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HomeMy WebLinkAbout09/18/2008 Adjourned Meeting / Study Session 295 YAKIMA CITY COUNCIL ADJOURNED MEETING - STUDY SESSION SEPTEMBER 18, 2008 - 8:00 - 9:30 A.M. COUNCIL CHAMBERS - YAKIMA CITY HALL 1. RoII CaII Present: Council: Mayor Dave Edler, presiding, Assistant Mayor Micah Cawley, Council Members Kathy Coffey, Rick Ensey, Norm Johnson, Bill Lover and Neil McClure Staff: City Manager Zais, Fire Chief Hines, Assistant City Attorney Martinez, and City Clerk Moore 2. Emergency Medical Services Levy Chief Hines gave a refresher on the EMS objectives that were discussed at the 7/22/08 public hearing and cleared up inaccurate information that was out in the public. Objectives: • Maximize ability to respond to ALL emergency 911 for help • Implement faster response times • Deliver a paramedic to the patient faster • Establish a team of two paramedics on every call • Lower fire insurance premiums Clarification • Private ambulance services will continue to transport all patients. The Fire Department will not transport patients. • The goal is to hire twelve firefighters and one dispatcher only. Council Member Cawley asked if the addition of twelve firefighters would alleviate concerns for having uncovered areas around the city. Chief Hines responded yes, that they will be able to put two additional engine companies in service, which will increase coverage. Council Member McClure emphasized that there will be an additional paramedic on scene, firefighters do not support transporting patient, and that we are not in competition with the ambulance companies, but in partnership with them. Council Member Lover asked if we had any firefighters trained at the intermediate level and wouldn't that satisfy the need? Chief Hines responded that the intermediate level is limited in their scope of practice. They are only licensed for six drugs and are not trained to do certain procedures. The intermediate level was designed for rural areas with volunteer fire departments. It allows them to start an IV, and administer six safe drugs (harmless if misdiagnosed). He compared it to giving a police officer a gun with only one bullet. It's better than nothing, but short of what they want to provide. They • 2 9 '6 ADJOURNED MEETING — EMS STUDY SESSION SEPTEMBER 18, 2008 want to deliver the highest medical care that everyone else in the state receives. For comparison purposes: • EMT - 100 hours of training and can do nothing invasive • ILS - 200 hours and can start an IV, create an airway and administer 6 safe drugs • Paramedic — 2,000 hours of training; can perform a procedure to open an obstructed airway, pace the heart, administer numerous drugs, interpret EKGs, etc. A common question is why does the fire department show up to medical emergencies? Chief Hines explained that the fire stations are strategically located for a 4 -5 minute response time everywhere within the city. They have fire staff trained for medical emergencies. The closest fire engine responds and is able to start treatment. It is about 50/50 as to who gets there first, an ambulance or the fire department. When there is a critical patient, there needs to be more than one EMT and one paramedic. Council Member Ensey said he has heard that, although the ambulances currently have only one paramedic, they are willing to add a second one. Why not accept that offer, cut down the amount of the levy using it to just hire more firefighters. Chief Hines referred to the five objectives. Two paramedics on scene is not the only issue and it wouldn't help with getting more resources to the scene faster. In addition, it has been a challenge for the ambulance companies to have even one paramedic on their ambulance with 62% turnover rates. Initially he would like to hire 10 -12 firefighter /paramedics that are already certified. In addition, it is a minimal cost to have a certified paramedic; the state average is about $3 an hour. A private paramedic on an ambulance is about $12 an hour. With a fire /paramedic, we have someone who can do all the tasks for the extra $3. Chief Hines said the paramedic program would be phased in. They would start by hiring 10 -12 paramedics, giving us three engine companies. They would then add more over time. There will be benchmarks and evaluations throughout the process. Council Member Lover raised the issue of Seattle Medic 1 and King County Medic 1 saying he sees this as moving toward the level of Seattle but he prefers King County's model. Chief Hines responded that King County is supported by an EMS levy and is what they are trying to mirror. They are going to have private paramedics and city paramedics. We can't afford to have two on the trucks, but want a public /private combination. Council Member McClure stated that we are not going the way of Seattle. We are really adding 12 firefighters to improve response time. The levy is really about hiring firefighters to lower our response time and then be able to use a small percentage of the money to train our personnel for better service our citizens. Mayor Edler reminded Council that the question brought forward by the Public Safety Committee was whether it was to be a permanent levy or not. Chief Hines pointed out that there has been a 62% increase in service volume and they are currently unable to respond to every call for help. There are times when there are no resources available and that is not acceptable. Their ability to respond is not a 2 297 ADJOURNED MEETING '`EMS STUDY SESSION SEPTEMBER 18, 2008 limited -term problem. It requires a permanent solution. Call volume will mirror the population. A limited levy, with a sunset expiring concurrently