PROVO, Utah – A bureaucratic restructuring years in the making, and one that may still take years to finalize, has at its core a simple request.
“The expectation for an ambulance to come when you call, and to come in a reasonable amount of time, is exactly the same on both sides (of the county),” said Francis Mayor Byron Ames last fall in a meeting of Summit County councilors and East Side mayors.
It was one of the first public airings of a request that officials said has been in the works for years: for East Side communities to operate their own emergency services.
East Side officials have publicly expressed a desire to return to a system where local community members volunteer as first responders and respond to calls from their homes. They say it would provide better service than the one operated by the Park City Fire District, which includes round-the-clock ambulance crews in North Summit and South Summit, staffed by part-time responders who often aren’t from the area.
The Fire District and county officials say the time for a homegrown service has passed, with liability laws and certification requirements ending the days of volunteer departments, and that, though they’ve tried, they’ve had trouble recruiting East Side residents.
The Fire District pays the part-time first responders in North Summit and South Summit about $13 per hour and caps their hours to avoid having to pay health insurance benefits, according to a report county staffers presented on the subject in January.
That’s led to staffing troubles, officials said.
“The hours and pay are not quite enough for EMS to serve as an individual’s only job, but too much to do in conjunction with another job,” the report states.
Often, officials said, the Fire District is hiring freshly certified emergency medical technicians to work in North Summit or South Summit who stay until they can get a better paying job with another district, often in the Salt Lake Valley where they live.
“We don’t need to be somebody’s training ground,” said County Councilor Doug Clyde last fall.
At the Council of Governments meeting last September, newly hired North Summit Fire District Chief Ian Nelson presented an idea for his district to take over services for the entire East Side.
In the report he submitted, he said that the Park City Fire District’s policies had driven many locals from the service.
“Responders are no longer allowed to respond from home. They are required to work a minimum of 48 hours a month and they must be at the station during those hours,” Nelson wrote. “… With the local responders all quitting due to these changes it has left no option other than to hire from outside the county.”
The Park City Fire District and county officials say moving to a 24/7 response model where ambulance staff is responding from the station has provided improved service and reduced response times.
Nelson’s report was short on specifics, and he was working on a more detailed proposal to bring to the County Council, according to minutes from a November fire district meeting.
Moving to full-time service like that in Park City would require a massive budget increase.
The county subsidizes East Side ambulance services with about $450,000 annually, the county report states. It would have to increase that subsidy by about $3 million annually to provide the five fully staffed ambulances that are operated in Park City.
County and Park City officials said the number of calls doesn’t yet warrant making that move.
The North Summit and South Summit districts receive 10 times fewer calls than Park City annually. The county’s report also indicates that North Summit and South Summit ambulance response times are on par with other rural districts, saying that there are no “glaring gaps in performance or inequities in service level across the County.”
County data shows that Park City ambulances arrive on scene about 9 1/2 minutes after being dispatched, while that number is 13 minutes in South Summit and 13 1/2 minutes in North Summit.
East Side crews are often traveling farther to a call, as well. The service area on the East Side is 1,162 square miles, compared to 104 square miles in the Park City district.
The two ambulances operating on the East Side — one in Kamas and one in Coalville — have two-person crews, which PCFD Chief Paul Hewitt said is the most efficient way to run the operation. But South Summit Fire District Chief Scott Anderson said that’s left his firefighters to pick up the slack and in effect staff the third member of the crew, doing so without compensation.
“You might say we’re frustrated with the current system,” Anderson said in a recent interview. He said the district has increased its staffing to account for the increased need to support the ambulance services.
Tom Fisher, who as the county manager is ultimately responsible for ensuring services are provided, said the county is open to changing how ambulance services are offered, and to possibly continuing to subsidize the programs on the East Side under a new arrangement, but that the North Summit and South Summit fire districts are not necessarily prepared to take over the operation.
“Money is part of the issue but it really isn’t the major part of the issue,” Fisher said in a recent interview.
He said that the North Summit Fire District lacks the staffing structure to support such an expansion, and that the chief has a full-time job in the Salt Lake Valley. Nelson was hired to head the district part time last July.
The Park City Fire District relies on its full-time staffers to administer ambulance services across the county, including providing human resources, billing and payroll support, as well as the myriad other tasks required to operate a fleet of machines and employ dozens of employees in a high-risk atmosphere.
Anderson said that taking over ambulance services in South Summit would likely entail a tax increase and a significantly increased budget. Multiple East Side mayors have suggested polling residents to see what level of service they’d like to see and whether they’d be willing to increase taxes to pay for it.
Nelson’s proposal advocates a return to a volunteer-based model, where EMTs wear pagers and respond in their personal vehicles to the station before heading out to a call, the same way the service was provided for years.
“The volunteers were residents of the communities they served and that had huge advantages. They knew the area, they had decades of experience and it provided them a way to serve their communities. The ambulances were staffed with three crew members to provide better patient care and manpower. There were more ambulances and more responders,” Nelson’s report states.
Officials have said that setup benefitted both the patient and the care provider and deepened connections in the local community.
But Hewitt said those days are largely gone, the victim of liability laws and increased requirements for training and certifications.
“When someone’s not breathing and details of that call comes in and makes them drive that Nissan 100 mph down that county road, it doesn’t take a lot of imagination to see that can be a disaster,” Hewitt said earlier this year.