Supervisor John McCowen opened Tuesday’s discussion of the local ambulance services with a worrying anecdote:
“I was told that last Friday we had a period of time in Ukiah Valley, Redwood Valley where there were no additional ambulances available, that every available ambulance was on-call. It had been a bit of a touchy situation for a bit of a time. The person informing me of this who was monitoring the radio traffic thought that dispatch did an excellent job. It appears that no one needing service had a delay of more than perhaps a few minutes in an ambulance getting there from what would have happened under absolutely optimum conditions. They also said we were very lucky. They also told me that the City of Ukiah put one of their ambulances online. I see an affirmative from the audience that that was true. I guess we have some gaps in the present system even in an area where we are arguably the best served by numbers of ambulances and availability. … One ambulance company decided, Well, we are going to down staff a unit and a half, I think was the number. So apparently they are able to arbitrarily staff up or staff down. When they staffed down then it was up to the remaining providers to try to cover the bases if necessary. So we apparently don't have a sustainable system here locally, let alone what's being described for some of the outlying areas.”
Brian Cleaver, head of Coastal Valley EMS in Santa Rosa agreed:
“Yes, we did in fact run to Level 0 which is in the inland corridor ambulances were all busy on call assignments. We were able to help support the system by bringing an ambulance out of Fort Bragg as backfill and then the Ukiah city ambulance also stepped up. So no calls were delayed and no calls were missed, but that's the kind of coordination that's necessary particularly in this environment. With a competitive environment, what we have always cautioned is that the two providers have an abundance of resources until they choke each other out and it begins to cause the system to collapse.”
But instead of dealing with the near-collapse of ambulance services in the Ukiah area, the rest of the Supervisors discussion was a confusing ramble about how to finance the administration and oversight of the increasingly fragile system, not how to support or improve the actual service.
Ambulance services in Mendocino County are a patchwork of small, independent, underfunded, autonomous operations, some government, some private, with strong local support but very fragile financing which only works through the dedicated efforts of local fire departments, Calfire dispatch, a few professional paramedics and a dwindling roster of dedicated volunteers.
This fragile arrangement was further disrupted a few years ago when Verihealth/Falck Ambulance Corporation started responding to calls in Ukiah Valley at the same time that the long established private company MedStar was responding. Before long this competition for Ukiah Valley ambulance calls produced a proposal to develop an exclusive operating area in the 101 corridor so that things could return to one ambulance service provider which would respond to all the calls, including the more lucrative inter-facility calls, thus providing some measure of financial stability to the “winning” service under increasingly difficult state standards.
The first Request for Proposals (RFP) for covering the exclusive area prepared by Sonoma County-based Coastal Valleys EMS Authority (CVEMSA) a couple of years ago included putting emergency dispatch services out for bid. Including dispatch in the RFP would have effectively prevented MedStar, the aforementioned local Ukiah ambulance service, from even bidding and probably handed the “exclusive” contract over to VeriHealth/Falck because they have no dispatch service arm.
After first agreeing to include dispatch services in the RFP, the Board of Supervisors reversed itself last year when Coast Supervisor Dan Gjerde returned from vacation and they voted (by a 3-2 vote, Hamburg & Brown dissenting) to remove dispatch from the RFP and continue using Callfire dispatch services which all the local agencies were happy with and which should never have been in there in the first place.
Then CEO Angelo decided earlier this year that because Coastal Valley was not much help during the 2017 Redwood Valley/Potter Valley firestorms, Mendocino County should separate itself from Coastal Valley and create its own local emergency management services authority (LEMSA). (Coastal Valley says they would have helped if their contract had included funding to pay for the help.)
The trouble with the CEO's idea was that here is nothing in place in Mendocino County to assume Coastal Valley’s rather complicated bureaucratic role; current estimates indicate that it would cost $600,000 a year or more for specialized medical administration oversight staffing.
The entire situation leaves local emergency services organizations in a barely workable limbo with no idea where large parts of their funding will come from, how they will continue to staff volunteer shifts with dwindling volunteers, and what level of service can be provided.
Just last month, Verihealth/Falck up and pulled two ambulances out of Ukiah and relocated them to Alameda County and Petaluma because, apparently, it made more economic sense than leaving them in the Ukiah area competing for calls with MedStar, creating the tenuous situation described by McCowen.
At the end of Tuesday’s discussion, the supervisors seemed stumped as to how to proceed, choosing only to authorize the creation of the three, so far unfunded, local positions, but with no deadlines, no financing, and the very real possibility of reversing course again and renewing the contract with Coastal Valleys, perhaps supplemented with additional money to cover as yet undefined additional services that CEO Angelo says were lacking during the October 2017 fires.
Meanwhile, if you find yourself needing an ambulance, especially in the Ukiah area, don’t be surprised if it takes longer and the ambulance that finally arrives says “Mendocino Coast District Hospital” on the side.
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