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Ambulance collaboration hits snag

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Posted: Wednesday, September 4, 2013 11:00 pm

Collaboration between the Teton County Fire and Rescue and Teton Valley Health Care hit rocky ground last week when an email from July emerged revealing that Fire Chief Bret Campbell had started preliminary talks with Teton County, Wyo., to negotiate a contract for ambulance service to Alta, Wyo., in the hopes of also leveraging it into a contract for Teton County, Id.

It surprised members of the steering committee that included representatives from the hospital, the fire department and Teton County, Idaho who thought the entities had been working collaboratively for months while awaiting the final results from the Mercer Group’s study of emergency services in Teton County, Idaho. The final draft arrived in August.

 Keith Gnagey, CEO of Teton Valley Health Care said Tuesday morning that he received a call the previous Thursday from Steve Foster, County Commissioners Administrator in Teton County, Wyo. According to Gnagey, the two met that day and discussed the ambulance and emergency medical services the hospital provides for Alta, Wyo.  According to Gnagey, Foster also said that Teton County fire chief and commissioners had approached Teton County, Wyo., with the overtures of negotiating a contract for ambulance service to Alta. He also gave Gnagey an email dated July 11 from Campbell in Teton County, Idaho, to Will Watsabaugh, fire chief in the Wyoming county.

“We are planning on operating an ambulance service in the City of Victor (and potentially in the South part of our county) regardless of any future with Teton County, Idaho, “ Campbell wrote. “Idaho law provides Fire Districts the authority to operate an ambulance service independently of cities or counties. Relevant to our discussion, the City of Victor wants us to run an ambulance for them ASAP. I had very good medics which are growing tired of our hospital ambulance system and are ager to operate our own ambulances. So we are prepared to operate two frontline ambulances and one reserve to service Alta and Victor ASAP. From one chief to another, anything you can do to help make this happen would be greatly appreciated. The big carrot for my department is strategically, operating an ambulance in Alta and Victor practically secures my department operating our county ambulance in the future. I believe the benefit to both of our agencies is efficiency and stability in the long-haul.”

“This was somewhat of a surprise,” Gnagey said on Tuesday morning.

However, Campbell and Gnagey agreed to meet as soon as possible to keep their collaboration going. County Commissioner Kathy Rinaldi who was also a member of the steering committee is giving the fire department a free pass.

“We were very collaborative,” Rinaldi said of the steering committee, “and I’ll give the fire district the benefit of the doubt as to how that email appears.”

She noted that the date of the email was before the study was complete.

“If it had bee dated August 11 it would have been different,” Fire Commissioner Kent Wagoner said.

He said that as drafts and information from the Mercer study trickled in, it did not present a workable solution for collaboration and incorporated elements that weren’t part of the proposal the fire department made two years ago. According to Wagoner the fire department had been planning all along to submit its own bid for the ambulance service this spring.

“Nothing from what we talked about from the Mercer Study was going to change that,” Wagoner said. “The idea of the joint venture really wasn’t on the table until the later part of July.”

Wagoner said the discussions with Teton County, Wyo., in regard to ambulance service started during talks of a new contract for fire service to Alta that have been underway for the last several months. He said Gnagey was aware of the negotiations and also that the fire department wanted to operate an ambulance in Victor. The hospital had never expressed an interest in running an ambulance in Victor, according to Wagoner.

“As far as I was concerned everything changed when he presented the idea of a collaborative effort,” Wagoner said.

Just days before the email came to Gnagey’s attention the fire department expressed their commitment to pursuing a joint bid for ambulance service with the hospital. The controversy started in 2011 when the fire district proposed taking over the county’s ambulance service and placing an ambulance in Victor. In 2012 the county commissioned a study by the Mercer Group to examine the most cost effective way to provide EMS services countywide. A steering committee with representation from the fire department, the hospital and the county guided the study. The final report recommended a collaboration between the ambulance district, the hospital and the fire department to reduce costs and improve services.

Ann Loyola, public relations manager for the hospital said the hospital found Campbell’s insistent language in his email disturbing. From the hospital’s point of view, the collaboration started when the study was commissioned and the steering committee formed.

“We all agreed to stop and wait and assist with the study and all agreed there wasn’t to be any competition between two groups,” Loyola said.

The Mercer study cited competition between the hospital and the fire department as one of the greatest obstacles in reaching more efficient services through collaboration.

At the end of July, according to Wagoner, Gnagey approached the fire department with another idea. For Wagoner, Gnagey’s idea was more workable than anything the Mercer Group had proposed. He said reaching out to the fire department was a   “bold move on Keith’s part.”

 Wagoner also said the fire department responded about two weeks ago with a framework for how they think collaboration for fire services could be worked out. While the fire department’s frame work is very practical, Gnagey said he wanted the two groups to first be able to present broader concepts of levels of service to the community before explaining the details of who would be which ambulances.

Both Gnagey and Campbell said Teton County, Wyo., expressed satisfaction with their current ambulance contract with the hospital.

TVN en Español

La colaboración entre los bomberos del condado de Teton y el hospital Teton Valley Health Care cayó en tierra rocosa la semana pasada cuando un correo electrónico desde julio surgió revelando que el jefe de bomberos Brett Campbell había comenzado conversaciones preliminares con el condado de Teton, Wyoming, para negociar un contrato para el servicio de socorro y ambulancia para Alta, Wyoming en las esperanzas de reforzarlo también en un contrato con el condado de Teton, Idaho. Sorprendió a miembros del comité directivo que dirigió un estudio colaborativo sobre servicios de ambulancia en el condado. El comité incluyó a representantes del hospital, el cuerpo de bomberos y el condado de Teton, Idaho, quien pensaba las entidades habían estado trabajando de colaboración durante meses esperando los resultados finales del estudio de Mercer Group de urgencias en el condado de Teton, Idaho. El esbozo final llegó en agosto.

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