Morrow County Prepares for Interim Ambulance Services

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Raymond Akers of Boardman holds up a recall sign on Feb. 21 at the Morrow County Commissioners meeting in Irrigon as call to action to remove all three commissioners from office (Photo by Yasser Marte/East Oregonian)

As the March 12 deadline looms for Morrow County before everything — or maybe nothing — changes, over 100 people joined the Wednesday, Feb. 21, Board of Commissioners meeting either in person or online for updates.

During the meeting, which was held in the Morrow County Government Center in Irrigon, members of the public commented and the county administrator presented an interim ambulance service provision contract for the commissioners to review.

Eleven people spoke during the public comment period. Each spoke in support of Morrow County Health District, offering concerns or critiques to the county. Outside before the meeting, a few residents collected signatures for petitions to recall the commissioners.

Controversy over interim contract

Ambulance service in the county has been a contentious topic for almost a year — since the county started reviewing its ambulance service area plan — but it has intensified recently, with talks between involved boards suspended for now and county residents filing petitions to recall each of the three commissioners.

The commissioners are responsible for ensuring that there is full ambulance coverage across the county. If the health district does vacate its service after March 12, as is the plan right now, then the county is required to have a plan in place to make sure its residents still have ambulances.

Both the county and the health district say they hope to resolve the issue before March 12.

Matt Jensen, county administrator, proposed an interim contract to the commissioners during Wednesday’s meeting that named Boardman Fire Rescue District as the sole provider of ambulance services starting at midnight on March 12, as it becomes March 13.

Boardman Fire taking over ambulance services is a major concern to the health district and its supporters.

“They had no intention of working with Morrow County Health District from the beginning,” said Irrigon resident Stuart Dick during his public comment. “It’s a hostile takeover.”

After the meeting, Emily Roberts, the health district’s CEO, said, “I think that they reopened the ASA at all to give Boardman another chance to bid on it. I think they’ve been their preferred provider the whole time.”

During the comment period, Roberts reiterated the health district’s willingness to extend its services for two years. The county had asked for 90 days. Neither entity was willing to compromise on those lengths at a previous joint meeting.

The proposed contract with Boardman Fire would have a similar setup to the health district’s. Like the health district, there would be seven ambulances — four owned by Boardman Fire, three leased and provided by the county — covering the three regions of Morrow County, two in each and the seventh as a floater.

The major difference is that Boardman Fire has emergency service providers on 48-hour shifts followed by four days, or 96 hours, off. Morrow County Health District has 12-hour shifts.

Roberts said the health district consulted with the Paramedic Foundation, a Minnesota-based nonprofit supporting paramedicine education, research and governance, to determine the appropriate shift length.

“There’s documented negative evidence when somebody is on that long,” she said, “for their health and for the outcomes for people.”

Research on health care shift work, like nursing, shows that accidents increase with longer shifts to the point that they can triple after 16 consecutive hours on the job. Not only are more mistakes made, but “alertness, vigilance, concentration, judgment, mood and performance are all significantly affected by fatigue,” according to research on fatigue in paramedics compiled by Central Queensland University in Australia.

Those effects can be dangerous both for the care provider and the patient.

But 48 hours is the same shift length that Boardman Fire personnel work now, so they’re already used to it. It also allows them to have lower staffing levels overall while offering the same coverage.

The other change for interim service is that the county does not have buy-in from the current Quick Response Teams, or QRTs, that provide additional service to the health district when all the staffed ambulances are already on calls. At this point, none of the QRTs have agreed to continue during Boardman Fire’s interim tenure as the ambulance service provider.

Unless something changes, though, like OHA returning the plan before March 12 or the county or health district going back to the negotiating table, Boardman Fire will be contracted to ensure there is no hole in ambulance coverage.

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