Commissioners receive input on ambulance service contract

DEER LODGE - Representatives of the northern areas of Powell County said they would like a board to govern the ambulance service. This would provide them representation and the return of some of their tax money from the new ambulance levy to the fire districts through which the three quick response units (QRUs) of the county operate. They would also like to see some of the tax money go to the Lincoln Ambulance Service which responds to many calls in northern Powell County.

But Powell County Commissioner Rem Mannix said he didn’t think all of that was going to happen. However, he and the two other commissioners do want to provide something to the northern reaches of the county and want that in the contract they are in the beginning stages of drafting with the Deer Lodge Medical Center.

“Now we are trying to provide something for you up there. There is nothing that says you guys have any right to anything up there. I mean, you’re paying taxes, yes, but that doesn’t mean you get something for it. Like I said, we pay a lot of taxes that we don’t personally get anything for. It’s for the good of the community, the good of the county, the good of whatever that’s being done,” Mannix told those at the meeting. “But we want to try to do whatever we can up there for you to help you guys out and that’s what we’re working on, that’s what we’re trying to get in the contract.”

On Oct. 9 a group of seven people from the areas of Ovando, Helmville and Elliston met with the Powell County Commissioners in Deer Lodge to discuss the ambulance levy that was passed by voters last November. That levy will provide 14 mills, which is approximately $250,000 this year, for the operation of the Powell County Ambulance Service. The service was in danger of not being operational any longer due to a decrease in transports from the Montana State Prison and due to lack of volunteers. That prompted them to run the levy, which then allowed them to come to an agreement with the Deer Lodge Medical Center (DLMC) so that the medical center would take over operation of the ambulance and contribute $60,000 of their funds for its continued operation.

Recently citizen-initiated meetings in Ovando and Helmville have questioned what service they will receive from the levy as well as other aspects of it. While the ambulance service had been a private entity the county commissioners became involved as they approved of the resolution for the levy, they will be the entity contracting with the hospital as the taxes will come into the county and then be provided to the hospital, which is privately owned.

The meeting last week was a continuation of the northern residents to seek answers. They told the commissioners what they would like out of the levy for the emergency services they receive which are not provided by the Powell County Ambulance Service.

Mannix started out the meeting by saying that the commissioners had recently met with the administration of the hospital to discuss the agreement and things are in the process of being carried out. He asked for input on the contract for the north end.

Leigh Ann Valiton spoke first and said that the residents of the north do not want to take away the ambulance service from the southern portion of the county.

“The big thing we want to make clear is that none of us are saying there shouldn’t be a levy. We just want to see that it gets disbursed fair and equitably,” she said. “We certainly don’t want to take anything away from the Deer Lodge area at all. That is not our goal.”

Valiton said she spoke with a representative from the Montana Association of Counties and asked if there were developments between conversations with him and Powell County Attorney Kathryn McEnery. McEnery said they spoke and explained that the county will not be running the ambulance service but will contract with the hospital. She said the ambulance service will be governed by a board of directors so that northern residents will have the opportunity to ask questions and provide feedback.

Valiton said that is what they would like and from the discussion between the commissioners and the hospital the previous day it sounded as though the hospital’s board of directors would run the ambulance. Valiton said the northern residents want there to be an elected board and believes there is a state statute requiring that. She said she feels that the election of a board should have been where the process started.

McEnery went over a few parts of the Montana Code stating how the county has interpreted the law and that since the hospital is providing the service, their board will oversee it. Attendee Kyle Graveley said that the issue with that is that there will be no representation from northern Powell County, just representation from the Deer Lodge area. When it was stated the commissioners would be the representatives for the county he further asked about a commissioner sitting on the board.

Mannix said that the tax money does not go out without the consent of the commissioners. When questioned about whether the contract will show where the approximate $250,000 would go, Mannix said the contract would authorize the budget.

“That still doesn’t give us where the money’s going,” said Graveley.

