DEER LODGE - The Powell County Commissioners and representative of the Deer Lodge Medical Center have taken another step toward finalizing a contract for the Powell County Ambulance Service, which will now be known as Powell Emergency Medical Services, LLC.
Although the discussion was not listed on the commissioners’ agenda and took place during one of the items entitled “usual and regular business,” the group reviewed a draft contract between the government and the privately owned hospital which would provide the latter with approximately $280,000 worth of tax money annually to assist in the operation of the ambulance service.
Last year the voters of Powell County agreed to a 14-mill permanent levy county-wide which would help fund the Powell County Ambulance Service as it was short on volunteers and call volume to the state prison had decreased as well as the amount of reimbursements. The precincts of Avon, Helmville and Ovando voted against it. At the time it was noted the Deer Lodge Medical Center (DLMC) would take over the service and contribute to funding it as well.
In recent months, residents in the northern part of Powell County have held two citizen-initiated meetings where they asked many questions about the levy and had concerns about its legality and what service they would receive in exchange for their tax money. The county commissioners have been working with DLMC to draft a contract and recently residents and first responders in the northern reaches of the county told the commissioners they would like their tax dollars to fund the QRU and ambulance services that serve them, rather than accept training and supplies as part of the deal.
The commissioners remained reluctant to that suggestion and did not want to provide money from the levy to any fire district, despite people pointing out that the QRUs must be operated through a fire district
At the start of the Nov. 5 meeting last week in regard to moving the contract forward, the only public present was the Editor-in-Chief of the Silver State Post. Commissioner Rem Mannix began by asking how the contract was coming and County Attorney Kathryn McEnery provided the commissioners with a copy of the draft contract. She said she put it together based on previous discussions, noting that she also wanted to share it with Sheriff Gavin Roselles who was present.
DLMC CEO Tony Pfaff said for the most part the contract is fine with the hospital. He said that he spoke with the hospital’s board and they would be alright with carving out the north end of the county and giving them back their taxes for them to give to what entity they want.
“I don’t know if we could even do that at this point,” said Mannix, “Personally I would like to see the hospital just go with a MOA or something with Lincoln [Ambulance Service] and then provide them with $10,000, $15,000 or something and provide training and supplies and stuff to all the QRU [Quick Response Unit] units.”
McEnery said that there had been a plan which was the basis for the levy to go forward with and have a contract for one ambulance service. She said there are still questions about the different use/needs in the northern part of the county. She suggested that in the first year of the contract they can hopefully answer those questions.
Pfaff said that he does not see the hospital making the north end of the county happy and does not want to be the focus of their ire. There was agreement from the commissioners and they rhetorically asked how it would be possible to cut out the north part of the county and distribute tax money equitably.
“Then how are you going to divide Helmville and Ovando out? Ovando’s paying a little bit more than Helmville, but Helmville has the QRU and Ovando doesn’t, I believe. So you do that and then you start giving it to the fire districts and then every other fire district, Avon and Elliston and everyone else will be saying we want our part of the pot too, so then pretty soon Racetrack, everyone’s going to want their money that they paid in,” said Commissioner Dan Sager, “I’m not comfortable with turning $30,000 over to the Helmville, Ovando fire department to use for whatever they feel the need for and that’s pretty much what they want.”
Sheriff Roselles said that his office was able to draw up some statistics and that there is a shared area between Lincoln Ambulance and the Seeley Lake service in the region of Ovando. The numbers and projected numbers were reviewed and Roselles noted that on some calls the Helmville QRU will arrive first and then they summoned the Lincoln Ambulance so some of the responses are counted for both entities. He clarified that Helmville, not Ovando, has a QRU, though there are some members of the Ovando Fire Department that help with the QRU.
There was some question on the service area of Ovando and Helmville and whether that would be based upon the fire district boundaries or the voting district. Roselles believed that it would be probably the fire district. Mannix believed it should be decided whether it would be based on the voting districts or commissioner districts and in the past the Powell County Ambulance has responded as far down Highway 141 as the Nevada Creek Dam.
