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HomeMy WebLinkAboutM052896 -------T¿~'O:~!~:\ ;~= c:< _ølli_l;ø_øl~ø_lm. ¡t_I;~ ..IJIII]................'.'.'.'.'."..'.'.'.'.'. '....piyJ~mØ9J~~m; """,:,",:,',:,. MINUTES WEEK OF MAY 28, 1996 The meeting was called to order by Commissioner Glen Huntingford in the absence of Chainnan Richard Wojt. Commissioner Robert Hinton was present. APPROVAL OF THE MINUTES: Commissioner Hinton moved to approve the minutes of May 13 and 20, 1996 as presented. Commissioner Huntingford seconded the motion. The motion carried. PUBLIC SERVICES BRIEFING: Director of Public Services Gary Rowe updated the Board on the following items: . An update on the chapters of the Comprehensive Plan will be submitted to the Board next week. A meeting will be scheduled next week to review the comments from the Community Plan meetings. The Growth Management Steering Committee meeting on June 5 will focus on Glen Cove. The PUD has initiated a water basin assessment process. The Board agreed that they support the CountyJs involvement. The Coordinated Water System Plan is complete except for the chapters that deal with Port Townsend's service area. The completed chapters will be forwarded to the State Department of Health for review. The infonnation on the service area will be available in Port TownsendJs draft Water System Plan that is due to be released in June. The process for designating Port Ludlow a "Master Plan Resort" in the Comprehensive Plan. The Advanced Life Support hearing is scheduled for Thursday evening. Sheriff Piccini has been asked to attend to explain his concerns regarding additional training and staffmg to handle ALS duties. . . . . . . ; VOL Page 1 22 f.~G:933 Commissioners Meeting Minutes: Week of May 28, 1996 . David Goldsmith is a member of the Community-oriented Policing Committee that has recently been fonned by the State. PUBLIC COMMENT PERIOD: The following issues were discussed: the proposed grooodwater policy for Marrowstone Island; the possibility of expanding this policy in the future to cover other areas in East Jefferson COooty; the discrepancy in the Irondale Incorporation Booodary Map and the Tri Area Community Plan Map; and the GMA designation of the Tri Area. APPROVAL AND ADOPTION OF THE CONSENT AGENDA: Commis- sioner Hinton moved to delete item # 1 and to approve the balance of the consent agenda items as submitted. Commissioner Hootingford seconded the motion. The motion carried. 1. DELETE Resolution re: In the Matter of Managing Through Development Regulations The Finite Ground Water Resources ofMaITOwstone Island (See items on next page). RESOLUTION NO. 42-96 re: In the Matter of Granting an Extension of an Existing Franchise on COooty Road Rights of Way to Jefferson COooty P.U.D. #1; Plats of Lazy C Ranch; Brinnon RESOLUTION NO. 43-96 re: In the Matter of Establishing a COooty Project as CR1259; To Chip seal Various County Roads (Ocean Grove Subdivision-Block II) RESOLUTION NO. 44-96 re: In the Matter of Establishing a Security Advisory Board AGREEMENT re: Standard Work Order; Developmental Disabilities Dental Program; Jefferson COooty Health and Human Services; Department of Social and Health Services, Division of Developmental Disabilities AGREEMENT re: Use of (1) Bed in Juvenile Detention Facility; Jefferson COooty Juvenile Services; Clallam County AGREEMENT, Supplement #3 re: Consultant Engineering Services; Provide Plans, Specifications, and Estimates for COooty Road Projects CRII07 and CP1116; Parametrix, Inc. AGREEMENT re: Provide Services for the Jefferson COooty Parks and Recreation Department; Arthur Hansen AGREEMENT, Interlocal re: Preparation of Jefferson COooty International Airport Essential Public Facility Plan; Port of Port Townsend Request to Transfer Equipment; Jefferson COooty Planning Department's American Scientific Incubator, Property item no. 15741; Port Townsend High School Food and Beverage Purchase Request; Refreshments for Boy Scout Troop #479, Election Volooteers; Jefferson COooty Auditor Application for Assistance from the Veterans Relief Food; Jefferson COooty Service Officers Association for $75.00 Appoint Member to Serve as the Youth Representative on the Port Townsend Community Center Advisory Board; Matthew White Accept Resignation from Member of the Peninsula Regional Support Network Advisory Board; Angelica Balderas 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. ~on re: proposed Resolution: In the Matter of Mana2ing Through Development Re2ulations The Finite Ground Water Resources of Marrowstone Island: Two residents of Marrowstone Island were present for this discussion. They feel that this policy is discriminatory and that restricting water on the Island will affect property values. Many of the residents on the Island have not had a chance to review the latest draft of the policy and they are requesting additional time to review it before the Board takes action. The Board agreed on a 45 day extension to allow the residents to review the latest policy and submit comments. VOL P2~ fAŒ 934 Commissioners Meeting Minutes: Week of May 28, 1996 BUSINESS FROM COUNTY DEPARTMENTS PLANNING AND PERMIT CENTER Request for Administrative Six (6) Month Extension on the Maryatt Short PI" 94-0017" h In r ion f 0 I Ro nd Hazel Pint Road. David Maryatt. Applicant: Representative for the proponent, Cy Heffernan, explained that this is a second request for a six month extension. He stated that the County, as lead agent on a Class 4 Forest Practice Pennit, required an Eagle Management Plan. He presented the Board with a letter dated February 14, 1994 from the State Department of Wildlife indicating that it was not necessary because the property was outside the required radius. After a brief discussion regarding the County's role and the Department of Wildlife's role in the process, Commissioner Hinton moved to grant another six month extension for the Maryatt Short Plat and to eliminate the requirement of the Eagle Management Plan. Commissioner Huntingford seconded the motion. The motion catried. Application for Assistance from the Veterans Relief Fund: Commissioner Hinton moved to approve an application for Veterans Relief Funds submitted by American Legion Post #26 in the amount of $375.29. Commissioner Huntingford seconded the motion. The motion catried. AwlIDntment to t~erson County Shoreline Management Advisory Commission: District #2 Representative: Commissioner Hinton moved to appoint Anthony Turner to a three year term on the Shoreline Management Advisory Commission which expires May 16, 1999. Commissioner Huntingford seconded the motion. The motion catried. PUBLIC WORKS DEPARTMENT PUBLIC WORKS DIRECTOR'S BRIEFING: Public Works Director Klara Fabry updated the Board on the following items: . There will be an open house for H.I. Carroll Park on Wednesday at 6:00 p.m. Funding for the reclamation work on the site is being charged to the Road Fund and the funds for the development will come from the H.J. Carroll Grant. The Port of Port Townsend turned down a request for a public access easement through the industrial area for the trail project. They cited safety concerns. She will be meeting with the Port