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The EOA is DOA

In 2012, the second of two expensive consultant studies pointed out the obvious: Mendocino County’s emergency medical services were inadequately funded, uncoordinated, hard to staff and fragile. Seven years later that description still holds.

At about that same time a huge Denmark-based medical services corporation named Falck/Verihealth showed up in Ukiah and started responding to 911 calls in addition to the long-established Ukiah-based ambulance outfit Medstar, creating a crazy race to emergencies to see who get to the patient first and get whatever reimbursements could be billed for. 

Mendocino County soon announced that the solution to both problems was the establishment of something called an Exclusive Operating Area (EOA), contracting with one outfit, public or private, for exclusive ambulance coverage for a designated area of the County, primarily the Highway 101 corridor from the Sonoma County line to the northern part of the County — but also including Anderson Valley.

Now, after seven years and after huge amounts of staff time and consulting costs, the long delayed EOA appears to have fallen apart. 

Last week Chief Doug Hutchison, Ukiah Valley Fire Authority fire chief effectively pulled the plug on the EOA, writing a letter to County CEO Carmel Angelo saying that the City of Ukiah and his fire authority had decided to withdraw from the EOA process. Hutchison didn’t say why, but in recent weeks it’s been common knowledge among local EOA participants that Ukiah didn’t like the answers or non-answers to the questions they had posed to the County and Coastal Valley Emergency Medical Services (CVEMS, the Sonoma County based administrative agency) that has been handling Mendo’s medical oversight and administration and which was coordinating the EOA Request for Proposals that was issued a few months ago. 

“The City of Ukiah will not be participating in the County' s proposed exclusive operating area (EOA),” wrote Hutchison, “and has directed city staff to begin investigating the procurement of ambulance services for the City and to make recommendations to the City Council. Please note, this direction does not preclude consideration of a collaborative option with the County if agreement can be reached under an alternate approach.”

Upon receiving a copy of Hutchison’s letter, Anderson Valley Fire Chief Andres Avila notified the AV Community Services Board that “Several things have changed in the recent weeks with the EOA and this [the Hutchison letter] is a formal development from Ukiah that will impact the process. The conundrum we are facing is being integrated into a poorly written RFP but we are also against the clock with a local and county-wide ambulance stability problem. I have discussed this with several people and will certainly be getting more information before Wednesday's [board] meeting [August 21, 2019 at the Boonville firehouse]. We can have a more detailed conversation then.”

Fifth District Supervisor (and former Albion-Little River Fire Chief) Ted Williams who has been following the situation and the EOA very closely, added, “I can't imagine the ambulance EOA effort will survive Ukiah's exit.”

Ukiah’s withdrawal comes on the heels of a series of other problems with CVEMS that have been buildling up over recent months such as much higher proposed costs for future services, poor or slow responses to ambulance and staffing shortages, and ongoing compliance with the latest state law updates for emergency services.

Complicating things further is the patchwork of dispatch services that the Supes had decided last year to consider consolidating but never got off the ground.

For now, everybody’s back to the drawing board — a drawing board that has been tottering for years and now has been tipped over.

County Notes

LOOKS LIKE THE COUNTY HAS A TENTATIVE AGREEMENT with their biggest employee barganing unit, the Services Employees International Union (SEIU). To our preliminary eye it looks like the employees are getting a pretty good deal, pay and salary-wise: An immediate 3% pay raise, plus employees who are “more than 10%” below market rate (according to the consultant’s analysis) will get raises bringing them “within 40% of 90% of the market.” Employees who are more than 5% below market will get raises to bring them to “within 40% of 95% of the market.” Then more comparable raises in Year 2 and Year 3 with some adjustments to the various percentages. 

HOWEVER, THERE’S NOTHING in next week’s Board packet about how much this will cost or how much of the previously budgeted/allocated $5 mil this represents.

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