Emergency Medical Service District 2 Board Meeting

0:00 webinar is being recorded and summarized dean thornberry here myrna france eric overholzer present chair marshall and i'll keep checking for councillor belcott um i i apologize for any interruption but we cannot hear the i cannot hear the chair's audio yeah it's got no audio i have no audio either

0:56 can you hear me okay yeah can you hear me um right now no oh can you hear me now i think it just needed to be turned up or on all right great so uh let's uh move on to the consent agenda so we have the approval of minutes from july 13th 2026 and approval of warrants for 2026 second quarter uh are there is there a motion to approve or did you have any questions okay moved and seconded all those in favor say aye aye thank you motion carries then moving on to separate business our first item is approval of

1:51 ambulance rate rates for 2027 and chief knorr i believe you're kicking this one off hello my name is john norman fire chief clark counts fire rescue and uh ccfr is one of the three fire service agencies served by uh the amr contract with ems district 2. for 2027 amr has requested a 10 increase in the rate for transports they are allowed to do so by contract they cited the 4.4 cpi plus an approximately 13 rise in costs for their other associated rates like labor fuel all the things that we tend to notice going up right now so the ems advisory

2:48 board met discussed these reviewed uh information from amr we gave them back some questions to clarify a few items they sent us clarifying uh information and the board is recommending that the full board adopt the 10 rate increase okay thank you are there any questions from the board comments chair i have a question on this uh 60. you don't need to delete your finger there's a 60.7 increase in auto insurance and i just wondered if that i know um insurance raised us on all of us but was there more vehicles added that it made it up go up sixty percent over sixty percent uh that i don't know uh that that would be a good question i don't know uh that that was information was provided by amr um i can say that uh we've seen

3:48 across the board in the public sector some pretty significant rises in insurance costs uh i would imagine that amr has seen the same types of things uh rocco from amr is here and could possibly answer that question if if uh if the chair would like yes that'd be great rocco would you mind coming up and just uh addressing that question that's fine or you can table okay i just got to hit the button um actually that's just our standard uh that's got an echo doesn't it at least i hear echo um i did prepare this document here that shows our actual accident rates uh uh and it shows actually we do a very good job of managing our action rates i provided both for clark county as gmr from a national perspective and our aggressive monitoring of our accidents um and how we uh do our claims actually shows a significant increase in our overall accidents per hundred thousand miles driven so i'll give this to diane

4:46 and she can share that with the board and as you know all our vehicles are equipped with vehicle cameras we actually monitor our drivers behaviors so anything that's considered excessive speed sudden stops um you know g-force maneuvers we actually get those camera activations and it allows us to proactively then uh coach our employees on safe driving practice we've been doing here that our accident rate here in clark county um is extremely extremely low and unfortunately that's just the cost drivers of uh just insurance cost and and um that we're experiencing um across the country well i i kind of assumed it was because everybody's insurance was getting raised but i just thought maybe you got an extra vehicle and i am i'm very happy with the all the times i've dealt with em uh ems so thank you yeah no i appreciate it and i'll i'll do my best to make sure that we can do what we can do to make sure that we're doing what we can do

5:44 to make sure that we're doing what we can do and to make sure that we're doing what we can do and to make sure that we're doing what we can do and to make sure that we're doing what we can do

6:38 Did all those in favor say aye? Aye. Motion carries. We're just fiddling around with the microphones here. There is a little bit of an echo, but I think we're going to press on. Thank you very much, Chief. And then, Deanne, if you could come up. I think you're dealing with item 2, 3, 4, and 5. So approval of the 2027 annual budget. Thank you. Deanne Cordes, contract administrator for Clark County. Today, we are requesting approval of the 2027 budget. This budget has the proposed increases for the contract administration that AMR will be paying. It also shows our state auditor fee. The CRESA dispatch fees, which are considered a pass-through. The medical program director fees, which are a pass-through. And then the contract administration through Clark 6 in Clark

7:37 County. I'm happy to answer any questions. Okay. Thank you. Are there any questions from the board? So the revenues, what's the source of the revenues? So that 231, 1101 is what AMR is providing to EMS District 2. And part of those expenditures that are a little bit below are considered pass-through. So that's part of what that administration fee is paying for. Great. Thank you. Other questions? Go ahead. You looked like you were going to ask a question. Okay. All right. Hearing no, any additional questions or comments, I'll entertain a motion to approve the 2027 annual budget. So moved. Okay. It's been moved.

8:37 Second. Moved and seconded. Thank you. All those in favor, say aye. Aye. Motion carries. Okay. Approval of amendment number 1 AMR contract. Yan? Thank you. So before you is amendment number one with AMR's contract. So the major, there's a few minor changes to this contract, and those have to do with response time exceptions, and then also some fee adjustments. We didn't know what we didn't know, and so that's, these are kind of squaring those up. It also is amending the different appendices that have the rates that you previously approved, as well as that contract administration fee, and then per the contract, we could increase the liquidated damages 4.4 percent. So it's just updating those amendments. I do want to let the

9:32 board know that AMR is still reviewing this. So what I'm asking for today is provided there's no changes, that the board approves the chair to sign the amendment once it's ready. I don't anticipate any changes. But if there are, I will bring it back to the board in a special meeting. And this amendment is expected to take place January 1st of 2027. Okay. Thanks for that caveat there. So are there any questions related to amendment number one? Hearing and seeing -- Yeah, I have a question. Yes, please go ahead. Just -- Just to make sure, all of the changes or all of the amended stuff is all -- you've got -- anything that's been changed is strikethrough and underlined? Or anything other than that?

