In reponse to the letter to the editor by Robert Vargas and published in the Westside Connect newspapers on Dec. 23, I believe there are some points that need to be addressed.
Vargas’ (2021) letter to the editor, he states “The history of Emergency Medical Services was formalized in about 1980, before this time many small towns like Newman were left with uncertainty about emergency medical care (https://emsa.ca.gov/about_emsa). This included no formal regulations and therefore no guarantee of ambulance coverage. Because of this uncertainty, Westside Community Hospital District was successful in obtaining support from local fire, police and city officials, therefore a parcel tax was established to supplement the operation cost of ambulance services, which was approved by a voter measure.”
This original tax was done in 1985 for the hospital. The hospital closed in 1994 due to lack of funding however the ambulance service was able to operate. No such infrastructure was set up to accommodate future prices and wages. The District has since filled bankruptcy, employees froze wages for four years and they have taken a pay cut in the past. Unfortunately, we continue to try and provide a 2021 service using 1985 income. In 1985, California Minimum wage was $3.00 per hour. An average house cost $80,000. Today minimum wage is at $15 per hour with the average home costing $250,000-$300,000+.
In Vargas’ letter he says Emergency Medical Services “are heavily regulated and every community in the state of California is guaranteed provider coverage. Many communities that are similar in demographics to Newman receive these services without a parcel tax to supplement ambulance services.”
Not funding a local EMS provider would require another ambulance company to provide the service. The wait time for the contracted ambulance provider into the local communities would be significantly past the current response times. Wait times could be anywhere from 25 minutes to an hour for an ambulance to arrive on scene.
The initial measure in 1985 was sought after due to people living in the West Side District constantly waiting 25 minutes plus for an ambulance. The funds collected in 1985 were intended to staff one full-time ambulance paying 1985 salaries, not to staff the desperately needed two ambulances and paying 2021 expenses and wages.
West Side Community Healthcare District is asking for each parcel to pay $92 a year. That’s only $7.67 a month to continue to staff the two full-time units. They are staffed 24/7, 365 days a year. West Side and Newman Fire agreement is held to the 8:59 standardresponse time.
West Side must arrive on scene in less then 8 minutes 90% of the time. Mountain Valley Emergency Medical Service Agency (MVEMSA) calculates the percentage after a total of 250 calls or 12 months to calcite total fines and penalties. However, West Side Management watches these times daily and weekly. This compliance assures West Side is providing consistent, fast responses. This is a significant improvement from 2017 when West Side had fallen to as low as 77% due to past management, insubordinate staff and lack of leadership. West Side current compliance reflects a huge increase. West Side is preforming at well above 90% consistent.
Vargas’ letter says “….the local regulator agency is Mountain Valley Emergency Medical Services Agency. This agency maintains the ambulance contracts for Stanislaus County.”
Mountain Valley will be leaving Stanislaus County and a new Local Emergency Medical Services Agency (LEMSA) will be named. That being said, without West Side Community Healthcare District, the new LEMSA will open the District’s areas in Stanislaus County up for a contract for service. The call volume in West Stanislaus does not support a full-time dedicated car in Newman, so this will be a continuous post for the awarded agency. This post will unfortunately be seldom filled due to the geographical location and travel time.
Most recently, Hughson lost their local ambulance provider. The citizens now constantly wait for a transport unit to respond from Ceres, Modesto, Oakdale, Waterford, Turlock and sometimes, even Newman.
West Side Ambulance was currently forced to down one unit for 10 days in September and eight days in October. The compliance report shows the importance of staffing two full-time units. In fact, the best numbers throughout the year, reflect when a third unit was staffed for only half the week for 12 hours a day. This showed we will need to look at staffing a third ambulance in the future.
Vargas’ letter says “All local areas have a similar regulatory agency. The contracts for ambulance services spell out the response time requirements for ambulance services in each community.”
Without West Side, other agencies will have to provide the service to our citizens. This will not be their priority and response times will sadly extend to far past 25 minutes. This means fire and law neforcement will be required to remain on scene for an unknown extended time waiting for an ambulance. This will also impact other local public services.
Vargas’ letter claims that “Newman will always have emergency medical coverage and the regulatory agency understands the importance of this service, so much, that there are some redundancies in the response matrix.”
I would ask where the redundancy would be? Fire can not transport. Local Fire is not consistent with Emergency Medical Technician staffing nor do they have Paramedics. With out the local Ambulance provider, the next Ambulance provider available (consistently staffed with an EMT and/or Paramedic) is 20 minutes, 30 minutes, 40 minutes, or over an hour away.
