WhidbeyHealth to end 10-year interlocal agreement with fire districts

Since 2008 Central Whidbey Island Fire & Rescue (CWIFR) and North Whidbey Fire and Rescue (NWFR)  have partnered with the Whidbey Island Hospital District (WhidbeyHealth), staffing Basic Life Support (BLS) Ambulances for the hospital through an Interlocal Agreement. CWIFR has staffed one ambulance and NWFR has staffed two ambulances through this partnership.

This program was initially implemented to improve responses to medical emergencies. However, increased staffing with emergency personnel who can respond to medical and fire calls also improved the level of fire and rescue service. This increased efficiency for taxpayers and provided a higher level of service for a lower cost than any of the agencies could have done separately.

Initially the fire districts paid approximately 15% of the cost of staffing the BLS ambulances, but over time this cost share has increased to approximately 36%. In 2019, WhidbeyHealth will pay the fire districts $201,495 for staffing each ambulance. The two fire districts have approached staffing the BLS Ambulances differently, CWIFR has staffed one ambulance with a mix of full-time and part-time Firefighter/Emergency Medical Technicians (EMTs). NWFR has used Part-Time Firefighter/EMTs to staff two ambulances.

WhidbeyHealth has notified the Districts that it intends to end the interlocal agreement under which the fire districts staff the BLS Ambulances. The hospital intends to hire Full-Time, Single Role EMTs to replace the staffing provided by the District and to use existing Paramedics to staff the ambulances to provide Advanced Life Support (ALS). This change would take effect on December 31, 2019. The hospital advised the fire districts that they would be willing to enter into a new interlocal agreement to pay the districts $0.035/$1000 of Assessed Valuation within the districts’ boundaries to continue response to medical emergency incidents. This would result in a revenue loss of $134,721 for CWIFR and $325,277 for NWFR.

This change will have several significant impacts to delivery of emergency services and the value provided to the community.

  • Fire district on-duty staffing would be reduced. CWIFR would have to eliminate the positions of six Part-Time Firefighter/EMTs and the Deputy Fire Chief. NWFR would eliminate Part-Time Firefighter/EMTs providing on-duty coverage. CWIFR would maintain a minimum shift staffing of two personnel while NWFR would no longer have on-duty staffing, relying solely on response of volunteer members and mutual aid, which takes longer and drains resources of neighboring agencies.
  • Reduction of on-duty fire district staffing results in lower staffing on the initial resources responding to emergency incidents and longer response times when on-call and volunteer members must respond from home to staff apparatus.
  • Single Role EMTs can deliver quality emergency medical care, but cannot provide the range of services provided by multi-role Firefighter/EMTs. Fire district personnel respond to a wide range of emergencies and calls for service, and also provide other services such as fire prevention inspections, hydrant inspection and testing, and public education when not responding to emergencies.
  • While ambulance service may not be impacted, the cost to the hospital in providing this service will be higher than it has been through a collaborative effort with the fire districts. Use of full-time hospital employees will result in higher personnel costs and the hospital will be paying the full cost for staffing the ambulances, rather than sharing the cost with the fire districts.

Since the inception of the interlocal agreement under which the fire districts staffed BLS Ambulances, the intent was to move towards a system of criteria based dispatch, where BLS Ambulances would respond to low acuity calls and provide patient transport. In 50% to 60% of medical emergencies, the patient only requires BLS care, use of a two-tiered system with BLS ambulances responding to low acuity calls and ALS and BLS resources responding to high acuity calls where Paramedic level care and additional staffing are necessary would increase the efficiency and effectiveness of emergency medical service delivery.

Emergency service delivery involves response to medical emergencies, technical rescues, hazardous materials incidents, and fires along with a multitude of other calls for service. Ideally these services are delivered through an integrated and cohesive system. One of the challenges our community faces is a fragmented system with multiple providers and funding mechanisms. In the long term, it may be time to discuss alternative options for EMS delivery across the Island.

CWIFR and NWFR remain committed working with our emergency services partners to provide the highest level of service to the community within available resources. We appreciate the hospital is trying to cut costs due to budget issues. However, our belief is that the proposal by the hospital district will be more expensive for taxpayers and deliver a lower level of service for the community at large.

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