Manager next week to discuss alternatives. Next week the Public Works Department will meet with Jefferson General Hospital regarding the transfer of the Multi-services Building. The Upper Hoh Road work is on schedule. They hope to open the road next week for public access to the Park. The South Shore Road project is on schedule. The actual road construction should begin in July. The Department of Transportation is cUITently striping the roads in the County. The fmal report for Public Works for 1995 was submitted to the Board. She visited the Paulson Property on Seal Creek Road and feels that the County is not at fault regarding the drainage problem. . . . . . . . VOL žt~A~~ 935 Commissioners Meeting Minutes: Week of May 28, 1996 PUBLIC WORKS DEPARTMENT BUSINESS She stated that, after researching the issue, she feels the intent of the Board in 1994 was to establish Third Street as a County road. Therefore, the Public Works Department will continue the process. Alan Carman, who represents the proponent, will work with the Department to provide the necessary infonnation and documents to proceed. The Board agreed that the issue should be resolved as soon as possible. 1) Emer2ency Appointment o~Manager and 2) AGREE: MENT re: Temporary Help for the Public Works Department: from June 1.1996 to Au2ust 31,1996: Kim Bailey: Klara Fabry infonned the Board that the Manager of the Bayshore Motel has submitted his resignation which has created an emergency situation. Her solution is to hire Kim Bailey, the custodian at the motel, to fill the vacancy until a new manager can be hired. Commissioner Hinton moved to approve RESOLUTION NO. 45-96 the emergency appointment of a manager of the Bayshore Motel and to approve the temporary help agreement to hire Kim Bailey for 90 days in the vacant position. Commissioner Huntingford seconded the motion. The motion carried. The Board recessed for lunch and reconvened as the Board of Health at 1:30 p.m. for a Health Board meeting. After the Health Board meeting, they reconvened as the Board of County Commissioners. AGREEMENT re: Standard Work Order; To Extend the Existing A2ree- ment ~rotective Services Early Intervention Services: Jefferson County Health and Human Services; Department of Social and Health Services: Commissioner Huntingford moved to approve the agreement with the Department of Social and Health Services to extend the existing agreement for CPS early intervention services from July I, 1996 to June 30, 1997. Commissioner Hinton seconded the motion. The motion carried. Memorandum of Agreement: To Hire Trainees Through the Duration of Their Current Pro2ram: Northwest Services Council: Commissioner Hinton moved to approve the memorandum of agreement with Northwest Services Council. Commissioner Huntingford seconded the motion. The motion carried. IMl.(Z) Out of State Travel Requests: Sherry Nesmith from Health and Human Services and Juelanne Dalzell from the Prosecuting Attorney's Office: Commis- sioner Hinton moved to approve the out of State travel requests for Sheny Nesmith to attend training in Portland and Juelanne Dalzell to attend training in Tucson. Commissioner Huntingford seconded the motion. The motion carried. Page 4 VOL 22 rMJ~936 Commissioners Meeting Minutes: Week of May 28, 1996 Fee Waiver otð!Jillc Work£þepartment Solid Waste Disposal Fees; Earth Day. Aprjl20. 1996 ( Also see Minutes of..A.¡uj1 8. 1996): The Board received a memo dated May 9, 1996 from Public Works Director Klara Fabry recommending that 10% of the solid waste fees from the Earth Day clean up of public lands and streets be paid out of the Road Fund and 90% be paid out of the General Fund or Community Services Fund. On April 8, 1996 a fee waiver request for this project came before the Board and was approved. The detennination of the Board at that time was that the fees would be paid from the Public Works budget, as they were in 1994 and 1995. On reviewing the latest recommendation from Public Works, the Board concUITed that their original detennination on April 8 is appropriate. The meeting was recessed and reconvened on Thursday, May 30, 1996 at 7:00 p.m. at the Clúmacum Fire Hall for the following public hearing. Contract with another County on a per call basis. The County fund these services through the General Fund. Fonn an EMS District. This mechanism was set up by the State to fund these seIVIces. The fonnation of an EMS District needs to be put on the election ballot. The legislation that allows for fonnation of the District also outlines who will serve on the governing body for this District. The RCW sets up a Board of Trustees made up of the County Commissioners, the Auditor, the Chair of the EMS Council, an EMT worker in the County, and the Superior Court Clerk serves as the Secretary/Treasurer for the Board. To meet the needs of our County, the proposal would be to establish, by ordinance, a Board of Supervisors to run the EMS District. The Board of Supervisors membership would include Fire Commissioners from the Fire Districts included in the EMS District. David Goldsmith then reviewed a list of common questions and answers regarding the fonnation of such a district (see attached). HEARING re: EstablWljng a Separate Taxing Authority to Provide Ad- vanced..1Jfe Support (A~mergency Response to AU or a portion of Unincorporated Jefferson County: Commissioner Huntingford explained the purpose of the hearing, introduced the Board members and staff present and then turned the hearing over to David Goldsmith, Deputy Director of Community Services, to review the history of this proposal. David Goldsmith reported that the Emergency Medical Services (EMS) Council was fonned to educate, train, and make recommendations for emergency medical services throughout the County. The EMS Council put together a report last year regarding the need for ALS services in the County. 50% of the 911 calls that come in would benefit from some kind of ALS response. 25% of that 50% are responses that require a paramedic who brings a higher degree of skills to the scene. The City of Port Townsend is the only area that has paramedics. The EMS Council's report provided three options for funding ALS services to the unincorporated portions of Jefferson County: 1) 2) 3) An EMS District can be fonned that is less then county wide (only a portion of the County), however, two Fire Districts would be the minimum number needed to provide the necessary funding for an EMS District. If an EMS District was fonned that encompassed only Fire Districts #1 and #3, about $150,000 of taxes would be generated annually. This is the minimum funding necessary for a District. If an EMS District is fonned the EMS levies of the Fire Districts would go to the EMS District. The Fire Commissioners have made it clear that they need the first $.25 per thousand to provide Basic Life Support (BLS). The County can, by ordinance, require that the fIrst $.25 per thousand be given back to the Fire Districts for BLS. BLS is the basis for an ALS program. The advantage of setting this requirement by ordinance, is that it can only be changed by ordinance, which requires another public hearing. If the fonnation of this District is put on the ballot and is not passed, there is no effect on the EMS levies that the Fire Districts cUlTently have. An EMS District would not replace the responsibil- Page 5 VOL 22 rAG~: 937 Commissioners Meeting Minutes: Week of May 28, 1996 ity of the Fire Districts for BLS. It is intended to enhance and supplement the services provided by the Fire Districts. It is not necessary to establish an EMS District to provide ALS, but the cost of ALS services make it hard for a single district to provide. David Goldsmith then explained the process for the establishment of the District: 0 The Board of Commissioners hold a hearing to detennine if there is enough public interest to put the question on the election ballot. If there is enough public interest, an ordinance is created which outlines the District boundaries, the structure, how the funding will flow, etc. A public hearing is held on the ordinance. The issue is put on the ballot. A 3/5 majority vote is required to fonn the District. 