The Board of Supervisors expressed plenty of skepticism during their March 12 discussion of the Exclusive Operating Area (EOA) proposal for County ambulance service. As “outreach” sessions commence around the County, all five Supervisors expressed “concern” about both the process and the feasibility study being conducted by an outside consultant about what they admit is basically a franchise arrangement for ambulance service in Mendocino County. Here’s a summary of the Board’s reaction and responses.
Supervisor John Pinches: (On existing services) These are mostly volunteers. You’re really talking about a franchise agreement with a single operator throughout the county. How will that interact?
Staff: It would essentially be a franchise agreement.
Pinches: This seems like an aggressive time line. It’s very complicated. Two months [for a feasibility study]? Seems more complicated than that.
Staff: We are building off of the 2011 assessment which identified problems with Emergency Services in Mendocino County. Of course we’d have to include the volunteers. This would help them, enhance their work, help them with training.
Pinches: Covelo calls are about one a day. How would you cover such a small call volume out of there? And a private company? How would you organize volunteers in that situation?
Staff: Volunteers make the system work and you still have coverage. We want to work with volunteers.
Pinches: I don’t see how one big franchise area could work.
Staff: Sonoma County has one ambulance system and they incorporate established units into their system. Mendocino County will have to incorporate our unique system here and we have to work with our volunteer partners. But we need something that’s more sustainable, fairer, more efficient and that we can monitor better. But if it’s not possible, we go to Plan B. This is the time to study this.
Supervisor Dan Hamburg: Is there general stakeholder support for this process?
Staff: There is concern about a change from the top. People think this might wipe away what was there before. We have to educate folks. This is just exploratory now. There will be no changes until we understand this. People providing the service now have to be at the table. We don’t want to steamroll anybody. It’s a big change and it will be unsettling for some.
Hamburg: It sounds great, but my concern is when you end up with winners and losers. Friction is likely. I hope this is collaborative in the best sense.
Staff: A franchise arrangement does not preclude partnerships with prospective providers.
Pinches: A single franchise area is what this is. Volunteers offer their services 24/7. And the volunteers do this for the community. But if you give them a “boss” instead of the community, I’m afraid volunteers will drop off because ‘I’m not taking orders from the community anymore, but from the franchise winner.’ Two months is ambitious. I’ve heard about the urgency for years, but people still step up and provide this service. I think the system is pretty good and I don’t want this to end up five years down the road with something worse. Two months seems very fast.
Supervisor Dan Gjerde: Make sure you involve the smaller fire departments. Mainly the problem is a lack of a funding stream.
Supervisor John McCowen: I know sustainable funding is an ongoing subject. I am concerned that we might be trying to fast track this process for a report by May 15. We need to connect with all providers and make sure this is deliberative, not done with an artificial deadline.
Supervisor Carre Brown: Keep us updated. If more time is necessary, let us know.
Pinches: We need a financial solution. It’s a legislative issue. This needs a legislative fix. This is really important, but the legislature has avoided it. CHP and Caltrans depend on emergency services on the main highways so that’s a real obligation and a budgetary commitment. How can you replace these small providers with one big franchise provider? How can you send an ambulance from a central location? I don’t see how this can be solved without legislative action. They have to contribute to this, at least for road accidents. Our volunteers have done a damn good job to meet this need with minimal funding.
Hamburg: There’s quite a bit of concern that we make things better and not more complicated.
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