ALS Services in Jeopardy in Washington City

Snohomish -- As of Jan. 1, Fire District No. 4 will no longer offer Advanced Life Support, meaning there will be no one to handle advanced in-the-field treatments for heart attacks, seizures, respiratory problems and other emergencies. The fire department hopes to approach voters with a levy to restore the service.

The loss of advanced paramedic services in Snohomish could put lives needlessly at risk, but without additional income there's no way to continue funding such emergency care, say local fire officials.

As of Jan. 1, Snohomish Fire District No. 4, which serves the city of Snohomish and outlying areas, will no longer offer Advanced Life Support (ALS) medic services. ALS paramedics are skilled in handling advanced in-the-field treatments for heart attacks, seizures, respiratory problems and other acute medical illnesses and injuries.

For the past three years, the Snohomish fire department has contracted with the Monroe Fire Department to provide the ALS medic services. The Monroe Fire Department put one of its paramedics in Snohomish to handle calls in Fire District No. 4.

But the contract has ended, and Monroe won't negotiate a new contract, said Snohomish Fire Chief Mark Collins. Monroe's population has increased to the point it needs the medic back, and Snohomish doesn't have enough funding to cover the cost of hiring a full-time paramedic crew.

Snohomish firefighters and emergency technicians will still provide Basic Life Support (BLS), which includes treating bleeding and some breathing and other medical emergencies. When more advanced treatment is needed, Snohomish crews will immediately take patients to the nearest hospital or rendezvous with an advanced paramedic from another fire district if one is available.

This puts elderly and those with heart problems at a disadvantage for quick treatment, Collins says, as response times for ALS service will go from six minutes to 12 minutes or longer.

"This is like going back 25 to 30 years in service," Collins said. "It's nerve-wracking, because everyone is going to need ALS at least once in their lifetime."

Five times, Snohomish Fire and Rescue has tried unsuccessfully to pass a levy that would cover the costs of the full-time ALS service, most recently in November 2005. ALS has become an expected service, and the department says it doesn't want to lose it. During 2005, the department received 2,400 calls for paramedics, with 742 of those needing advanced life support.

The fire department hopes to approach voters again in April or May with another levy vote to raise about $1.1 million the cost of staffing one ALS paramedic 24 hours a day. To a property owner, the cost per $1,000 of valuation would be about 32 cents, Collins said. That works out to about $64 annually for a $200,000 home.

Valley General Hospital officials say they're equally concerned about the loss of service and are offering $50,000 to help the fire department get a full-time paramedic.

"This certainly is a reduction in the level of service," said Dr. John Bennett, who will become Valley General's emergency-department medical director Jan. 1.

"The community wouldn't notice any difference if there were no heart attacks," he said. "But if there are, then the service provided could be vastly different."

Valley General CEO Mark Judy said he hopes the community will step up and match the funding the hospital is providing, and he expects the fire department to get a levy approved by the voters.

"You can't just take $50,000 and put that toward operating costs, because it won't go very far and doesn't solve the problem," Judy said. "Instead, it's to be used to start a snowball effect where maybe the city, county and others step up to help as well."

The fire district, which already is holding public meetings to alert the community to the medic changes, hopes to educate the public enough to pass a levy vote. In the past, the department says it didn't do enough to explain what residents would miss without the advanced service.

"I never wanted to sound like I was threatening people," Collins said, "but we recently did a poll and people do want to know that information, and we have to be the ones to tell them."

If a levy passes, money would begin being collected in 2008, but fire officials say they'll start the service up by the fall with reserve funds. The district would be without ALS service for at least six months, but it would use the reserve money to pay for ALS service the remainder of 2007, and then tax money would come in beginning in 2008 to keep it going.

Christopher Schwarzen: 425-783-0577.

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