0 0 0 He then reviewed the handout which detailed the levy rates in each of the Fire Districts. If the whole County was included in the EMS District, $430,000 would be generated at $.25 per thousand. There are a number of existing commitments between Fire Districts for provision of ALS services which would have to be honored from the taxes generated by a county wide EMS District. He then reported on the written testimony received regarding this proposal: . A letter from Fire District #5 which was sent to all their constituents urging them to come to this hearing and voice their opposition to Fire District #5 being included in an EMS District. The Fire Commissioners from Brinnon and Quilcene have submitted letters stating that they don!t want to be included in a county wide EMS District. Fire District #6 has indicated that they are satisfied with the services they are getting from the City of Port Townsend. Sheriff Piccini has submitted a letter stating that if this District is established, his Department would need an additional 3 or 4 dispatchers, and all the dispatchers would need to be trained as EMS Dispatchers. . . . Commissioner Huntingford then opened the hearing for public testimony. ~ Gardiner, stated that she is concerned about this issue being placed on the ballot, because the Gardiner area is small and could not out vote the Port Ludlow area. Clark McHurol\, Port Ludlow, explained that he became involved in Emergency Services through the emergency preparedness program. 160 people in the Port Ludlow area have taken the ARC, First Aid and CPR classes and there are 80 neighborhood captains for emergency preparedness. There are paramedics available in Port Townsend most of the time, but last year there were 71 times when they weren't available. There is a need for more aid cars and paramedics on a 24 hour basis. He feels this should be put on the ballot, so the people can make their own decision. He feels it should be proposed as a county wide district. He added that he serves on the EMS Council. Joanne Clyd.e, stated that she lives in Port Ludlow and just recently resigned as the Director of Emergency Services for Jefferson General Hospital. As a provider of emergency care for the last 9 years in this community, she is concerned that there are things missing in our system. People in the County aren't aware of what we do and don't have in the way of emergency medical care. The person on the street, who isn't involved in emergency medical care in any way, has an impression of what they will receive which is based on what they see on television. They think that if they ca11911, people will show up at their door who can give a certain level of service. They understand that they won!t receive services as quickly in a rural area, and that there may not be as many people to respond, but they still expect a certain level of service. The volunteers that do respond have to be credited for the care they give, the training they go Page 6 VOL 22 tAc~938 Commissioners Meeting Minutes: Week of May 28, 1996 through, and the dedication and time they volunteer to provide the services they can provide. They provide a very good service. She is willing to participate in providing the public with education regarding the services we have and don't have in this County. She would like to hear from the public regarding if they are willing to pay for these services and where this falls in their priorities. When you talk about human life, it's hard to put a dollar value on it. She then related several scenarios where having a paramedic could save a life because of the types of services they can provide that an EMT cannot because they aren't trained for it: Anaphylaxis (allergic reaction), airway control, techniques to get fluids to small children, and where there are chest injuries. The Fire Commissioners have to consider if the public really understands the issues, and if they understand the status of emergency medical care in the County. Gaty Phillips, Fire Commissioner from Quilcene, said that his issue with the ALS proposal at this point is lack of a concrete plan. Every Fire District in the County operates differently and he isn't sure how the ALS system will interact with all of the different Fire District systems. Quilcene doesn't have an EMS levy cUtTently, so they would be taxed at $.50 per thousand. They don't know what would happen to the second $.25/thousand. Would it come back to the Fire District or go to the ALS system? They don't know where the location of the ALS station would be and they don't know how that would effect runs to the Quilcene area. There is a major concern with the volunteers. He doesn't feel this has been handled well, politically, with the volunteers. The proposal should have been taken to the volunteers in each District so they understand how it will work with them. He is also concerned for the mutual aid systems that are already in place. Will the Districts that have these agreements be able to keep them in place, or will they be forced into this system? He doesn't know how the public can be educated about this, in such a short time span. He feels that he would have to say no to this proposal, at this time, because he doesn't know what it would mean for the community, the volunteers and the people of the District. It seems like Port Ludlow and Chimacum really need this now, and he feels they should have that available to them. If it started out with those two Districts, then the other Districts could do mutual aid agreements with them on a call by call basis. He would like to see minimal involvement from the County and if a District is set up he would like to see each Fire District represented by one Commissioner. Dennis Hannan, Fire Commissioner in Port Ludlow, stated that at the minimum in Districts # I and #3, an ALS program needs to be provided in this County. He feels it is incumbent upon the Fire Commissioners of District #3 to extend an invitation to the Commissioners of District # I to fonn a cooperative to provide an ALS program. This program doesn't need to be county wide because Quilcene doesn't have an EMS levy, Brinnon is a long way away, and District #6 already has ALS coverage from the City