“Well, it’s going to provide the services that we requested,” replied Mannix.

Valiton said she is not sure why the hospital board would be governing the funds coming from the county.

McEnery replied that what the DLMC CEO Tony Pfaff said during the meeting with the commissioners the previous day is that in operation of the ambulance service the levy money is only part of the total funds needed. The hospital is contributing the rest of the funds to operate the service. McEnery noted that as per that discussion it was clear that representation was important to people of the north and the hospital agreed they would welcome such people to address the board or ask questions.

Commissioner Dan Sager said that through the contract the northern residents could request something like $10,000 toward the Lincoln Ambulance Service. He also said the hospital would be accommodating to provide training and supplies to the QRUs. He said they need language to speak to what they are going to ask in the contract.

Valiton said that what the residents want is something that is fair and equitable and one way to do that is by looking at the money contributed by the different areas.

At the suggestion that the approximate $30,000 paid by the precincts including Helmville and Ovando, Mannix replied that he pays school taxes but does not use the school as he has not had school aged children from some time. He said that the ambulance will respond to the north end of the county if they are requested but it will take them a long time to get there and it will not be very often. Hence he said through the contract they are trying to get some assistance to northern Powell County.

Attendee Tressa Graveley said it is confusing because there had not previously been talk about a contract before and asked if there would have been a contract contemplated by the county if residents of the north had not brought issue with the levy.

Mannix replied that they would have had a contract and that no tax money has yet been collected. At the current time the hospital is paying for the operation of the service.

Kyle Graveley asked how the hospital acquired the equipment from the ambulance service to which Mannix said the ambulance service gave it to them.

Attendee Brian Quigley said that he believes it would be within reason to ask the fire districts what they need as the QRUs are operated through the fire districts. Kyle Graveley agreed that the QRUs are operated through the fire districts by state law. Quigley said that it would provide better representation of what the different services in the county and would be better for the commissioners also so they would not have to guess what each needed.

Mannix asked if at this time it would be satisfactory that the ambulance service provides all the QRUs with expendable materials, equipment upgrades and training. Tressa Graveley said it makes more sense that money would go to the districts so the QRUs can put it in their budgets and spend it for what they need. She also said that for some it would be better to train with the Lincoln Ambulance Service as they are the ones with whom some of the QRUs rendezvous.

Heather Quigley said the Elliston QRU already has a contract with St. Peter’s Hospital out of Helena for supplies. Though Elliston has a transporting ambulance, they prefer to give the patient either to St. Peter’s or the Powell County Ambulance Service. She agreed that they would rather funds be given to the fire district so that the ambulance can put it in their budget. Graveley added that they need to make sure that the equipment is compatible with Lincoln Ambulance.

There was some discussion on the boundaries of the Powell County Ambulance. Commissioner Doug Crachy said the administration of the hospital can get to Elliston faster than St. Peter’s Ambulance. It was noted that when the Powell County Ambulance lost volunteers they would no longer respond to Elliston. However, with the new service they will respond and will take patients to Helena if needed.

Bringing the discussion back to the matter at hand, Valiton asked if the contract could be reviewed before it is approved which Mannix said it would be. Valiton said it is hard to put a monetary amount on what the QRU services should receive, but it sounds like the county should go to the fire districts and divide the money as needed.

Mannix said that neither the county nor the hospital considered doling out money to the different fire districts. Instead they are willing to provide supplies and training and make a donation to the Lincoln ambulance.

“We want to make sure that it’s more than just supplies and training because they’re getting that. That part is really fairly inexpensive compared to the operating expenses,” said Valiton.

“We can take that under advisement. I don’t know if that’s going to be something that’s going to be done that way,” said Mannix who said if they write checks to the fire districts in the north they would have to write them across the entire county out of the county-wide levy.

