Vancouver's plan to sever ties with a medical services district worries Dennis Mason, chief of Clark County Fire & Rescue, who says the move could cost the county's rural communities.
The city has an interlocal agreement with EMS District 2, which is run by the county. The EMS district contracts with private ambulance company American Medical Response for services within the district — an area covering Vancouver, Battle Ground, Ridgefield, La Center, Woodland and outlying areas.
But under the terms of the Vancouver proposal, the city would enter into its own contract with either AMR or another ambulance company when the district's contract with AMR expires in 2014.
If Vancouver moves ahead with the proposal, the EMS district would have to enter into a separate contract without Vancouver's involvement.
"We just don't know what the results (of that) will be yet," Mason said, referring to the financial effects on rural areas. "We're concerned it's not going to be a coordinated EMS system."
Late last week, Mason sent a letter to Vancouver requesting the city pause to re-evaluate the plan. A number of city and fire district officials from within the EMS district also signed the letter.
Among Mason's top concerns: That having two separate ambulance contracts will fracture the EMS system, increase costs and stifle medical response times.
Removing the most populous city from the district could make it harder to attract an ambulance company willing to serve it, Mason said. Without Vancouver, the EMS district would be four times the size of the city but receive about a third of the calls, Mason said.
But officials at the Vancouver Fire Department say a move toward two separate-but-collaborative contracts would likely do just the opposite — improve the city's response times for medical emergencies and create more flexibility.
While Mason says separating Vancouver from the EMS district could increase the cost of ambulance service within the district, officials with the Vancouver Fire Department say those costs will likely increase in the coming years anyway.
AMR receives money from user fees and Medicaid to pay for its services. But with user fees currently 17 percent below the market rate, AMR has expressed a desire to increase them during the next contract period, said Joe Molina, Vancouver's fire chief.
"We haven't been to market in quite a while," Molina said. "So because we're going out for a (request for proposal) for ambulance service, there will be cost increases, even if we decided to stay in one contract. There's going to be a cost increase, period."
Officials at the Vancouver Fire Department say their goal is to work alongside the EMS district.
Dan Olson, Vancouver's deputy fire chief, said the ideal situation would be for both the EMS district and the city to sign contracts with the same ambulance company, so they could collaborate on services.
Contracting directly with an ambulance company would create more flexibility for the fire department, Olson said. In the long run, that could save the department money and create better service.
Although officials who are wary of Vancouver's plan understand flexibility is Vancouver's top issue, Mason said a single contract for ambulance services would work best for all of the communities EMS District 2 serves.