of Port Townsend, as well as a number of other reasons. ALS is needed in Chimacum and Port Ludlow. He understands that the county wide vote would be in September, and he questioned why this would be put on the ballot. If we have a county wide ALS District, administration of that District would have to be funded. He asked why we don't just give that money to the Districts? With regard to the Sheriff's concerns about dispatching, the City of Port Townsend is already getting ALS dispatching through the Sheriffs Department. Between Districts # I and #3 there would be $198,000 (1996 figures) generated at $.25 per thousand. Another concern by the Fire Districts in the County is the potential that the Chimacum and Port Ludlow Districts could out vote them and push this vote over the top for the entire County. He doesn't want to see that. Most of the resources are already in place. There are some vehicles, especially in Districts #1 and #3 in place already. District #1 cun-ently has a volunteer para- medic who works elsewhere and District #1 has provided him with the equipment necessary. He doesn't understand why there are startup costs in the proposal other than for administration. He doesn't feel we can go immediately to a fully developed County wide system (including the West End), because the distances are too great. It would be better to start out with two or three Page 7 YO'- 22 rM ~939 Commissioners Meeting Minutes: Week of May 28, 1996 districts so there won't be the need for the startup costs. There is already administration setup for these Districts and additional administration would not be required. Commissioner Huntingford stated that the County has been working on a structure for this District that would have one levy issue, instead of two. The structure would also include the Board of Trustees, as required by RCW, but there would be only one meeting yearly to go over the budget with the Board of Directors which would be composed of the Fire Commissioners and emergency medical personnel from the Districts involved. The County wouldn't expect any administrative costs for the Board of Trustees. Dennis Hannan responded that if the District is established county-wide, then the paramedics will be County employees. If the paramedics are employees of the Fire Districts, then they can be firefighter/paramedics. Mike Zehren, Port Hadlock, stated that he is a fITefighterÆMT for Jefferson County Fire District # 1, the EMS Captain, and on the Master Plan Committee for Fire District # 1. One of the goals of this Committee is to make Fire District # 1 the center of ALS services in the County for the year 2000. ALS is needed because call volume is increasing. Port Townsend is stretched to the limit and they aren't always available. Paramedics equate to increased survival rates. Fire District # 1 has completed the preliminary stages of installing a temporary modular unit to house a paramedic and future staff. The Committee will now begin evaluating the fIfe suppression and EMS needs of District # 1 for the next 20 years. The Committee is asking that the public support an ALS system in this County~ ~, Fire District #2 Quilcene and President of the Firefighters Association, stated that at the last Association meeting a vote was taken of the EMS volunteers and 95% of those present were against having this program at this time. They believe that the Districts are spread out too far. If a paramedic is called for in their area, by the time the paramedic gets to them, the person would be stabilized or they would have to meet the paramedic in route. Brinnon, Discovery Bay, Port Townsen<L and Fire District #6 all have paramedics available to them. It would be a costly program for them to consider in their area. It would be good for Port Ludlow and Chimacum. Robert Larson, Fire Chief for District #6, said that their District has growing pains, for ALS and other concerns. What will a paramedic do when he can't get to a house? The access ways are terrible. Will there be 2 paramedics on at all times to provide 24 hour coverage? If there is a call in Quilcene, will there be a paramedic to cover Port Ludlow or Chimacum? If it goes to a county wide vote, it won't be "rent-a-paramedic" it will be full time paramedics. They will be county employees with retirement and medical benefits. What will the paramedics be doing when there isn't an ALS call? If the program is set up with mutual aid agreements between Fire Districts, then these people can be hired as fIfe fighter/paramedics and be useful. He agrees with the Sheriff's concerns about dispatch. If there is an ALS District, paramedics may come in on a BLS call and push the EMT's out. Where would the paramedics be stationed? If they are full time employees, they'll need an administrator, a secretary, a computer system, and voice mail, etc. He feels that if the County wants to do something with ALS it would be beneficial to support Port Townsend in putting on full time paramedics who have a car to respond to ALS calls through dispatch. He feels there are a lot of questions that need to be answered. He feels this will start a bureaucracy that will grow and grow and grow. Dick Broders, 4503 Old Gardiner Road, Port Townsen<L stated that he has concerns about this proposal. He is concerned that the $.50 per thousand levy that Fire District #5 already has, will be lost. He feels District #5 would lose a portion of it's funding and it is an area with a low tax base which needs the funding it has to keep the minimum it has right now ($.50 per thousand EMS Levy.) He is also concerned for the south County areas, particularly Brinnon, because if it Page 8 VOL 22 Í'~G;940 Commissioners Meeting Minutes: Week of May 28, 1996 was centered in ChimacumlPort Ludlow area, it wouldn't do Brinnon much good. He is very concerned about the method of financing this program. The levy rate of $.50 per thousand would cost a property owner with a $100,000 house, $50.00 per year. This is extremely unfair because some people pay nothing, some people that have property pay a lot more and some people with businesses pay thousands and thousands of dollars. He feels fmancing this district through property tax assessments is an extremely unfair way to go. He feels it would be more fair to fund this program, if it was county wide, from the County budget. He is also concerned with this type of financing for a specific levy rate ($.25 or $.50 per thousand) because when property values go up, the property owner automatically pays more. He doesn't feel a county wide district should be fonned. ALS is a good thing to have. He feels the County should fund the things we need to have, and the things that aren't so desirable should be voted on. He concluded by saying that there may be more of a need in Chimacum and Port Ludlow, and he doesn't want to see this put on the ballot as a county wide district. John Harpe, Port Hadlock, said that he is a volunteer paramedic in the County. He has 13 years of EMS experience and 9 years as a paramedic. He said it is a privilege to serve the people of Jefferson County in his chosen field. He surveyed the calls he has responded on this year and reported that in Fire District # 1 he has responded on 63 calls that were in need of a paramedic. He administered some type of advance life support in 32 of the 63 cases. Of all the calls he responded to this year, he was able to save 4 lives. He has responded 7 times mutually (mostly with Fire District #3.) He urged the Board to pass some type of ALS program in this County. ALS is not a new concept. If the other Fire District haven't been seriously thinking about it, they should be and need to be making plans now to provide ALS for their districts in the future. He thanked the people on the EMS Council for all the hard work they put into this proposal. He then reviewed the American Heart Association recommendation for people who suffer a cardiac atTest. The recommendation is that BLS respond to such a call within 4 minutes, and ALS respond within 8 minutes, in order to supply that patient with a good chance of being resuscitated successfully. That will be hard to do in this County, but an ALS program would be the fITst step in the right direction. He then reported that he was asked to speak for Judy Gunter, 1511 Irondale Road, to voice her support for an ALS system in the County. An unidentified man asked Mr. Harpe how many paramedics would be needed if an ALS system is put in for east Jefferson County? Mr. Harpe stated that it would all depend on the amount of money available and the commitment of the people in the County for the system. Mr. Harpe added that if the citizens feel they can't afford to pay for an ALS system now, there should at least be an attempt to develop mutual aid agreements with some districts for these services. RA. Howe, Fire Commissioner for District #5, Gardiner, stated that the voters of Fire District #5 approved going from $.25 to $.50 per thousand for Emergency Medical Services last year. The people involved in the Fire Department feel that ALS is a good thing for the high density population areas of the County. Fire District #5 is too remote to benefit from an ALS system. This is partly because they have an agreement with Sequim, and because they can call on Port Townsend. The Fire District raises between $8,000 to $10,000 every year by sponsoring a Sa1mon Derby. They feel that relinquishing any or all of their EMS funding would be a disservice to the District. They favor the best kind of medical aid their people can buy, but they have to draw the line somewhere. They hope that in 5 or 10 years they've got it. Judy McFerran, volunteer FirefighterÆMT and resident of Port Ludlow, the President of the Volunteer Firefighter Association in Port Ludlow, and the Secretary for Fire District #1, sees the importance of ALS in the County. The longer a transport is for a patient, more things can happen to that patient. Fire District # 1 is in a unique position, because many of the other Districts have to come through it on their way to the hospital. Whether a patient makes it to the Page 9 VOL 22 rAG~941 Commissioners Meeting Minutes: Week of May 28, 1996 hospital or not can be effected by what is done to them in route. Another thing that is important, is the quality of life they have after their trip and stay at the hospital which can be effected by a paramedic. The kind of care a patient gets in route can detennine, not only that the patient survives the call, but that they have a quality of life afterwards. That's important because we can live through a lot of things and not have the quality of life that we would want. The average age of the citizens in Port Ludlow is 62. With citizens 62 and older there will be cardiac cases, diabetes and other problems that ALS can have an impact on. Highway 104 is in the Port Ludlow district and there are many motor vehicle incidents. All an EMT can do is basic life support. She is grateful for the opportunity to call on paramedics. EMT's don't do what they do for recognition and should not feel threatened by a paramedic coming in. Their importance is not diminished by that. The paramedics are the fIrst to say that an ALS system depends on a solid BLS system. When an EMT is working with a paramedic in an aid car, they let the EMT's do what they know how to do and they do what they can do. There is room for everyone. They never fight over a patient, but people have expressed fear that this may happen. This shouldn't be a fear. She asked that the citizens of this County be allowed to vote for themselves on whether they want ALS or not. The citizens need an education about what they are being asked to vote on. Bob Moser, Chair of the EMS Council of East Jefferson County, explained that they put together this package over many years. The main point of the whole EMS system is to provide the best possible care for every citizen of Jefferson County, whether they live in the rural area, or in the Port Townsend urban area. He is an EMT-IV which is as far as he can go as a volunteer. In the future there may be an EMT -I designation which would be more skilled, but that isn't the full answer either. Paramedics save lives. The EMT saves the paramedic. When an EMT calls for a paramedic they are not giving up any authority, the main concern is the patient's care. There is no way in this County to get to a cardiac patient in 4 to 6 minutes, but when they meet a paramedic in route, the heart damage that's already started can be cut down. An EMT cannot start an airway on a child, or give them intravenous fluids. A paramedic can. He urged the Board of Commissioners to put an EMS District on the ballot because the people in this County have a right to decide their own destiny. There are some concerns such as dispatching and possibly something can be put together to address that through this program. Mamie Moser, EMT at Coyle (Fire District #2), stated that the Coyle area is 23 miles from Quilcene, but is in the same Fire District, and they are 40 miles from Port Townsend. There is no way, even when they call a paramedic from Port Townsend, that they can get to a patient in 6 minutes. There is no EMS levy in Fire District #2 which means that they would be levied $.50 per thousand over what they are paying now. It would cost her and her husband over $100 per year. She feels this is dirt cheap. What price can you put on a life. If she or one of her neighbors need a paramedic she is willing to pay $100 plus per year. If they call a paramedic from Port Townsend, the patient gets billed an additional $450 over what they are billed for a BLS call. If an ALS levy is passed most of the people in the Coyle area will be paying about $50 per year or less. It would be worth it to them to pay the $100 rather than $450. Ms. Moser stated that she doesn't understand why more dispatchers would be needed if paramedics are available, than if there aren't paramedics available. There will be the same number of calls. The two deaths that have occUlTed in the Coyle area have been a man in his early 40's who was stung by a bee, and the other was a SIDS baby. She wants an ALS system so that a paramedic is closer to the calls. We live in a democracy and we should all be able to voice an opinion on how tax dollars are to be spent. The details on how the money will be gathered and spent can be worked out, once we