with the County, presents challenges. There would be public confusion including a perception of competing with the County EMS levy. That will jeopardize passing either of the levies. There is also a problem with the timeline; full implementation won't happen until well into 2011. Voters will be asked to vote on the levy again before they even realize the full benefit. In addition, a limited levy creates recruiting problems. It is going to be very difficult when good candidates are told we can only guarantee their employment for one year. City Manager Zais stated his support of the permanent levy with respect to the limitations in the statute. When the issue was first looked at, the assumption was there would be options of a six or ten -year levy. Research has shown that is not the case, yet it has been difficult to explain why. We are trying to give clarity on the sunset issue. It either has to be a permanent levy or it is limited to the time left on the County's levy, in this case, three years if it is passed in February. We are limited to a choice of two ballot propositions; one being permanent and one expiring in 2012. Council Member Ensey suggested waiting three years and combining with the County for a ten -year levy. Chief Hines re- emphasized that the need is immediate. We are unable to respond to every 911 call now. We would not only have to wait the additional three years, but also another year before the funds are actually available. That would be four years from now before we could increase service. By request, Assistant City Attorney Martinez clarified the process that could be taken if voters became unhappy with a permanent levy. A citizen could petition for a referendum at any time. The Council would also have a choice to pass an ordinance lowering the amount collected or deciding we would no longer collect money. Council Member Coffey clarified that a permanent levy is not really permanent then, but could be eliminated; she noted the importance of having that option for future City Councils. It was clarified that, because it is a property value tax, it is capped at a growth of 1%. Even if property values go up 25 %, the EMS part is still capped with the 1% growth. Council Member Johnson asked if overtime costs will diminish with the increased staffing. Chief Hines explained that their minimum duty staffing is 19 people. They have a staff of 24 for scheduling and to cover vacations, sick time, etc. He said that 95% of overtime is non discretionary, but is due to sick /vacation /holiday coverage. 3. Audience comments Eugene O'Dell, Advanced Life Systems, said his company supports hiring more firefighters, but is concerned about having paramedics on the fire trucks. He suggested addressing response times with a tiered response system. Rather than going out on all calls, have Emergency Medical Dispatch source the calls. He spoke about having two paramedics on their ambulances in the past, but now there is a national shortage of paramedics. It was his opinion that the shortage could be 3 29 ADJOURNED MEETING — EMS STUDY SESSION SEPTEMBER 18, 2008 mitigated if the overseas conflicts could be settled. He pointed out that there are also ongoing costs associated with having paramedics, e.g. equipment and continuing education. Peter South, a paramedic, referenced new research he had seen that claimed patients had better outcomes when there were fewer paramedics on the scene. Although there were no conclusions drawn due to limited data, the dilution of skills was considered one of the reasons. A dilution of skills occurs when a person does not get to exercise their critical skills on a frequent basis. He suggested that instead of putting a paramedic on every fire truck, private companies could have a seasoned paramedic on call to assist at calls. He also suggested the ambulance companies, as well as Yakima County and City Fire, have access to GPS beacon information to enable better management of resources. Mayor Edler suggested he take that idea to the EMS Board. Jerry Davis, Fire Chief for the City of Selah- County District 2, said he was neither for nor against the City levy, but hoped there was good public education to avoid confusion with the County EMS levy when it comes up for a vote. Randy Raschko, President of the Yakima Firefighters Union, emphasized that there are two big components; one being fire suppression. The levy will give them the personnel to fight fires. Every EMS call they go on is a potential life- threatening emergency and raising the standard of care is a good thing. This is a model that is used throughout the United States and throughout the world. He urged the Council to support the proposed amount and the duration. Mayor Edler closed the public comment period. City Manager Zais advised the proposition language needed some fine tuning to clarify that the City Council has the authority to levy up to $0.25. He suggested changing the wording to "up to $0.25 per thousand" and eliminate "or less" to avoid redundancy. COFFEY MOVED AND McCLURE SECONDED TO CHANGE THE LANGUAGE TO "UP TO..." AND FOR STAFF TO PREPARE LEGISLATION TO PUT OPTION "A" ON THE BALLOT. After final Council comments, City Manager Zais advised that there will be a significant cost for a special election ballot, estimated at $40- 45,000, that will need to be included in the 2009 budget. The motion carried by a 5 -2 roll call vote; Ensey and Lover voting nay. 4. Adjournment CAWLEY MOVED AND McCLURE SECONDED TO ADJOURN TO SEPTEMBER 30, 2008 AT 8:00 A.M. IN COUNCIL CHAMBERS FOR A STUDY SESSION REGARDING THE YAKIMA POLICE ATHLETIC LEAGUE. The motion carried by unanimous voice vote. The meeting adjourned at 9:12 a.m. 4