambulance service would be NVH, Lifeline or North Star.

“I do not believe I am going to compete with the hospital, but if they get the contract I will assist them,” said Allen, adding that while he had no intentions of dissolving North Star, if the hospital got the contract and needed his ambulance service he would donate it to NVH. “I am in support of working with the hospital, because they are a tax-based facility, publicly owned and very transparent in what they do,” said Allen, “and by merging the two (Tonasket EMS and NVH), there will be more funds available as a publicly-funded agency. Also, NVH would have the ability to pull from their staffing of around 250 employees, whereas Lifeline has about a dozen employees here in Okanogan County.”

Wayne Walker, General Manager of Oroville’s Lifeline, said they were looking into answering the commissioners Request for Qualifications and said he thought he had enough crew members to cover both Oroville and Tonasket EMS.

“Obviously we would have to hire some additional staff, but I believe it would be doable,” said Walker. “Right now our entire company has about 65 people with stations in East Wenatchee, Wenatchee, Omak, Okanogan and Oroville. As we continue to move forward and get a grasp of the multitude of call volume and type of calls, we are looking at whether we would be able to provide a paramedic to the north county. If we decide to move forward with the Tonasket EMS, we would be able to provide a paramedic.”

Walker said there are either two EMTs scheduled in Oroville per shift or a combination of an EMT and a EMT-IV, who doesn’t have the full capabilities of an EMT-A, but holds a special endorsement from the State of Washington allowing them to start IVs.

“We get a lot of calls for motor vehicle accidents in which there are three or four occupants. With the EMS, everyone is local so we can staff it, but with Lifeline they will only have two EMTs and have to call in folks from Omak. That’s a long way and a long time to wait,” said Jackie Daniels, an EMT with Tonasket EMS who was employed by Oroville until Lifeline took over that ambulance service ten months ago. “Tonasket EMS has three ambulances and 13 EMTs right now. We also have cooperation and good relationships with Loomis Fire Department, Mt. Hull Fire Department, Aeneas ValleyFire and Rescue and Tonasket Fire. We work very well together; we have trainings together and it is great when you arrive on a scene and they already have things started. I think it would be hard for Lifeline to get that rapport going. The quality of care would be greatly reduced, and when seconds count you need all hands on deck.”

“I think it is important to point out, studying our data from the time of the call to getting to patients within the city limits is averaging four minutes,” said Walker. “Calls outside of Oroville, dependent on distance and things, are a little different. But we have a pretty solid four-minute response time within city limits.”

Allen said the only emergency vehicle driving instructors in the north county are himself and one at Tonasket EMS. Tonasket EMS also has a senior instructor to train new EMTs.

“In the event Lifeline gets the contract, they will lose both driving instructors and the EMT instructor,” said Allen.

“It would be a disservice to go with Lifeline. It would cost a heck of a lot more, and the care would go downhill,” said Daniels. “Also, Lifeline is not civically minded. We do standbys at events like the football games, the rodeos, the fishing derby and the Jet Ski Races. Lifeline wanted to charge Oroville $1300 for an eight-hour shift at the Jet Ski Races. The Chesaw Rodeo or the Fishing Derby wouldn’t be able to afford them. And certain events can’t take place without an ambulance standing by.”

North Star provided stand-by services at the Jet Ski Races Saturday, June 4 and Sunday, June 5.

“It was all volunteer; we told them we did it by donation. They said they wanted to keep it with the local people,” said Allen, who employs four or five EMTs from Oroville and five or six from Tonasket.

“We are very thankful to serve citizens of the Oroville district,” said Walker, who has two Oroville residents employed as EMTs. “We’ve been able to participate in the mass casualty drill, and we started doing public first aid and CPR classes bimonthly for Oroville residents and courses for any businesses in Oroville.”

“I don’t think people realize all the things we do behind the scenes,” said Daniels. “For example, I’m a child passenger safety technician, so I do the car seat checks. When I do the safety checks for expectant parents, I’m working with an agency so I get grants. But those would go away if I was not affiliated with any agencies. I’m a taxpayer. I want the county commissioners to be good stewards of the money.”