fmd out if people want ALS or not. Sheriff Pete Piccini expressed his concern regarding dispatch for ALS services. Presently to maintain the BLS, the Sheriffs Office has nine dispatchers who dispatch 24 hours a day to Port Page 10 VOL 22 rM;€ 942 Commissioners Meeting Minutes: Week of May 28, 1996 Townsend and the CO\Ulty, including all the Fire Districts. If the County ends up with a full blown, county wide ALS system with pre-arrival instructors, it would mean a dispatcher would have to be on the phone with the person at the scene and they would keep them going until an EMT or a paramedic arrived and relieved the dispatcher of that responsibility. He doesn't want to have to provide that type of service because it would require two dispatchers on duty 24 hours a day, 7 days a week, to man two consoles. He feels it would require 4 or 5 more dispatchers to support a full blown ALS system. If the County does end up with an ALS system, then the dispatchers would have to be trained in call screening. Call screening means the dispatcher has a standardized list of questions and if the questions are answered yes then a paramedic is dispatched. If the questions are answered no the BLS can be dispatched. A. Q. A. Q. The Sheriff answered the following questions: Q. Don't many Counties go to separate fife/medical and police dispatch system when ALS systems are implemented? Yes Doesn't the Sheriff's Office already have 2 dispatch consoles? The Sheriff pointed out that he said "to man 2 consoles." The Sheriff has been asking for extra people for quite some time, whether or not there are paramedics. The Sheriff stated that is correct. A. Kent DeWitt. Fire Chief District #3, stated that he doesn't feel that the need for more dispatchers should be tied to whether there is an ALS system or not. A paramedic is trained to decide whether they should go on a call or not. The CUlTent system we use requires the dispatcher to make many calls to detennine if a paramedic is available. With an ALS system a paramedic could already be going to the call which would eliminate 4 conversations for the dispatcher. The need for more dispatchers should be part of the long range planning process. Jim Avery, EMT for Hadlock and a member of the EMS Council, stated that one of the provisions of the ALS planning was to have a paramedic start to respond to every call. They could be turned back if it was detennined by the BLS responder that the paramedic is not needed. The system can be set up so there is no extra dispatching at all. If a paramedic is on his way when the call is made, that will be a gain of 2 or 3 minutes. Sheriff Piccini expressed concern about the Department having to answer to why a paramedic wasn't dispatched on a specific call, if they are available. He added that he will need at least one more dispatcher if an ALS program is developed in the County. Mr. Avery suggested that the 9 dispatchers that are cUlTently employed be sent to some specific training. He suggested that the EMS Council may be able to provide some funding for the dispatchers to go to training. Pete Piccini stated that he advocates all of the dispatchers being trained in call screening. Sally Grace, Quilcene, stated that she has heard calls when the dispatchers have three different Districts calling in at once. When there are three calls from three Districts with different portable radio frequencies, there needs to be someone to help the dispatcher. Another man asked if it would be reasonable to have a corp of volunteer dispatchers trained and available to use as needed? Pete Piccini answered that is no longer feasible because of the training needed to run the new E911 system. The Sheriff noted that he is not saying he is for or against ALS, he is just trying to point out the effect it would have on the dispatching services he Page 11 2 2 rAL~ 943 VOL Commissioners Meeting Minutes: Week of May 28, 1996 provides. Commissioner HWltingford added the he feels the dispatchers do a great job, especially with the workload they have. Hattie Bachmat11\, Gardiner, said that she Wlderstands that response time can't be as good as it should be because of the number of miles involved. The Miller Peninsula is vel)' remote. She doesn't know that this needs to go COWlty wide. Keep this within the two districts that have the greatest concern. Taxes are a concern for retired people who live on a fixed income. Taxes are driving people out of their homes. Have these services provided locally. The system in the Discovel)' Bay and the Gardiner area has been outstanding. This needs more studies, communication, and education before it is implemented. The citizens of west Jefferson COWlty would be providing funding to this district if it is COWlty wide and they would get no benefit from it whatsoever. She concluded by saying that she feels the ALS program should not be implemented COWlty wide. It should remain local. w:any Westeriaard, Commissioner Fire District #1, said that he was at the meeting where putting this before the voters of the COWlty was discussed. The idea was to give evel)'one a chance to vote on it. If they don't want it, or can't afford it, they should vote against it. He can Wlderstand the concerns of the people in Gardiner, Brinnon and Quilcene. If Districts # 1 and #3 put this in they can possibly work out an agreement to provide some coverage to those areas. Joe Coates, Discovel)' Bay, said that he retired after 27 years of this type of work. He doesn't feel that this area can support a full ALS system -- dollar wise, call wise or training wise. A paramedic has to have enough calls to keep their training up and in force. If they don't get enough of certain medical procedures, their license isn't any good. The dollars generated by taxes for this District are not enough to fund ALS services. If the Sheriff needs 9 dispatchers, 9 paramedics or more are needed to cover the COWlty. The taxes generated will not fund more than 2 or 3 paramedics salaries, benefits, equipment and vehicles. Einar Forsman. fonDer EMT and Fire Chief in Gardiner, said he is for paramedics, but they (Gardiner residents) would lose half of their levy (Gardiner is at $.50/thousand). They have to use the derby funds and donations to operate right now. Losing this amoWlt wouldn't help Chimacum and Port Ludlow much, but it would make a big difference in their operation. He would like to see ALS, but he doesn't see how they could support it in the Gardiner area. ~ Fire District # 1 Fire Commissioner and Fire Fighter, stated that he doesn't think the people in this COWlty know what ALS is. For a small group to say they want it, but they don't want to pay for it, bothers him. District #7 would get their tax money and could get the service they want. They would get something out of this. He reported, as the President of the Jefferson COWlty Fire Commissioners and Secretaries Association, that they took a vote of confidence for the EMS CoWlcil to take this proposal forward to the Board of Commissioners, at their last meeting. He pointed out that if there is a paramedic available, he can start to a call and then be turned back if he's not needed. The response time would be a lot better if the