Vargas’ letter says “each community will have emergency medical coverage. The way this system works is the local government agencies, most often fire departments, alos respond to emrgency medical calls. Most fire departments have emergency medical technicians and some have paramedics. The determination of service level is based on the community’s support. So, if you dial 911 in the Newman area you will get locally available emergency medical technicians or emergency first responders that have specialized training to assist with medical emergencies. Most fire department responses for emergency medical calls are also governed by local emergency services regulations.”
In review of this, Newman does not have an Emergency Medical Technician responding to every call. They are only at the EMR level. When it comes to the skills, training and equipment differences, an EMT is far less equipped, trained, skilled and experienced then a Paramedic. The EMR has even less training, skills and equipment. Nothing against EMR’s or EMT’s. They are our extra hands and a huge support for the Paramedic. But they are the support. Not the lead.
Vargas says that in “the Newman area, the local agency Mountain Valley Emergency Medical Services Agency has established that the fire department must be on-scene of a medical call within seven minutes of dispatch and must have at least one specialized medical responder. This means that in Newman if no ambulances were available the fire department would be at the scene of a medical emergency in no more than seven minutes 90 percent of the time or face reprimand. You will not be left without emergency lifesaving services, which differs from what was stated by the local ambulance service.”
However, Fire departments also respond to other calls for service. While fighting a grass fire, house fire, haz mat spill, structure check, fire alarm, or providing mutual aid to other areas, the personnel needed for a medical emergency would not be available.
Vargas’ letter states “Local fire departments carry specialized emergency medical care devices including automatic external defibrillators, Epinephrine, Glucose, Narcan, specialized airway devices, glucometers, aspirin, oxygen, Lucus mechanical compression devices, pulse oximetry devices and more. You can visit your local fire department and see all the wonderful life-saving devices they carry.”
With the newly added expanded scope of the Emergency Medical Technician (EMT), additional skills have been implemented. However, local fire departments cannot guarantee an EMT 100% of the time. They are at the EMR level. Without the EMT, the additional treatments and skills stated can not be utilized. Excluding the automatic external defibrillator.
Also, the Paramedic has a greater scope allowing the use of far more medications, treatments and skills. Paramedics also have several additional tools which help to stabilize and identify more cardiac, respiratory and traumatic issues. With the higher level of training , skills and equipment, this gives the patient the best chance for survival and gets them to the most appropriate facility for definitive care. This has been proven to save more lives, especially with a minimum transport time of 30 minutes.
Vargas said “As a community, we are being deceived into believing that without paying a parcel tax there will be no ambulance or emergency medical services in the Newman area. This is not true and as a community you can receive the same ambulance service with no parcel tax. Don’t allow yourself to be fooled by the local ambulance service. Reach out to experts in your community that know the truth.”
At no point has any deception been presented. Transparency and facts is what has been shown to our citizens. With the temporary downing of 1 unit during September 21’ and October 21’ due to short staffing, we show the district can not meet the the needs of the public. (See compliance report listed above)
In 2018, West Side had Fallen below the 90% compliance three times and was given a letter of major breach from Mountain Valley EMSA. Their intent was to revoke our license which would shut down our District. In October 2018 a new board was elected and Mountain Valley began the process of revoking West Side’s license to operate in Stanislaus County. In September 2019, West Side brought management back to West Side with an appointment of an interim Chief of Ambulance operations. The new and current Chief of Administration was appointed December 2019, with the interim Chief staying on as the Part-Time Assistant Chief.
In the past three years since the letter of major breech, this District has undergone new management, new elected Board members and a positive turnover of employees, with employee moral at the highest it’s been for over a decade. West Side has shown that this District is here for one reason; to provide the best public service to the citizens as it can. “Care, is what we give.”
If West Side is not able to staff two ambulances full time (at the bare minimum) West Side will not make the 90% compliance and start the breach of contract process again. This will lead the definitive closure that was avoided in 2018. Period.
Mr. Vargas, I respect your opinion and understand the frustration and animosity you may have against our district. In my opinion, the letter you submitted to the editor appears to be strictly emotionally driven. I would encourage all who read this to really focus on Mr. Vargas’ last statement and “Reach out to the experts in your community that know the truth.” The truth about providing the best quality Emergency Medical Service (EMS) that is being delivered now. Please speak to your local Fire and Police Departments. Then give West Side the opportunity to answer all your questions.
I welcome any dialogue that Mr. Vargas or anyone else has on this issue.