McEnery said that it is a very rough ballpark number to say that the Helmville and Ovando area use 10 percent of the ambulance calls and it is more likely around six percent. She questioned whether an allocation should be made based upon dollar figures or upon use or need for services.
Upon questions from Mannix, she said that so far this year there have been 17 calls for Lincoln Ambulance into Powell County and over 400 calls for the use of the Powell County Ambulance. The group also talked about how calls in which the ambulance does not transport a patient cannot be reimbursed. Roselles said that at times, the Helmville QRU calls for Life Flight and the Lincoln Ambulance does not respond.
“If we’re going to do it all, do you really need to allocate, unless you’re going to break it up?” asked Pfaff.
Mannix said they are not allocating $30,000 right now to anywhere and cited the hospital will get the entire levy for the ambulance service.
“It doesn’t necessarily have to be that amount of money going up there because anyone that’s up there and coming this way or whatever and gets in an accident, they’re going to want the ambulance service,” said Mannix.
Pfaff suggested that talks be started with Lincoln Ambulance and Sager said that Lincoln Ambulance has not gotten anything from Powell County so he thinks they would be happy for some compensation to which Commissioner Doug Crachy agreed. Pfaff said he didn’t think that would be an issue.
McEnery questioned whether the agreement would continue the response of Lincoln Ambulance to the Ovando area which was confirmed. Sager said that St. Peter’s Hospital in Helena responds to Elliston, but the ambulance at the hospital in Deer Lodge could get there just as fast.
Mannix clarified that there would be no changes to the way things are done but the contract would commit a donation to the Lincoln Ambulance for their service to Powell County calls.
Roselles said that the group should also keep in mind the Seeley Lake Ambulance as they respond as far as Ovando as well.
In regard to supplies, Crachy noted that a representative from Avon ambulance said that the defibrillator pads used by St. Peter’s Hospital are different than those used by the Powell County Ambulance Service. Pfaff said that could potentially be corrected. It was later noted it was the leads that would be different and Mannix said it probably would not be hard for DLMC to order in whatever supplies they need.
Sager said that the first year of the contract will be a work in progress to which Mannix agreed and that money and training will probably have to be adjusted as time goes on. Pfaff said that he would like the contract to continue on further than a year to which the commissioners agreed it would be a long-term relationship and at the one-year point both entities may want to make some modifications. Pfaff agreed and said that regardless of the length of the contract there should be an annual review.
McEnery questioned what reporting information would be supplied to the commissioners and mentioned quality improvement. Pfaff said that quality stuff such as quality assurance could not be provided, but he could provide statistical numbers such as response times, type of call and other figures.
Sager asked Pfaff if the number of transports via Life Flight have been down since the ambulance is now operated out of the hospital and he said it seems to be. Sager added this agreement has the potential to be a good deal and Pfaff went over how and why the doctor in charge of the ambulance will be changing soon.
It was also noted that financials would be provided to the commission twice a year and while the commissioners would not approve the budget for the ambulance, they would be provided with it for their review. Mannix later clarified that the county would like the budget just for the ambulance and not for the entire medical center.
In regard to training, Pfaff said that all QRU entities in the county will be invited to all trainings. In response to a question by Mannix, Pfaff said that a training could take place in the northern end of the county if there is a group of responders in attendance.
As for the commissioners or the public attending hospital board meetings regarding the ambulance, Pfaff said it is likely the topic will be discussed in some form each meeting. He said that ambulance board would likely meet quarterly, which would be open to the public, while the regular hospital board meetings are not. Mannix reaffirmed that the ambulance board meetings would need to be open to the public and properly posted. Pfaff agreed that open meeting laws would be followed.
Various other parts of the agreement were discussed a little bit including that the hospital will contract for billing and there are now 25 paid EMTs. The sheriff’s department is pleased with the ambulance service and once the contract is all done Pfaff will meet with the county QRUs to see what they need.
Ovando resident Leigh Ann Valiton, who helped organize the citizen-initiated meetings in Ovando and Helmville regarding the levy, was contacted by the Seeley Swan Pathfinder following the meeting. She responded via email, “We weren’t aware of any scheduled discussion about the levy according to the posted online agenda so we will wait for the article to find out what happened.”
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