Mendo’s Collapsing Ambulance Services

In October of 2017 after the Board of Supervisors decided to retain CalFire as the operator of the County’s fire and emergency services dispatch center, they voted 3-2 for the following agenda item:

“Formation of an ad hoc committee to work with the City of Ukiah and possibly the City of Willits to form a unified approach regarding contracting for Emergency Medical Services (EMS) and Fire Dispatch Services; and to negotiate with CalFire for enhanced dispatch services that will optimize an Exclusive Operating Area ambulance contract."

Supervisors Carre Brown and Dan Hamburg petulantly refused to volunteer to even be considered for the ad hoc committee on combining dispatch services to save some money for the agencies involved. Readers may recall that the Sonoma County-based Coastal Valley EMS, the agency that the County blindly turned emergency services administration over to lock-stock-and-barrel, had tried to push through a dispatch RFP and a privatization schedule until Supervisor Gjerde got back from vacation and convinced Supervisor Georgeanne Croskey that putting Calfire’s local dispatch operation out to bid was a bad idea. So Croskey changed her earlier vote for the RFP and joined Gjerde and McCowen in postponing the Dispatch privatization indefinitely.

But Hamburg and Brown, citing a version of staff-(i.e., Coastal Valley EMS) right-or-wrong, steadfastly refused to reconsider — even when faced with a phalanx of local firefighters and cops who explained in detail why privatizing Dispatch was a very bad idea.

In explaining at that time why she had no interest in saving the County and the City of Ukiah some dispatch money by consolidation, Brown specifically referred to the prior week’s 3-2 vote to hold off on the Dispatch RFP, adding that she was sure Supervisor Hamburg felt the same way. “Thank you, Supervisor Brown,” replied Hamburg, indicating his solidarity with Brown’s nonsensical refusal. 

In the end Supervisors McCowen and Croskey were appointed to the dispatch consolidation ad hoc committee, but not until Brown and Hamburg had again reminded the other three Supes that they had no intention of participating in the “cooperative” manner they always talk about.

Fast forward to January of 2019, right after Supervisor Ted Williams was seated to replace Hamburg as Fifth District Supervisor when the following item was quietly approved on the Consent Calendar:

“Approval of Formation of an Ad Hoc Committee Regarding Contracting for Dispatch Services for Fire and Emergency Medical Services and Appointment of Supervisors Williams and McCowen.”

The Board Clerk conveniently noted: “Previous Board/Board Committee Actions: On October 3, 2017 the Board appointed Supervisors Croskey and McCowen to an ad hoc committee regarding contracting for dispatch services; on December 18, 2018 the ad hoc was disbanded due to Supervisor Croskey’s impending departure from the Board.”

Supervisors McCowen and Croskey’s committee had produced nothing in 14 months before their ad hoc was unceremoniously disbanded when Supervisor Croskey up and moved to Ohio with her cop-husband without having done a single thing in her short tenure after having been appointed to finish out Supervisor Tom Woodhouse’s similarly accomplishment-free term when he resigned after going nuts while Supervisor.

So the Dispatch consolidation committee re-established itself with newly seated Supervisor Ted Williams replacing Croskey along with McCowen.

A year later and that committee has again produced nothing. We have no idea if they even met because ad hoc committees are not subject to Brown Act meeting requirements.

Introducing himself as “Tom Allman, private citizen,” former Sheriff Allman raised the subject again last Tuesday during the Board’s discussion of the shortage of ambulance services on the Highway 101 corridor. However, Allman didn’t bring up the sorry history of the subject.

“Tom Allman, private citizen. My family and I live up north. Ambulance services are critical. I'm not trying to muddy the waters. But I want to remind you that we have five 911 centers in this county. We have the Willits Police Department, the Ukiah Police Department, we have the Sheriff's office, we have Highway Patrol and we have Calfire. In the middle of January we have nine people working in the middle of the night when no calls are coming in. We're talking about how much our ambulance service will cost. We could easily save some money working with our other entities and have two 911 centers in this county — one for fire and medical, and one for law enforcement. We could save a lot of money. I have stood at the podium many times on this. If you are going to have a conversation about ambulances whether you're talking about the EOC (Emergency Operations Center) or whatever, please have a conversation about consolidation of our communication systems to save money and make it more efficient for everyone. MedStar (the long-running private ambulance service in Ukiah) also has their own dispatcher. I'm sure if we said we would dispatch for MedStar, Leonard Winter (Medstar owner/manager) would stand up here and say, Let's make it work. We can do this. We are in the right situation. Ukiah city manager Sage Sangiacomo said that we should not piecemeal this. I'm telling you this would be a good chance to consolidate this conversation with medical services and 911 centers. As a citizen of Willits and a friend of the Hosfords (who recently lost an elderly family member possibly because of an ambulance shortage), I don't know if she would have lived or died if another ambulance would have been there. But her odds would have been much more in her favor.”

Third District Supervisor/Board Chair John Haschak replied as he and his colleagues always do to “private citizens”: “Thank you.” 

Then they proceeded to ignore Allman’s suggestion, as the earlier summary of the history of the subject clearly demonstrates. 

Then, having ignored Allman and others who wanted something done sooner rather than later, with Haschak at the helm, the Board rambled on aimlessly and at length about committees and meetings, and groups and ad hoc this and that.

The ambulance people in the room all agreed that the biggest problem facing the ambulance service in the Highway 101 corridor is Covelo. They haven’t had an ambulance there for a year now since the big Danish conglomerate Falck up and left with no notice (after soaking up $60k for partial service for a year), apparently belatedly realizing that there wasn't any money to be made in stationing an ambulance in Covelo.

