Nearly three years after questions arose about best practices for Vashon’s paramedic service, change to that service is underway.

As of today, when islanders who are critically ill or injured need emergency medical care, it will not be Vashon Island Fire & Rescue paramedics who tend to them, but a team of rotating paramedics who work for South King County Medic One. The plan behind this change calls for the model of care to remain unchanged, but the people who will provide that care will be largely different. Vashon Island Fire & Rescue Chief Charlie Krimmert said last week that he expects the public to notice little difference, apart from some new faces and aid vehicles on the road.

“It is our intent that the change will be seamless to them,” he said.

For several years, the county’s Medic One program contracted with VIFR to provide paramedic services on the island. In turn, VIFR received about $2 million annually to employ a team of eight medics. Now, the five medics that have remained with VIFR to this juncture have joined the ranks of South King County Medic One and are part of the medic pool serving the island and the broader area.

This change applies only to paramedics, who handle life and death emergencies, not emergency medical technicians, who respond to more routine emergency calls.

Supporters of the transition say this move will ensure that all of the paramedics who work on Vashon will keep their skills honed by transitioning through communities far busier than Vashon, which is one of the slowest in the region. Additionally, they say that South King County Medic One, with many medics, is better equipped to handle large emergencies and has enough staff to avoid routine overtime for paramedics — a recurring problem at VIFR.

The road to arrive at this transition has been rough at times, with some in the department supporting the move, and others speaking up against it. Krimmert, who stepped into the chief role last month after serving as a volunteer for 16 years, had not supported the transition, but believes the current plan — tooled and retooled along the way — is strong.

“I have not been an advocate of this, but I believe the two or three years of effort have gotten us to a plan with viable service,” he said. “We will have a high level of delivery.”

Last October, Michele Plorde, director of the county’s Emergency Medical Services, presented a plan for the new arrangement to the fire commissioners in a public meeting. She stressed then that much would remain the same for island paramedic response after the transition, and she reiterated that point last week.

“We want to maintain that,” she said. “We want to keep as many things similar as needed.”

The plan, which has remained as she presented it last fall, calls for two paramedics to serve the island at all times and, initially, for one Vashon paramedic to partner with one King County medic. Plorde said Keith Keller, the chief of South King County Medic One, and others will pay close attention to how things are going on Vashon before they transition away from that element of the plan.

“Keith will be on it and the MSOs (medical service officers). There will be a lot of conversation and an ear to the ground,” she said.

The proposal also calls for paramedics to respond to calls in two-person teams, following Medic One’s standard for best patient outcomes. However, as has been the practice on Vashon, it calls for splitting the teams — combining one paramedic with a lesser-trained emergency medical technician (EMT) — during transports and if two critical calls occur simultaneously. In the rare event that both paramedics need to transport a patient off-island at the same time, South King County Medic One would provide back- up paramedic coverage to the island, via ferry, King County Sheriff’s Office helicopter or boat, or the South King fire boat.

Plorde noted that all parties involved have worked hard to make the transition happen — the fire commissioners, the fire department and the different labor groups. Like Krimmert, she expects the change to go well.

“I anticipate it going very smoothly,” she said. “The paramedics are so professional. That is where the rubber hits the road. The paramedics are really trained to put patient care first.”

She added she expected some stress to be involved, with the change itself and the ferries, but that it would not pose a large problem.

“They are so equipped to deal with stress. They do it every day,” she said.

While the paramedic service to the island is not expected to mean much change for islanders, the transition does have some large implications for the department. Among those is a loss of firefighting capability, as the departing paramedics are all firefighters, and those coming on are not. To that end, the department has hired two new firefighters/emergency medical technicians, Darren Lenz and Bradford McMullen. Lenz has been a volunteer with VIFR since 2010, according to Assistant Chief Bob Larsen, and McMullen has been working with an off-island department as a volunteer.

Despite both men being firefighters, Krimmert said they are currently attending a 19-week firefighter academy to hone their skills and further familiarize themselves with the district’s procedures and practices. The academy, run by the South King County Fire Training Consortium, provides training for all its members. An additional benefit, Krimmert said, is that the standardized training makes collaboration when mutual aid is needed easier and more seamless.

The two men are slated to be working with the department full-time by June 15. Noting the decreased numbers of firefighters at VIFR during this interim period, Larsen said the department is working to fill the resulting openings with crew and volunteers.

“It puts a little added pressure on our resource pool. It will be great when we have them here,” he added.

Additionally, the district is working with Myron Hauge, an island paramedic who decided not to make the change to South King County. Krimmert said VIFR plans to retain him as a firefighter for a time, although those specifics have not yet been finalized.

As has happened repeatedly throughout this process, those involved have only good words to say about the level of care Vashon’s paramedics have provided and that the change is about emergency care best practices, not the individuals who have provided that care on Vashon.

Krimmert spoke along those lines last week, noting that Medic One sets the national standards in the field. But he also praised Vashon’s paramedics for going beyond those standards and providing community-oriented care — something he expects members of the department to model to ensure the new paramedics will do the same.

“We are going to set the bar for them to do so,” he said.

This version of the story correctly states that King County Medic One contracted with VIFR to provide paramedic service; an early version erroneously stated that VIFR had contracted with South King County Medic One.