paramedic was stationed somewhere in District #1 or the south portion of the COWlty, than if the paramedic was dispatched from Port Townsend. He asked if an EMS District could be fonned that would not include all of a Fire District? David Goldsmith reported the EMS District can be fonned from any defmable, contiguous geographic area. Only the residents of the area to be included in the EMS District would vote on whether to fonD the district and tax themselves for this program. ~ City of Port Townsend Fire Chief, stated that one paramedic is better than none. The biggest thing that needs to be done in the COWlty, is to let the public know that a paramedic will not necessarily be available for evel)' call, because they may already be on a call. If the program uses "rent a medics" then they don't have to pay all of the employment benefits. He suggested that if the District's levy the $.25/per thousand, possibly the COWlty could match that amoWlt to provide more funding. The City of Port Townsend doesn't have full time paramedic services. He advised that if a District needs to call a paramedic from Port Townsend, they need Page 12 VOL 2 2 rMJ~ 944 Commissioners Meeting Minutes: Week of May 28, 1996 to call early. Howard Scott asked if this District would effect the City of Port Townsend's EMS levy? David Goldsmith answered that it would not, because the City would be outside of the District. Rolf Schumann then explained the proposal which was brought before the Board of Commissioners by the EMS Council: .. The requirement for three years of high volume experience for a paramedic to come and work in the County was to make up for the low call volume in this area. Paramedics who are just out of school need to use their skills every day. Paramedic versus fITefighter paramedics: The trend is for paramedics to do just those services instead of being paramedic/rITe fighters. The straight medical people have a duty to perfonn at a fITe scene, which is rehabilitation of the fITe fighters. Training levels: An EMT has 110 hours of training. They don't do anything invasive. The next level of training and certification is to be able to use a defibrillator. Semi- automatic defibrillators are used in this County. Many of the EMT's are trained for that, but that's just the flTst step in cases like cardiac arrest. The chances of a patient that has been defibrillated going back into ventricular fibrillation again is very high. A paramedic can back up the defibrillation with medication therapy to control the heart and make it stable. Basic EMT's and EMT's that are certified to use a PTL airway can only use them on adults. An IV Technician (30 to 40 hours of training) can start IV fluids (nonna! saline or sugar water) which can be used to treat a small portion of a diabetic emergency, but they can't treat pediatric cases. The EMT -1 (Intennediate level EMT) is being developed in the County and they will be able to do defibrillation, the PTL airway, IV Therapy and administer a limited number of drugs. They will be able to use nitroglycerin, take care of respiratory problems and anaphylaxis problems. This program won't be in place for another year or more. An EMT at the highest level of certification has about 150 hours of training. A Paramedic has about 2,000 hours of training. They can see things that EMT's don't recognize, because they don't have the training. The working relations between EMT's and Paramedics: Every emergency medical responder has a job to do and they work as a team. Problems with our current system: 25% of the calls received need a paramedic. The City of Port Townsend paramedics don't go on 25% of the calls. If there is a paramedic stationed at Highway 104 and Center Road, 20 to 25 minutes of driving time can be cut from a response from Port Townsend. .. Number of Paramedics: The system could only afford to put one paramedic on a day. He concluded his presentation by asking that the people be allowed to vote on this. Commissioner Hinton asked how many paramedics the City of Port Townsend has on staff? Howard Scott reported that they have three full time paramedics. Commissioner Hinton then asked how many calls the City of Port Townsend handles per year? Rolf Schumann, Paramedic with the City answered that the City averages approximately 1,000 EMS calls per year. About 50% of those calls are BLS calls and 25% of the remainder are intennediate level life support (such as starting an IV) and the other 25% need more complicated procedures. These statistics indicate that another set of paramedics could be put on out in the County and they would be able to keep their certification current. The system being proposed would use medics who work full time in another District to work part time here. This system would not require the payment of benefits or overtime which will allow the plan to go forward without a huge expense in personnel. Another benefit of using part time paramedics, is the experience they have from their full time job. .. .. .. .. The discussion turned to the budget for this proposal and how the proposal would work to provide the coverage by paramedics. Paul Nickel, Fire Chief for Kingston, stated that they started with a system just like the one proposed and it worked for them for eight years. It was the only way they could start their program. They used off duty paramedic from Pierce and Page 13 VO!~ 22 fAC;945 Commissioners Meeting Minutes: Week of May 28, 1996 Kitsap counties. There are ways to work out the problems to be able to provide the service. There are people that have done this before. Wayne Kin¡:, Gardiner, suggested that developers be charged an assessment on their building permits since they are the ones creating the problems. Chimacwn and Port Ludlow are pushing this deal. Is everyone in the County getting their own paramedics? A fee could be put on the building permit which could be divided between fIre, police, water and schools. One of the biggest problems in the County is the Aid Cars and Deputies fmding the people who call. He would like to see a GPS (Global Positioning System) put in place. He doesn't think everyone should be taxed for what two districts want. John Illman, President of the Marrowstone Island Emergency Medical Services, stated that he feels this board wants ALS. He would like to see a county wide vote, without the West End if possible. If this ballot measure fails then the Districts that want to go ahead with ALS should work on a plan to do that on their own. Earl Wells, Port Ludlow, stated that he would like to see the whole County be in this District. It seems like there is a money issue here and if the whole County was taxed there would be more money for the program. Possibly some compensation could be made to the Districts that are using that money in their budget already. We need to sit down and figure out a system that would work so that we can get the money that it will take to do this. Districts #3 and # 1 seem like they are ready to go for this, and it looks like this is a golden opportunity for the whole County. Ifwe don't all do this together it will feel like the big guy is eating the little guy. It's our people that we're talking about