Leonard Winter’s Ukiah-based Medstar company has been responding to Covelo calls since then and every time his staff responds it takes an ambulance out of the already under-equipped and under-staffed ambulance 101 corridor for up to four hours at a time. And, as Winter noted, about a third of the time they return with no patients on board for one reason or another.

Supervisor Ted Williams has been trying to focus the Board’s attention on the problem for the last few months, but he seems to think that the only way to solve it is to throw money at it.

Supervisor Williams: “It's been nine years since the Fitch study. It's been nine years of Let's have meetings, let's get fire people in the room, let's get ambulance providers in the room, send it out to this committee or that and we haven't gotten anywhere. This situation is worse today than it was nine years ago. It may be that we have to get a group together, but I only want to do that if funding is a possibility. We need to get a group together to address creative solutions to the outlying areas. But if it's not backed by public money I don't see how we are going to make progress. We have gone through that exercise n-times. Why has been no estimate of the cost, why are we still talking about this a decade later? Where is the breakdown?”

No one knew. But the Supervisor’s own Board colleagues and staff might be one possibility.

This was followed by more talk about plans and committees and meetings and funding. But it was so unfocused that AVA reporter Malcolm Macdonald was moved to try to light a fire under the Board.

Malcolm Macdonald: “I live on a ranch where one side of my family has lived since the 1800s. If you break a leg or an ankle there you crawl up the hill to the nearest relative or friend or neighbor, you get in a car and drive to Willits and hope that Dr. Bolan or one of his proteges is on call that day. That's the reality in this county. If you are on the coast in the past you might see Dr. Logomarsino. That's the reality of being in a rural area. I am hearing a lot of obfuscation here. You have an opportunity to do something. But you would rather form a committee to start a study to form an ad hoc to get some "stakeholders" which may be real stakeholders maybe not. It ends up just being a runaround and runaround and the runaround and we are still here. I was glad Supervisor Gjerde actually asked for a date in his question to the Ukiah city manager. You have people here interested in your legacies. Just like I told the hospital board in Fort Bragg, you have a fiduciary responsibility to vote no on negative money coming in month after month. With this runaround you are going to abrogate your responsibility to public safety right now. It's already happened. You can't change the past. But if you are going to go down this ‘form a committee to form a something to form a something else’ — that's ridiculous! As I used his say to my students: catch a clue. They are flying by all the time. Maybe you have to do some piecemeal things. Maybe you need a countywide plan. But that may not be possible unless you want to wait for six or eight or ten years and we are talking about supervisor Williams’s legacy. Catch a freakin’ clue! This has to happen in the here and now. You better get some dates and hear from people with experience in ambulances. Make them come up here and talk to you.”

A few of them did, again noting that for the short term at least the main problem is Covelo and the time and frequency of responses there.

Dr. Mills Matheson, medical director of the Bechtel Creek medical clinic, said he’s heard lots of complaints about the inland ambulance service, and that there is no longer a reliable ambulance service. “Something must be done as soon as possible to improve the ambulance service otherwise there will be more harm to our patients,” said Matheson. “The proposal to add an ambulance to the 101 corridor is a reasonable patch while a long-term solution is worked out.” After describing some personal medical anecdotes, Matheson concluded, “We need a reliable ambulance system right now.”

“Private citizen” Tom Allman returned to the podium to agree: “This is a critical time. We are coming up on these summer months. Whatever you decide, I certainly suggest that you do a six-month quick fix while we talk about what kind of solution there is going to be. Whether it's MedStar or the Fort Bragg ambulance, let's get somebody who is going to commit to being up in the north quarter of the county as soon as possible. Then we can have a conversation about how we are going to solve the problem.”

Dr. Matheson agreed: “We need a quick fix, a band-Aid on the situation while we think about the long-term solutions.” 

Both “private citizen” Allman and Dr. Matheson’s quick-fix/bandaid suggestions were ignored and the Board voted unanimously to ask Coastal Valley EMS Mendocino coordinator Jen Banks to come up with a financial summary of the situation for further discussion at an upcoming meeting. No Board members mentioned addressing the very specific and undisputed problem in Covelo which is obviously where attention must be paid. 

Nor did anyone follow up on Allman’s long-simmering dispatch consolidation proposal where large amounts of money could be saved and re-allocated to ambulance services. (Not to mention the millions wasted annually on tourism promotion and a juvenile hall for a dozen or so teenage gang-delinquents — neither of which will be mentioned by Ms. Banks.)

Meanwhile, the County’s newly formed emergency medical services committee is meeting this week, although, as Fort Bragg ambulance manager David Beak noted, they are a newly constituted group and cannot be expected to come up with anything substantive soon.


Since Tuesday’s meeting, Supervisor Ted Williams posted this comment on the Fifth District facebook page:

“I ask you to watch the ambulance discussion from our Tuesday BoS meeting. It's long. What I submitted as a fifteen minute item consumed two hours. It began somewhat contentious, but in the end I was proud of the full board for engagement, asking critical questions and hearing varied messages from the field. More questions than answers, but with the board better aligned on the problems, I left confident that we're on the initial phase of identifying solutions. Years in to an ambulance crisis, we don't have the core causes documented. That's about to change.”

Given the sad 21st century history of County’s and Board’s abject inattention — if not outright bungling like the years long Exclusive Operating Area disaster — to the worsening inland ambulance situation and some rather obvious fixes, we doubt that anything will change. We hope we’re wrong.

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