Buck, Conway at odds in Weld ambulance service debate
January 8, 2013
University of Colorado Health officials outlined what many fire board members, community leaders and even the Weld County District Attorney appeared to deem a golden opportunity in the search for the highest quality ambulance service moving forward.
But the search for a concrete deal is far from over.
Fire boards from Windsor-Severance, Johnstown and Milliken met at a joint work session at Medical Center of the Rockies on Thursday to see for the first time the nuts and bolts of a plan that could bring sweeping change to the region's emergency services.
Under the proposal, a new ambulance jurisdiction — District 5 — would be added to the already vast network of services offered by UCHealth throughout Fort Collins and Larimer County. The communities of Windsor, Johnstown and Milliken would each have a dedicated, fully staffed ambulance stationed at fire halls in each town. Crew leaders could use a fourth, floating ambulance as needed depending on call volume or emergency types.
All ambulances would be dedicated to the communities — not just borrowed from Fort Collins or neighboring cities.
In addition to the increased staff, UCHealth officials explained the deal would ensure quicker response times and more cutting-edge medical technology, including remote cardiac arrest data transmission and more state-of-the-art therapeutic hypothermia treatments. The affiliation with UCHealth — formerly Poudre Valley Health Systems — could also mark a step forward in interagency cooperation, which officials said was vital as the medical industry is forced to become more streamlined and efficient.
"We can do this — we're not too small," urged Windsor-Severance Fire Chief Herb Brady. "We're not second-class citizens. We are large enough to have the best emergency medical services in the world."
Brady has worked in the industry for 30 years and said that the crux of the issue has been and continues to be about the vision moving forward — not necessarily dissatisfaction or suffering with the current provider, Banner Health.
With the growth of these communities, he said it was paramount to work together and that UCHealth had, to date, provided the most comprehensive and supportive administrative structure.
"We all have to be held accountable. I think we have very good providers both with Banner and the fire department, but it's the system behind it that brings out that excellence," he said, touting UCHealth's rigorous provider-evaluation and education.
"It's also the system behind it that can destroy it."
The four ambulances would be deeded to the communities, and UCHealth would maintain supplies, upkeep and staffing.
Windsor has an existing, fully staffed ambulance stationed at the Medical Arts Centre on Main Street near King Soopers. Banner Health operates that facility and ambulance, which serves the community and doubles as a relief ambulance for the Greeley area.
Under the proposed deal with UCHealth, there would always be a dedicated ambulance in the community — as well as towns to the south — and resources could be easily shifted across the western part of the county to accommodate needs while maintaining top-notch response times.
That single measure — among the many indicators of quality service — has repeatedly been called into question during Banner negotiations last summer and when Windsor-Severance Fire Rescue entered into a letter of intent with UCHealth in November.
Brady and others reiterated that it wasn't necessarily a question of existing problems as much as it was about visions moving forward. With the new system, officials promised city responses times — those within much of the Windsor area — of nine minutes or less.
For more outlying areas, that number would be 12 minutes or less and rural areas on the outskirts of the district under 20 minutes 90 percent of the time.
Under the Banner system, between May 7 and Oct. 31, response times to Windsor were within 20 minutes 93 percent of the time, according to data provided by Banner CEO Rick Sutton in December, surpassing the goal of 90 percent.
Gene Haffner, North Colorado Medical Center/Banner Health spokesman, said those were the latest figures immediately available.
"The bottom line is that we feel we proposed a reasonable contract that has some pretty high standards for quality of service and response times and quality of personnel," Haffner said ahead of Thursday's meeting. "We would be hopeful that they would talk with us again after they're done with the exploratory process."
Part of the reason fire officials have said the negotiations are ongoing is because other providers have not been willing to station full-time, devoted ambulances in the communities because of their smaller size.
Johnstown and Milliken Fire Chief Ron Bateman saw it another way.
"The sleepy towns that we once knew are now gone forever," he said. The population that would be covered by the proposed District 5 would be nearly 50,000 residents — roughly the size of Broomfield or Castle Rock.
"I'm not concerned with better," he added. "I'm concerned with best."
If a deal were struck today, new ambulances wouldn't be rolling down Main Street right away. That's because it takes about 120 days to take care of the added staffing and training, ambulance transfers and infrastructure improvements to the fire stations where crews would live on 24-hour shifts with fire crews — an added value officials said would strengthen the interconnectedness of emergency care.
That process could take even longer because of a complex series of legal challenges and potential lawsuits against Weld County.
Attorney Dick Lyons is consulting with the three jurisdictions on the matter and separated the legal mess into two issues, which he said ultimately point in favor of the fires districts.
The issue of whether the districts have the "authority" to pursue an outside contract, he said, is outlined in previous court decrees in a similar way that communities can contract trash services, making it a non-issue.
The other issue is whether UCHealth was rightfully denied in a letter from Weld County officials dated Dec. 21.
A new application has since been submitted while the legal issues are sorted out.
After the hour-long presentation from EMS leaders, the three fire boards met with the attorney during an executive session to discuss the legal entanglements and the road ahead.
Those discussions will likely become known in the coming weeks and at the next board meeting, though it is possible they could elect to take the battle with the county to court.
Additionally, commissioners at a Dec. 26 meeting took up the issue of whether the emergency medical services code should be amended, giving them full purview of all ambulance negotiations within the county. They have repeatedly said they don't necessarily think these fire districts understand the magnitude or feasibility of such sweeping changes.
The issue has — and continues to — polarize parts of the community.
"I would like to encourage these fire boards to proceed with this in spite of what threats may be out there," said Weld County District Attorney Ken Buck at the meeting.
Buck lives in Windsor and criticized commissioners' staunch positions on the ambulance negotiations and what he described as Commissioner Sean Conway's contradictory opposition about larger groups imposing their will on local governments, citing recent comments he made about tighter rules for the oil and gas industry.
"In Weld County, we shouldn't have to live with a one-size-fits-all ambulance service," Buck added.
After the meeting Conway stressed that he was at the meeting to learn instead of making a "political statement." He joked that he was "pleased to know the district attorney is on the job."
"Ken is entitled to his opinion. Obviously he has strong opinions," Conway said. "The district attorney may only be concerned about Windsor, which I appreciate — that's where he lives. But I'm charged as a county commissioner to represent the entire county on this issue."
Commissioners will meet with the fire boards Wednesday during a work session, to hash out some additional concerns, which he said he had plenty of — about two sheets full.
"I made a commitment to listen and learn as much as possible," he said. "My hope is these discussions lead to an overall discussion of how we can better response times and everything else. I have great optimism that we can have a positive impact during this whole process of bettering services for all of Weld County."