10:31 That is correct. So the way that I did this is if it's an existing, in the existing contract, it's struck through. And if it's new, it's got that double underline. Okay. Gotcha. Thank you. Thank you. Okay. And so what we're looking for now is a motion to approve amendment number one, provided there's no additional changes. So moved. Been moved. Is there a second? Second. Moved and seconded. All those in favor -- oh, there's a hand up. Nope. I forgot to take that off. Oh, okay. You have a yellow background, so it kind of blends in. All right. So all those in favor say aye. Aye.

11:25 Aye. Motion carries. Okay. And then moving on to approval of amendment number two, the Cowlitz Fire District 6 ILA. Thank you. Let's go ahead at the end. Thank you. Amendment number two before you. So the EMS District 2 has an interlocal agreement with Clark County Fire District number six, and they help us with our contract administration. The amendment before you today is to increase their rates, the rates that EMS District 2 will be paying them in 2027. Their rates did increase 10%, so it'll be going up to, I believe it's $33,000. $33,000.

12:16 And so this one has been approved by the fire chief and is ready for your approval today and will be signed once approved. Again, it will not take effect until January 1st of 2027. I'm happy to answer any questions. Okay. Are there any questions? I have just a quick question. As Deanne just stated, it looks like that contracting administration will go up to $33,000. thousand um but we have it in the 2027 proposed budget at 38 000. is there a reason for that variation yes thank you that's a great question there's also some county administration fees that are contained in that contract administration fee of the 38 000. so just the portion that goes

13:10 to clark six is 33 and again the remainder comes to the county for my time and our legal time thank you diana thank you so from the 33 000 to the 38 000 is for the county fees yes it's some county fees in there for a contract administration that is correct ems district 2 is getting a really good deal yes okay thank you uh then uh if there are no other questions i'll entertain a motion to approve item four moved it's been moved second moved and seconded all those in favor say aye aye okay motion carries and then finally item five here approval of amendment number one for the medical program director's uh contract

14:10 thank you before you today is amendment number one to the medical program director contract and again the only change in this amendment is for the increase in rates for that medical program direction and these rates will start as of january 1st 2027 and they're going up 4.5 percent which is when the cpi was pulled at the time and so they're going up to 74 934 and again they'll take place january 1st of 2027. this one is still with the medical program director so today i'm asking for the board's pre-approval provided that there are no changes to this amendment once approved by the medical program director then authorizing the chair to sign the amendment again if there are changes i will be bringing them back to the board at a special meeting great thank you uh any questions or comments if you have any questions or comments

15:10 from the board hearing none is there a motion to approve amendment number one to the medical program director's contract pending no changes i'll move okay thanks for your motion is there a second second moved and seconded all in favor say aye aye aye motion carries okay uh we're moving rapidly along here update discussion items ems administrative board uh and i think chief knorr we're going to call you back up to discuss that so i just want to give a little update on amr's compliance in the second quarter so as a reminder uh the high density and low density areas those are not defined by

16:09 popular population density they are defined by call density as the program was looked at prior to the 2015 contract so essentially areas south of 179th street are high density except for a carve out for the city of battleground so it'll run up and catch battleground in high density the rest of the of uh unincorporated clark county uh and the small cities are in what was considered low density there's also a portion of low density on the far east side of vancouver's response area out past prep still so in during the second quarter amr continued to do a good job meeting uh their priority one and twos those are high life threat calls uh in the high density areas they made it ninety one point five seven percent of the time in low density areas they made it ninety percent of the time the goal is ninety percent so obviously we're watching that number

17:06 they're right at the ninety percentile uh i'd also like to remind you that high density areas get an ambulance in nine minutes and fifty nine seconds ninety percent of the time that is a goal low density areas is 19 minutes and 59 seconds considerably longer uh at ninety percent of the time on the priority three and four calls those are are uh something that where someone is injured but there's not an immediate life threat they made their high density calls in nearly ninety seven percent of the time they're low density ninety five percent of the time priority fives and sixes uh we tend to call that a a lower priority call these are people that aren't going to suffer negative adverse actions if they're not immediately transported to the hospital and again they made uh their low density and just under 93 percent of the time uh or excuse me high density and then the low density at 98 of the time inter-facility transports that's what's the uh non-911 routine that's what's the uh non-911 routine that's what's the uh non-911 routine

