Emergency services levy on Aug. 19 ballot

Douglas Okanogan Fire District No. 15, Brewster and Pateros residents will be asked to approve or reject a six-year emergency services levy in primary election voting Tuesday, Aug. 19.

The levy would replace the existing levy, which provides the bulk of financing for the fire district's ambulance service; the levy amount will remain unchanged, said Tonya Vallance, director of emergency services for Douglas Okanogan Fire District No. 15. Property owners will pay an estimated 47 cents per $1,000 of assessed property value in the first year, which determines the amount that can be collected for all six years, Vallance said.

Approval in Pateros and Brewster is contingent on approval in both cities and the district. If the levy is approved the money would be collected beginning in 2009.

Currently the levy raises about $87,554 from the district, $36,889 from Brewster and $15,970 from Pateros, for a total at $140,413. The money helps pay for the EMS service, including four paid staff, the ambulance and emergency medical equipment.

The emergency medical staff and volunteers cover a lot of ground-about 230 square miles, Vallance said. The district boundaries run from the Chelan County line past Wells Dam, to mile marker 17 on the Methow River (SR 153), north to the little stand of pine trees on Highway 97 to Davis Canyon, south to Bridgeport State Park and Jack Wells Road. "We cover down to the city limits of Bridgeport on (Highway) 173," Tonya said. The paid staff is supplemented by a pool of dedicated volunteers, she said.

Voters approved previous levies in 1996 and 2002; fire district officials decided to seek the first levy because of the demands on the previously all-volunteer force. At that time the ambulance crew was responding to about 200 calls per year, Vallance said, and while the volume of calls fluctuates from year to year the long term trend is upward. Tonya estimated the ambulance will respond to "well over 500" calls in 2008. More people are moving into the area, she said, some segments of the population are getting older and are more susceptible to disease. In addition, sometimes people are delaying medical treatment due to the costs, she said.

At least two people from the paid staff are in the office on weekdays; they do all the billing, keep track of inventory, prepare statements for submittal to insurance carriers-which is a big (and important) job in itself. Insurance submittals are very detailed, Vallance said, and they must be right, or they will be returned and payment delayed. In addition, a member of the paid staff usually is on call after office hours.

The fire district is certified to provide intermediate life support and must have somebody certified at the ILS level on the first vehicle to respond on every call, Vallance said. The intermediate level is one step below paramedics; they are certified to administer intravenous fluids, to work with obstructed airways, administer six medicines that are prohibited to ambulance personnel with basic life support training, and other skills.

All personnel with the ILS certification must take continuing education classes and renew their certification (including a written test and practical demonstrations) every three years, Vallance said. Those requirements apply even when the EMT is a volunteer, she said. State rules make no distinction for the size of the agency; however big or small, "we have to play by the same rules as the big boys," irrespective of cost.

And the same market forces that apply to the big boys also apply to smaller agencies like Fire District No. 15-fire district officials are paying the same fuel costs and are subject to the same inflationary pressures as every other agency. Supply costs are increasing, Vallance said, and suppliers have tacked on fuel surcharges to offset their rising costs.

At the same time reimbursement from some insurance carriers, and especially publicly funded insurance like Medicaid, is falling far behind expenses. Vallance estimated that the fire district receives about 23 cents in reimbursement through the Medicaid program for every dollar spent.

Because it's a revenue measure, the levy must be approved by at least 60 percent of the voters (in this case, in all three jurisdictions) to pass. Ballots were mailed late last week; they must be returned the Okanogan and Douglas county auditor's offices by Election Day.