Ambulances Chasing Each Other

About a year ago I talked with Leonard Winter, the operator of Ukiah Ambulance, about ambulance operating procedures. During the conversation Winter mentioned that he was working to roll Ukiah Ambulance into a nonprofit so he could get grant funding to provide paramedic-ALS (Advance Life Support) service to outlying areas like Anderson Valley. He subsequently put together and sent to me an impressive three ring binder with excerpts from CHP's Ambulance Driver’s Handbook, California Vehicle Code, California Code of Regulations and California Health and Safety Code. A cover letter to the package bore the letterhead MEDSTAR AMBULANCE of Mendocino County, Inc. with him as CEO and again stated that non profit status “…will allow us to expand our areas of response into areas that are not currently being served or cannot be served on a per-profit model.”

About the same time we started hearing on the dispatch radio, responses to calls from an ambulance outfit called Verihealth. Verihealth is an ambulance provider based out of Petaluma but also with a corporate presence in southern California. Verihealth had, I'm told, been providing local inter-facility transfers but now seemed to be positioning itself to take emergency response calls as well.

Verihealth bills itself as “A healthcare organization revolutionizing the pre and post hospital continuum of care through innovation, analytics and leading edge technology.”

Ukiah side people who listen to scanners for entertainment, started telling stories of Ukiah Ambulance and Verihealth personnel racing each other to calls in hopes of winning transports. Not long ago a Ukiah City firefighter visiting me here in AV asked if “Verihealth had elbowed it's way” into our (AV Ambulance's) business yet?

The general feeling seems to be that Verihealth is a usurper into the area of Mendocino County emergency medical response.

The consumer-oriented among us might see this as a good thing — having competition among ambulance services to help keep prices down. But the truth is, in any rural setting there is only so much business, and emergency call volumes even in the higher populated regions are most likely not high enough to support two separate EMS provider organizations.

It seems that one or both of these two now competing ambulance services in Ukiah do understand this and have been pushing the County to establish what is called an Exclusive Operating Area or EOA for the whole county. This would install one single ambulance provider for the whole county. To this end the County has hired an out of state consulting firm Fitch and Associates, LLC to study the possibilities.

Fitch and Associates, LLC claims to have already talked with some of the County EMS providers and will, next week, be holding a series of meetings throughout the County to talk with all “… stakeholders, interested parties and community members …” with regards to just what such an EOA might look like. The smaller players in the County such an EOA would affect include not only Anderson Valley but also Coast Life Support in Gualala, Mendocino Coast District Hospital, Elk Fire and Ambulance, Laytonville Ambulance, and Covelo Ambulance. Some struggling providers like Covelo might welcome the change.

What this means for Anderson Valley is not clear and could take different forms. Having a grant-driven nonprofit model might well be able to provide a higher level of response (ALS vs BLS-Basic Life Support) but where would we be left when the grant money dries up? Given the extremely high cost of providing modern medical services how could a for-profit like Verihealth afford to pay paramedic level responders when according to the Anderson Valley Ambulance Board we just barely squeak by with fully volunteer ambulance staffing?

Other questions arise: would community members still be able to join as members annually to get their potential ambulance transport needs covered? Or if an Exclusive Operating Area is established, could Anderson Valley be exempted and stay the way it is?

It seems inevitable that for Anderson Valley any change from the same volunteer-staffed ambulance that has served us so well for over 60 years will cost us more money.

From an email sent out by Fire Chief Colin Wilson. “This is an announcement of a public meeting to be held at 1800 (6pm) on April 15th at the Vets Building in Boonville. The purpose of the meeting is to inform us of a study being done to consider the establishment of an “Exclusive Operating Area” (EOA) for ambulance service in Mendocino County. This is a preliminary study that is in the information gathering phase. If an EOA is established it could mean anything from no practical change in Anderson Valley to a major improvement in service to a major decline in service. If you are interested in the future of EMS in the Valley and the County you might want to put this meeting on your calendar.”

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