The Great Ambulance Controversy

Commentary by Samuel Strait – July 27, 2022

While there has been much to say already about the recent request by Del
Norte Ambulance to become Del Norte County’s sole and exclusive provider
for services, obscured in the verbiage is the basic importance as to
what is best in the current circumstances for Del Norte County
residents.  In an effort to clarify that particular question following
my attendance of the meeting of the County’s Board of Supervisors, I
read the Ad Hoc Committee’s report, spoke at length with Del Norte
Ambulance’s, Ron Sandler, continued with a thorough questioning of
Supervisor Valerie Starkey, member of said Ad Hoc Committee, and
acquainted myself with several articles pertaining to both Del Norte
Ambulance and its history of service to the County’s residents.

Before we get to the merits or lack there of where granting Del Norte
Ambulance an Exclusive Operating Agreement (EOA) to provide service to the
County, it is important to understand the available options for the BOS
to consider.  They are three in number, none of which would exclude Del
Norte Ambulance from being our ambulance provider.  The first, is to
continue the current arrangement with Del Norte Ambulance until their
contract with the County to provide universal service to all needing its
services until the contract expires in 2027.  The second is to allow Del
Norte Ambulance an exclusive operating agreement with the associated
enhancement of oversight that accompanies such arrangements.  The final
option is to offer competitive bidding to other ambulance service
providers including Del Norte Ambulance in a bidding process at county
expense.  It was the Ad Hoc Committee members preferred choice that an
EOA was the most reasonable option.

The reason given for the choice was cost, increased oversight,
accountability, stability, and success in other local jurisdictions. 
The negatives were listed as it being a monopoly, quality of past
service, and the risk factor to the County of it being an exclusive
service should Del Norte Ambulance not live up to expectations.  What is
notable about the negatives is that Del Norte Ambulance, due to the
limited nature of service requests, is already a monopoly without the
constraints that an EOA would provide.  As to quality of service, with
the exception of Fire Service Personnel, no other reporting service,
members of the public, or first responders had issues with Del Norte
Ambulance’s level of service.  And finally, just as with any other
private entity, an EOA, provides no substantial risk to the County as it
can be terminated at any time should Del Norte Ambulance not live up to
its commitments.

A further examination of the “complaints” submitted by fire personnel
appear to reveal an ongoing sense that fire personnel and ambulance
personnel are at odds in some emergency situations where ambulance
personnel should be the primary medical service provider.  Many of the
“complaints” appear superficial and without serious merit.  Those that
have come to the attention of the North Coast EMS director, Larry
Karsteadt, have been satisfactorily remedied and Del Norte Ambulance was
recognized as being in compliance and cooperative.  While it is
relatively easy to infer motive for the level of complaint from fire
service responders due to recent activities of its retired Chief, Bill
Gillespie, in taking steps to move toward permanent hired personnel and
the comments offered via zoom at the BOS that ambulance service should
become a “public service”.   It should be noted that this is also an
expensive alternative and would be an ongoing expense to this
community.  We are not a huge population with a great demand for
ambulance service necessitating a change to public service.

Clearly the notion that Del Norte Ambulance service is less than a
quality service must be taken into account, whether allegations by fire
service personnel of inadequate service is the case, and whether
“statistics” can possibly shed light on this charge are unlikely.   It
is none the less curious as to why County and City fire services would
be the only shade on the proposal. Testimony of the majority of those to
the Ad Hoc Committee and the recommendations by North Coast Medical
Services to proceed with what is already a sensible option of granting
EOA to Del Norte Ambulance comes with very few uncorrectable risks to
the County. I fail to see the need for hesitation on granting Del Norte
Ambulance’s desire to be exclusive and protect as any “good” business
venture would its value and its value to its consumers.

As with the ambulance service, it may behoove the County to take a close
look at what is being offered by local Fire Protections Services as a
necessity for Del Norte County.  What has been recommended by retired
Fire Chief, Bill Gillespie, and current Fire Chief, Kevin Carey as
“corrective measures” for Del Norte Ambulance personnel, perhaps should
be also something Fire Service personnel need to be acquainted with as
well.  Having “pissing contests” at the scene of an emergency does not
reflect well on those that are involved.  There are unavoidable mistakes
enough at all levels of emergency services, certainly an untucked shirt
or disheveled uniform does not merit the level of a “complaint”.
Similarly, feelings that lack of trained or “proper”  personnel or
“failure to engage” make no difference to the person in distress when
all that is required is the best service under the circumstances.  In
any event, none of this past history of dubious complaining should be
involved in determining what is best in the present circumstances for
the public.  In the eyes that oversee its operation, Del Norte Ambulance
has had few complaints from those it services for many decades.  Hence,
Board of Supervisors, where do you go from here?