calling for help. Let's get together and make a system that maximizes what we have. ~, County Auditor, reported that to validate a measure in just Chimacwn and Port Ludlow would take 1,425 voters of which 825 would have to vote yes. If the measure went county wide (Port Townsend would be excluded) 2,637 voters would be needed to validate the election and 1,583 would have to vote yes. These figures are taken from the last general election which had 62% voter turnout. Four years ago the voter turnout was 56%. The Board may want to consider those figures in their decision on how and what to put on the ballot. This is an odd year election and the County pays the costs for the election. Ken Brow, Port Ludlow, stated that he is surprised that this meeting is being held. Nine years ago he was in meetings like this, saying the same things to the same people about the same issue. That long range plan hasn't gone very far. He is still a health care provider and would like to see this matter go to a vote of the people. He asked those present to go home and ask three people if they would think that the responder that showed up at their house if called, was a paramedic? Many people think that when Fire Department EMT's show up that they are paramedics. We need to educate people very quickly before this vote comes up. Many other areas have done similar programs. We just need to let the people know they don't have paramedics now. Kent DeWitt, Fire Chief at Port Ludlow, said that there would be potentially enough funding at $.25 per thousand to have two paramedics. Has anyone thought about where the second paramedic would work from? In order to go to a vote, there needs to be a plan. People want to know where the money will go. If this is just going to be Chimacwn and Port Ludlow, then he feels that it doesn't need to be put to a vote. The Fire District Commissioners can work out their own system. The people in Port Ludlow know the difference because they've been educated. The only reason that this proposal has been presented this way, was to be fair to the public. Maybe there's another way to get the publics input -- maybe an advisory ballot. He doesn't know if the boundary is less than a whole County, if the paramedic would be restricted to answering calls just in that area. Who's to say that a paramedic could also do Home Health care checks and clinic things through the Hospital? He's saying look at this more and consider other Page 14 VOL 22 rM/946 Commissioners Meeting Minutes: Week of May 28, 1996 options. Leadership is needed from the County to guide this process along to work with everyone involved to make this a win-win situation. Gordon James stated that he isn't involved with any of the Fire Departments or EMS. He pointed out that he feels the people who are afraid of losing something shouldn't take something away from someone else who might want it. He's afraid of the vote. He feels that if the people in Districts # 1 and #3 want this program, they should be able to vote for it and have it. Anyone who has had the experience of watching the EMT's and Paramedics come in and save one of their loved ones, would gladly pay $100 for this right now. He's seen what they can do and he wants this. Mark J. Bowes, Northwest Regional EMS and Trauma Care Council Administrator, reported that the Council saw that there was interest in ALS in Jefferson County three years ago. There was a grant for $40,000 available at that time to buy ALS equipment for Jefferson County. Unfortunately the County did not take advantage of that grant. A grant for $82,000 was given to Jefferson County for communications equipment. The Regional Council is willing to help educate people (make presentations, etc.) to get the word out on ALS in Jefferson County. They are a resource that is offering their services to the County. The Regional Council will provide dispatchers training. He reported that a study was done regarding volunteer EMT's and personnel and it was found that if the volunteers were to go away for some reason, it would cost $1.7 million dollars to hire EMT's to replace them. The volunteers are the backbone of the system. He then explained about a new piece of equipment called the Life Pack II and how it will help paramedics and doctors in the future. James Arsutkh" President of the Coyle Volunteer Firefighters Association and an EMT-IV, said that his Association has mixed emotions on this proposal, because they want more information on what it's going to cost, and how it's going to be run. Ifwe don't know this information, how can this be put to a vote? He personally feels that having a paramedic available would be great. He feels everyone should work together to make the system work for everyone. If we don't get paramedics now, we will need them in the future. Commissioner Huntingford advised that Rolf Schumann's figures indicate that if a paramedic was paid $10 per hour for a 10 hour day, 365 days per year it would cost $87,000. If the paramedic was paid $16 per hour it would cost $131,000. These figures do not include any employee taxes. Rolf Schumann added that these paramedics could be put on as independent contractors so there would be no employment taxes. Doris Fuller, Secretary for Fire District #6, reported that they have had an agreement with the City of Port Townsend since 1981 for paramedic services. They have had excellent service and they want to continue that contract with the City. That is why they are against this EMS District. Ron Garrison, Fire Commissioner in Brinnon, stated that he has been a Commissioner there for 13 years. If this issue is put on the ballot as a county wide district it will pass. The thing is that the people in Brinnon who vote this in would expect paramedics to show up on their door. Who will explain to them that they won't? If you're going to do this make sure the people are informed of where the paramedic is coming from. Brinnon won't have the same level of service that Port Townsend will have. The Board concurred that they would accept written comments on this issue until Friday, June 7, 1996 at 5 p.m. Commissioner Huntingford stated that the Board will have to work on what the plan is going to be and the people of the County need to understand what services they currently have, and what services they can expect to have if the EMS District is formed. Page 15 VOL 22 I'M,' 947 Commissioners Meeting Minutes: Week of May 28, 1996 Mamie Moser concluded by asking those present who feel they don't want ALS services because they have what they need where they are, to stay in their own district. The district they drive through may not have those services available. Commissioner Huntingford thanked everyone for coming and closed the public hearing, MEETING ADJOURNED 'V , ton, Member ~..._. ~, "~, , ,,<vr:ov,"',. " " SEAL' , i' " .~< ¡.-;S"'.I' \. . . ",' ,. Co " (' ":" ~" ;-;:-:--"..../' I. " .' .... ¡#, .. \. '," , "c , \ '" '" . :'" \' ATTEST: \: :" I,,¡ .l:! ":/, ,';~ / ' , . .. . " .. ~ .I:....*,:,..J' . .' \ . 10.. IIP'.-.' "':' '" ,'" -'.' '" /' '. r "\ "". 'l's,)""'""'." ,,_..,,_.,.~.. .. Q¡1h{ {ì r}()#J1Jd . ~aþ/ ~oma Delané'y, CMC / U Clerk of the Board Page 16 VOL 22 rAr,ç948 /