Despite last minute concerns from others, Lincoln County commissioners OK five-year contract to PacWest for ambulance services

 

By QUINTON SMITH/YachatsNews.com

Citing its long history in the community and problems a new provider could face, Lincoln County commissioners voted unanimously Wednesday to renew five-year ambulance service contracts for much of the county to Pacific West Ambulance.

“There’s a saying ‘If it’s not broke, don’t fix it’ and I think it applies to this situation,” said commissioner Doug Hunt. “PacWest is a known entity with a long track record in this community.”

Although it had letters of support from four fire chiefs and the director of nursing at Oregon Coast Community College, the board received last-minute letters from two firefighter unions and the chief executive officer of Samaritan Health Services’ two local hospitals asking for closer scrutiny or changes in the contracts. The two union chapters expressed concern about PacWest still missing county-required response times and hospital CEO Dr. Lesley Ogden said a recent PacWest change on patient transport from the coast into the Willamette Valley was jeopardizing patient health.

Commissioners did not address those concerns directly, other than to say that coast-to-valley transport was not a part of the county’s ambulance contract.

PacWest has held the county-required contracts for four of the five service areas for most of the last 35 years, expanding coverage as local, publicly-funded fire departments found the service costly to operate and got out of the business. Its current five-year contract expires June 30 and when the county opened the five service areas up for bid, American Medical Response/Northwest of Portland submitted a last-minute challenge for four of the contracts. AMR/Northwest is an arm of a $4.3 billion nationwide medical transportation company.

Executives of both companies made presentations to commissioners two weeks ago.

The county is divided into five ambulance service districts – north Lincoln County, including Lincoln City and Otis; Depoe Bay; central Lincoln County including Newport, Siletz and Toledo; Waldport including Seal Rock and Tidewater, and the Yachats area. North Lincoln Fire and Rescue operates a back-up ambulance under a mutual aid agreement with PacWest to supplement operations there.

Neither PacWest nor AMR/Northwest bid on the fifth service district contract held by South Lincoln Ambulance, a private, nonprofit staffed by Yachats Fire District personnel and controlled by Yachats chief Frankie Petrick. Commissioners approved that contract Wednesday without comment.

In their bid documents, both companies said they would charge $1,500 and $21 per mile for ambulance calls, which is PacWest’s current rate for services.

Cites local experience

Citing local fire chief and college support, commission chair Claire Hall agreed with Hunt that she didn’t see “a compelling reason to disrupt something that’s working right now.”

“AMR has lots of experience around the country but not Lincoln County experience,” Hall said.

In questioning AMR/Northwest representative Sam Flores, commissioners expressed concern about how it would staff, house and administer ambulance service given a change that could be just 45 days away.

While paramedic shortages are nationwide not just in Oregon or Lincoln County, Flores said AMR could pull in resources from across the country to meet staffing needs until local hiring is completed. In a follow up letter to the board last week, Flores explained that AMR submitted a bid at the March 1 deadline because it wasn’t aware of the open contract “until a local fire chief brought it to our attention” Feb. 23.

Flores also said the company was looking at real estate both for its offices and to help employees relocate.

“Although we might not be fully staffed right away, we can pull from other areas of AMR,” Flores said. “I believe we have the resources to meet the contract.”

AMR/Northwest previously said it would offer jobs to all PacWest employees, including office staff. Flores seemed to back away from that Wednesday, telling commissioners that it would offer jobs to paramedics and would “consider” hiring PacWest’s office workers.

PacWest owns offices in Newport and Lincoln City to house ambulances, paramedics and business staff and rents space at the Toledo and Central Coast fire departments. It has 74 employees including 40 paramedics/EMTs and 22 office staff, which does a lot of billing for parent company MetroWest Ambulance.

PacWest general manager Jeff Mathia told commissioners Wednesday that PacWest asked for response time changes last year because of staff shortages made worse by the ongoing coronavirus pandemic. He said additional paramedics are due to finish training by July to bring staffing levels up to standard, that it was using “traveler paramedics” to fill some shifts, and is leasing a house and two apartments where new hires can stay for up to six months while they look for housing.

The company is installing new computer equipment in ambulances, he said, so everyone will know ambulance locations and availability and “to better track response times.”

“We want to do what’s right … and we’re doing what we can to meet the contract,” Mathia said, asking commissioners to look at new response time reports due in July.

Firefighter, hospital concerns

Two firefighter union locals – one in Depoe Bay and the other in Newport – sent letters asking commissioners to look more closely at PacWest’s response times and staffing. Depoe Bay’s fire chief had a bitter disagreement with PacWest last year over a failed plan or disagreement about providing a backup ambulance service.

The Depoe Bay firefighters union wrote a three-page to commissioners outlining its concerns that the increase in ambulance calls has outstripped PacWest’s ability to “keep up with the demand for the service this county so desperately needs.”

The Newport Fire Department’s firefighters union local asked commissioners to delve more deeply into response times, the number of ambulances on duty in the four service areas, and how many times PacWest had to respond to calls with one paramedic.

Ogden’s letter acknowledged staffing issues in all medical fields, but said ambulance service – especially delays in getting patients from Newport or Lincoln City to hospitals in the Willamette Valley – was “failing to occur in a timely manner and patient safety is in jeopardy.”

Patients needing to be taken to the valley or Portland were “boarding for hours or days” in emergency rooms until Samaritan could find an ambulance to transport them, Ogden wrote, and that patient wait times in Newport and Lincoln City for transport to the valley were double what Samaritan is seeing at its three hospitals in Benton and Linn counties.

The county’s ambulance contract allows inter-facility transport – generally considered to be the most lucrative part of the ambulance service business – if it does not interfere with 9-1-1 response locally. Ogden said PacWest notified her in April that because ambulances were needed in the county for 9-1-1 calls, it would no longer take patients farther than Corvallis.

Ogden asked that commissioners either require inter-facility transports in the county’s contract or remove any reference to it and therefore allow Samaritan to develop or contract its own service.

Although commissioners did not directly respond to any of the new comments, Jacobson thanked AMR/Northwest for its bid.

“This process deserves competition,” she said.

• Quinton Smith, a longtime Oregon journalist, is the founder and editor of YachatsNews.com and can be reached at YachatsNews@gmail.com