18:06 ift that is uh transferring people generally out of the hospital to another location it might be to home it might be to another uh facility a step down facility or something of that nature and they're making those times at 98 and 99 percent of the time one of the caveats in the contract calls for amr to not call for mutual aid more than three percent of the time that's when they call on another ambulance service to provide uh coverage for them they called for mutual aid six times in the quarter and so that is they are allowed up to three percent they were at point zero three percent so they're doing well there they gave mutual aid 198 times that is either to camas washougal fire uh north country ems or to ccfr i would point out that a majority of those calls are to clark cow's fire rescue where ccfr is the first out unit for high priority calls within our fire rescue unit that's the first out unit for high priority calls within

19:05 fire district if we're busy on a call and another high priority one or two comes in amr will take those calls amr also responds to all the threes fours fives and sixes in ccfr's area but they'll pick that up for us so uh we were busy that in that quarter and so amr picked up a few calls for ccfr in that area amr can request an exemption and so if they if it meets certain criteria then a call will be exempted from the 90 percent uh response criteria or the the response time criteria rather and so they requested 24 exemptions in the second quarter 23 were granted one was denied and and there's um lots of different things that can cause that was kind of in your report there but um if if a call was originally sent as a bls ambulance so two emts rather than emt and paramedic and they determined that it needs a higher priority that uh allows an exemption because the an ambulance responded but it wasn't as

20:05 certainly the right level and they have to call another unit there that will create an exemption for it oftentimes construction road conditions or or things that are outside of their control uh causes a delay and they can request that and that's part of what uh fire district six does is the ambulance uh uh contract coordination as they evaluate all of those exemptions one of many duties they have in administering that contract but tara at fire district six goes against a set of criteria determines whether an exemption should be granted or not if amr fails to make their times uh they are fined for that and so based on this there wouldn't be any second quarter fines because there weren't any uh they were meeting their criteria okay are there any questions i just noticed on this one that was uh denied

21:05 it was an address change was that something that uh should have been known or could have been known there are times when uh so if if if cresa if the call goes through 9-1 and crescent takes the wrong address um and then the address is determined to be mistaken they may have been sent to northwest when in fact the address was in northeast um that there's a an exemption given for that uh there are times when amr takes the call direct and they could uh they may have gotten that address wrong and that that then becomes on them to correct that so i can't speak to that specific uh item in there but that does occasionally happen okay thank you chief i have a question for you yes go ahead just um curious about we added one exemption

22:04 to the to the amended contract here i'm trying to look it up there's a fourth exemption category now d dn is coming up i think to fill in uh fill in the blanks dean that is exactly or excuse me counselor thornberry that is exactly why we added that in so this particular one was so it's not outlined in the contract specifically as an exemption which is why it was denied but in our amendment we have added that when the when the nine i think it's psap which is crescent if that was that's that's a result of this one denial that we had here yes that is correct okay all right very good you were very close okay anything else from any counselors

23:02 just uh voice my appreciation the chief nor and the administrative staff um for the the work done here and and good reporting um the last i have one just small question uh we spoke about the priority one and two goal of 90 percent uh and could you remind me of the goal for priority three and four and also five and six so that the time goals remain the same it's it's uh 959 in high density and uh 1959 in low density so high density is everything south of 179th street uh and a carve out for the city of battleground so it runs roughly not quite 90 seconds a little bit uh east of 90 second up around the city limits of battleground to the east side of battleground back down and then extends on out so uh for example fire district 3

24:00 the majority of fire district 3 is low density uh except for the city of battleground portion that's high density and those zones were created as a result of a system analysis that was done uh prior to the 2015 contract being put in place uh thank you chief nor i i do understand we have a higher senior population so i can imagine our our density of call is is higher in the city of battleground um so now i understand thank you i appreciate that that that leads me to ask a question too if this was done prior to 2015 there's been well how often are is the call density evaluated it it has not been evaluated since that time um it uh we talked about it prior to the contract uh going in place uh on one one of 25 and at that time amr uh to change the density response zones which

25:00 would have had to put more vehicles in service which have would have raised the cost to everyone okay just recognizing that there's a lot of growth that's happening there has um yes okay part of part of that reason ma'am is is the uh was the agreement with ccfr to do priority ones and twos within our area because the ccfr area is almost wholly within low density but as you know along the i-5 corridor it's it's a lot lower density than what was done prior to the i-5 corridor we've seen significant uh growth the only area of ccfr that is in high density is a small area down along salmon creek south of 179th that has very few people in it but just happened to fall within that high density map great thanks for that explanation thanks for all this information too don't think we've seen this for i don't know when we've seen this so it's good to get the details here okay uh no other questions from the board i don't see any uh

25:59 then we'll move right on to public comment is there anyone from the public who would like to make a comment do we have anyone online nobody signed up chair and nobody's online okay all right uh then i guess just before i adjourn i would like to make a couple comments because this may be my last meeting and i would just unless we have a special meeting to take care of a couple of changes that might happen but i just wanted to say i've served on this board for four years the first year not too much was happening uh but uh since then quite a bit has been happening so i want to uh just uh state my appreciation to everyone who's been involved i think we're in much stronger shape than we were before adding to the board itself and setting up the uh advisory uh administrative board

26:56 so i think there'll be uncertainties going forward no doubt but i think we're in a much better shape to deal with though so thanks everyone and with that i'll adjourn this meeting our next meeting january 11th thanks everyone thank you sue thank you