Big Sur, CA Keeps Ambulance; Westmed Future in Doubt

Feb. 28--Big Sur's full ambulance service stays, paramedics and emergency medical technicians probably won't have to take pay cuts, and ambulance services won't be cut back. And Monterey County is picking up the tab, for now.

But county officials also want a complete overhaul of its emergency response system, and could have a new ambulance contract and provider in place by next year.

Supervisors on Tuesday decided to pay Westmed Ambulance Inc. $150,000 to keep a fully staffed ambulance in Big Sur for a year after a community outcry against a plan to alter the service.

And they told county Health Director Len Foster to report back within a month on what kind of county subsidy would be needed to keep Westmed's anticipated employee and ambulance cutbacks at bay until long-term changes can be made.

"We want to keep status quo," Supervisor Lou Calcagno said, adding that he wants to keep ambulance services and employees "whole" while the county develops a new system. "We don't want the employees to be disgruntled."

Supervisors also directed Foster to report back within three months on plans to develop a new request for proposals for a new ambulance service. An emergency medical service task force will look at ways to develop and pay for the new ambulance system, as well as alternative forms of governance, such as the formation of a joint powers authority, a nonprofit provider, or a public-private partnership model.

A request for proposals for the new system would be sent out by January, if all goes according to plan. Westmed officials have already indicated they would welcome a new request for proposals. Westmed is working on the second year of a five-year contract after replacing American Medical Response in January 2006.

Calcagno said he wants to make sure the new system and proposal requests are completed as soon as possible.

Jan. 1 "is about as far as we want to go," he said. "I don't particularly think the board wants to sit around talking about ambulance service for the next two years."

Also Wednesday, supervisors approved a series of proposed changes to its current ambulance services contract, with the notable exception of cutting the full-time Big Sur ambulance. The proposal to cut Big Sur service was aimed at allowing Westmed to restore its bottom line.

The changes include an increase in response time requirements in some rural areas in South County, North County and surrounding Salinas.

After reporting losses of more than $2 million during its first year in the county, Westmed officials had asked the county for permission to make the changes even after the county offered up to $1 million in financial assistance.

Westmed officials said those changes, in conjunction with staffing and pay cuts, would help the company save $1.4 million this year and stay afloat. They told county officials they'd have to leave the county if the changes weren't approved.

The supervisors' plans appeared to mollify most in a packed gallery attending to express their displeasure.

Big Sur residents, including the community's volunteer fire brigade, originally denounced plans to replace a full-service ambulance with a quick response vehicle, staffed by a single paramedic and unable to transport the seriously ill or injured. But they quickly changed their tune once they heard the supervisors' plans and began offering improvement suggestions for the new system.

Paramedics, emergency medical technicians and other Westmed employees, already engaged in contentious contract negotiations with the company, reacted angrily to Westmed's proposed cutbacks, including the increased response times and eliminating the Big Sur ambulance, which would involve laying off paramedics. Last week, they picketed the company's Salinas headquarters, saying the proposed cutbacks would put patients in danger.

At least 40 turned out at Wednesday's meeting, including union representatives Jeremy Lyon and Andrew McLaughlin, but abandoned their protest when they reportedly got word of the supervisors' remediation plans before the board returned from closed session.

Still, Soledad's interim fire chief, Steve Negro, panned Foster's description of the increased response times as "slightly changed."

"I guess I wonder if a slight change in response times means someone will end up slightly dead," Negro said.

One speaker blasted county officials for getting into the contract with Westmed to begin with, and urged supervisors to cut ties with the company.

Supervisor Jerry Smith said ambulance service has been an issue in the county for decades, and can't be blamed solely on current county officials or Westmed.

"This is not a problem that just came up today," Smith said.

Foster said he accepts full responsibility for the botched request-for-proposal process that brought in Westmed in 2005, adding that he believes county officials are "committed to doing things right this time."

"I just hope I know what 'right' means because it tends to change."

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What's Next 30 days: Supervisors to review subsidy proposal for Westmed to offset employee pay and ambulance cutbacks. 90 days: Supervisors to look at plan for establishing a new ambulance system. Dec. 31: New ambulance system and request for proposals to be complete. January 2008: Request for proposal to be sent out for new ambulance system.

Jim Johnson can be reached at 753-6753.

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