Last month, the Bonner County Fire Chiefs Association held three public forums. The BCFCA pointed out, in multiple, evidence-based ways, how emergency medical services would be improved in our county if all the EMS providers simply worked together, shared resources and communicated better.
If the BCFCA recommendations were implemented, response times would be reduced, patient care would improve, and some duplication of service could be eliminated.
The following is an abbreviated list of the BCFCA recommendations:
• Ambulance operations — Separate and relocate the two Bonner County Emergency Medical Service department ambulances (and crews) housed near Bonner General Health. House one ambulance and crew at the Sandpoint fire station. Move the other ambulance and crew to the Northside fire station in Ponderay. These moves improve response times for Kootenai, Ponderay and Sandpoint immediately.
Relocating the BCEMS ambulances/crews eliminates a $7,000/month BCEMS lease payment. This also eliminates the need for building two new “ambulance only” stations in the same communities as the noted fire stations. The Dufort Road and Highway 95 ambulance station built three years ago cost approximately $1.5 million. Administration of BCEMS should be moved to the Dufort Road ambulance station to further streamline spending and infrastructure utilization.
Emergency calls for service, equipment breakdowns and non-emergency patient transfers can quickly exhaust the available ambulances in the county. The research showed there is ample room in existing fire stations for at least two more 24/7 ambulances in the county (one below the Long Bridge, one between Priest River and Sandpoint). The ambulances could be staffed with a combination of firefighters and BCEMS employees. The additional ambulances will better serve those areas and back up the existing ambulances. An additional reserve ambulance could be housed in Sandpoint for use during peak emergency demand.
• Support — The fire district and volunteer ambulance providers serve a critical role for EMS response times, emergency operations and for the extra staffing needed for patient care. To perform their duties well, they require appropriate EMS training and equipment. Currently, the fire and volunteer ambulance districts pay most of their EMS training costs and equipment purchases. The Bonner County Board of County Commissioners should fund the costs of EMS training and equipment for the fire district and volunteer ambulance providers from ambulance levy revenues. The volunteer ambulance areas — Clark Fork, Schweitzer, and Priest Lake — bring in four times the revenue they get returned to them for their operations each year.
• Governance — The BOCC regionalized Bonner County EMS in 2005. They have directed and funded BCEMS operations, with the help of their own EMS manager, utilizing nearly all the ambulance levy and patient transport revenues as their funding source. The research revealed a large number of BCEMS managers have resigned or “moved on” since 2005.
The fire chiefs recommend the BOCC implement a Joint Powers Board concept like Kootenai County EMS. A combination of elected officials from the county, the cities and the fire and volunteer ambulance districts should be responsible for the oversight of the countywide EMS system. The JPB will provide accountability for every EMS dollar spent among all the providers, offer a more stable environment for the EMS manager and provide full transparency for the public and the providers.
There is currently no monthly forum for EMS operations for all representatives of the emergency providers, the medical community and other stakeholders in Bonner County. A group like this (10-15 participants) last met two years ago. The BOCC needs to restart a true stakeholder group. Working with all the providers is challenging. Doing the hard work of establishing supportive organizational relationships, developing consensus and team building are the best paths forward.
The BCFCA believe our county EMS system would be better if we implement these recommendations (and others we have already brought forward). Our community members and guests deserve the best patient care and robust EMS delivery system our emergency resources and revenues can provide.
Mark Sauter is the elected president of the Bonner County Fire Chiefs Association. He served in the fire service for 30 years, holding the ranks of firefighter/paramedic through fire chief. He has committed over 700 volunteer hours to this project.