Brian Quigley said that was not where he was going with his earlier suggestion, but instead that the county should listen to the representation from the fire districts. He noted that the districts surrounding Deer Lodge would put the money toward the Powell County Ambulance.

Mannix said they want to listen to the needs of the districts for equipment and supplies but he does not think they will start handing out funds to the fire districts.

“I think its fairer to do an allocated cost where we spend the money how we feel fit for our district, not waiting for the handouts of what the hospital’s willing to give us or not give us,” said attendee Thomas Applegate noting that if the services don’t spend all the money they can keep it for the future.

Mannix said they can talk about the subject, but it probably will not happen. However he said there is open discussion back and forth about what services can be supplied to the services in the north.

“So this is sounding like you guys just want to give the money to the hospital and then the hospital would be the one putting contract money out and that is not how you spend taxpayer’s money. That is a private entity. They should not be in charge of taxpayer’s money,” said Kyle Graveley.

He continued to say that while he understands there is new management of the ambulance service they have never catered to the north before and no guarantee to them that it will change until they see the change.

The question was brought up about contract length and the commissioners asked the attendees what they thought it should be. Brian Quigley strongly recommended a one-year contract and said that he feels that the QRUs will be going before the hospital administration begging for what they need.

“I hope there’s no begging to it. I hope it’s just a mutual understanding,” said Mannix.

“I can see us getting left out. Take it or leave it is what I see,” said Quigley.

Heather Quigley said the administration of the hospital was involved with the levy earlier as they agreed to take on the ambulance service if successful. They should have foreseen some of the issues. She also said that with the two paramedics currently employed by the hospital cannot provide advanced life support around the clock. Mannix said they are planning to hire two more.

Valiton said that to recap the meeting, the residents of the north would first like to see that an ambulance board be created that gives county-wide representation. Secondly they would like to work together for equipment and the fair distribution of funds. Lastly she said that the residents would like to redo the levy vote. She said that she believes a lot of the planning should have been done ahead of time and that it could either have been for the ambulance service area or a better plan for fairness if run county-wide.

Sager said that the ambulance service wanted the levy to be a county-wide vote. Applegate cited a statute about how a levy can be modified if there is a problem. He also questioned if the levy should have been for more in order to completely fund the operation of the ambulance.

In response to a question of why the levy was for the amount it was, Crachy said the ambulance service requested 14 mills specifically. Mannix said that was their projection of what they needed. He also said he believes the administration of the hospital is intelligent and that they would have looked at the numbers before they agreed to take on the service with the passage of the levy.

Tressa Graveley said the resolution was misleading as it stated services would be provided county-wide.

Mannix said there was nothing about county-wide in the resolution except that it is a county-wide tax. He also said that the ambulance service will provide some things to the north end but they would not be giving money to every fire district in the county. Tressa Graveley said that not every fire district has an EMS service and that only those with such a service would be entitled to receive any funds.

Heather Quigley said that Helmville and Ovando will not be serviced by the Powell County Ambulance and supplies and training are not going to cut it. She said that the fire districts should be put in the contract for the areas that will not be serviced and they should get their tax dollars back.

Applegate suggested a breakdown of the use of the Lincoln ambulance in Powell County and the Helmville QRU. He said he could come up with operating cost percentages and will submit that to the commission before the contract is finished.

Sager said that at this point they have been the closest to getting some assistance to the northern areas of the county.

Mannix said that he is personally hurt because he feels that through this issue people have believed he is a bad guy and has lied. He said he has never lied and that when the ambulance service approached the commissioners about the levy vote he urged them to speak with residents in the northern part of the county. He continued that now the commissioners are trying to get the QRU services something although there is nothing in writing entitling them to anything.

“I hope everything can work out great, that everyone can get along great, that whoever’s running emergency services out there is willing to listen to everybody, but we’ve got to give it a try first,” said Mannix.

Applegate said that the residents just want to be informed and represented. Valiton said that this is not a personal issue with the commissioners, but a matter of fairness.