Proposed paramedic plan moves ahead

County emergency medicine officials will return to the island next week and present a revised plan regarding combining Vashon's paramedics with those of South King County Medic One.

County emergency medicine officials will return to the island next week and present a revised plan regarding combining Vashon’s paramedics with those of South King County Medic One.

Michele Plorde, the director of King County’s Emergency Medical Services, will lead the presentation, intended for the fire commissioners and members of the public. Reached last Thursday, Plorde said she will focus on the plan’s operational details and important financial aspects for Vashon Island Fire & Rescue (VIFR). She characterized the proposal — which she planned to continue working on this week — as sound and not very different from the paramedic service Vashon currently has. She added she hopes islanders will attend the Tuesday meeting.

“I definitely would love to see what people think,” she said.

Medic One Chief John Herbert will also attend the meeting, and with VIFR’s Interim Assistant Chief Bob Larsen, will help provide information and field questions she might not be able to answer, Plorde added.

For many years, Medic One — King County’s highly respected paramedic program — has contracted with VIFR to provide paramedic services on the island. Island paramedics, who respond to life-threatening illnesses and injuries, have the same training and follow most of the same protocols as those in the rest of the county, but have worked under VIFR’s leadership and out of the Vashon station. In return, VIFR has received more than $2 million in county levy funds annually to provide those services to islanders. Combining Vashon’s paramedics with those of South King County Medic One would mean forgoing those funds as well as losing firefighters, as Vashon’s paramedics are also firefighters. It would also mean instead of being served by Vashon’s small group of paramedics — now just seven — those who are critically ill or injured would be served by rotating crews of paramedics of a pool of approximately 80 who rotate throughout the area, including in Burien, Kent and Renton.

In a sometimes tense public meeting last March, Plorde’s predecessor, James Fogarty, presented a draft plan to the commissioners, some members of the department and the community at large. In April, after beta testing the plan, former Fire Chief Hank Lipe sent it back to the county for revisions, saying it could leave the island vulnerable and without paramedic coverage for too long. Now, Plorde says, she believes those concerns and others have been addressed, and after more than two years of “meandering” progress, she said she believes progress is at hand.

“I am hoping we are closing in on the end,” she said.

In a significant step, the paramedics of South King County Medic One recently approved a county proposal to assume control of Vashon’s Medic One program; Plorde said she believes that approval accounts for about 50 percent of the work involved with moving ahead. If everything goes smoothly, she said, Vashon’s paramedics could join South King County by Jan. 1.

“That is very smooth, but not unrealistic,” she added.

Several steps would need to occur between now and then, she said, including working out the details of an operational plan, the transfer of assets between VIFR and the county, and Vashon fire commissioner approval. Additionally, she said, while county officials are working with the VIFR commissioners, members of the South King County union will work with members of the Vashon union to agree to terms for integration. On Vashon, as late as Monday of this week, some of the island’s paramedics said they had received almost no information regarding recent proceedings, an indication that step has not yet begun. Finally, Plorde said, the King County Council will need to approve the final plan, and County Executive Dow Constantine will have to approve it as well.

The possibility of combining Vashon’s paramedics with those of South King County has been under consideration since the spring of 2014 and has supporters and critics. Those at the fire department in favor of the proposed change say it would mean that the island would be served by paramedics accustomed to responding to a high volume and wide range of calls, that the department would have more depth to draw from when one of the paramedics cannot report to work — greatly reducing overtime — and that in a large-scale emergency, it would provide backup paramedic services more quickly than other avenues for assistance.

Conversely, critics, including some of the island’s current paramedics, have spoken out against the proposed change. In March, at the most recent public meeting about the issue, Vashon paramedics Mike Garvey and Myron Hauge spoke up against the plan as it was proposed and took issue with some its premises, including that island paramedics’ skills had degraded from lack of use. On the contrary, they said, the long transport times inherent in transporting a critically injured or ill patient from Vashon means a high level of skills is necessary.

“I’m a better medic here than I ever was in Seattle,” Hauge said at the March meeting. “I have to be.”

Garvey, a longtime paramedic, also said at the time that he believes Vashon’s current system is efficient.

“I can’t see where there’s a real problem, where we’ve got to fix this problem,” he said at the time.

Others have voiced concern about the financial ramifications for the district, as well as concerns over diminished capacity to fight fires.

Speaking to the controversy around the proposal, VIFR board chair said if moving ahead with the plan will benefit the island, the board must do it.

“What is best for the community is what we are after,” she said. “We are not trying to vote anyone off the island.”

The roots of this proposal go back to March of 2014, when Mark Brownell, a Vashon paramedic and the the battalion chief of emergency medical services at VIFR, and Dr. Sam Warren, Vashon Island Medic One’s medical program director, raised concerns about the island’s paramedic program. At that time, they sent a letter to the medical director of Medic One and Fogarty. In particular, they noted that instead of conducting hospital transports in two-person paramedic teams — per Medic One’s guidelines for best outcomes — Vashon completes transports with one paramedic and an emergency medical technician (EMT), a responder who is trained to respond to lesser emergencies. While this practice leaves a paramedic available to tend to another critical island emergency, it also potentially compromises patient care, Brownell and Warren said.

They also expressed concern at that time about the number of calls Vashon paramedics go on, saying they are far fewer than the recommended number to maintain their skills in working with critical patients.

In the summer of 2014, following a public meeting on the issue, VIFR’s fire commissioners voted to move forward with a plan to combine its paramedics with those of south King County. Since that time, progress has been slow, and Plorde said she has made making significant progress a priority since stepping into her position after Fogarty’s retirement in June.

“The people of Vashon deserve action,” she said.

The public meeting is slated for 6:30 p.m. Tuesday, Sept. 27, at Station 55 on Bank Road.

“I look forward to the conversation,” Plorde said.