New ambulance contract causes stir

The final meeting for two departing Bainbridge Island fire commissioners ended with bitter accusations that the chairman of the fire board was trying to sabotage attempts to forge a new contract with the Bainbridge Island Ambulance Association.

The Bainbridge Island Fire Department has contracted with the nonprofit Bainbridge Island Ambulance Association since 1999 for basic life support transportation services, and talk of a new contract has dragged on for more than a year.

Some, however, are worried that the delay in finalizing a contract is because Bainbridge Island Fire Board Chairman Dan Morrow does not support a new agreement, and wants to open the contract up for bid by for-profit ambulance companies from off-island.

The main concern is that a for-profit competitor will undercut the Bainbridge Island Ambulance Association’s rates to obtain the contract with the fire department, and then raise rates later.

Talk turns testy

At the Bainbridge fire board’s last meeting of the year, outgoing Commissioner Paul Bang-Knudsen accused Morrow — who was appointed to the board in 2012 — of trying to “railroad” the BIAA.

Bang-Knudsen recalled how he appointed Morrow to the board last year with the expectation that he would do a fair job. That has not been the case, he said.

“This board has voted 3-2 earlier this year to continue the contract. However, the chair has used department resources and his title as chair to continue this one-man attack against this partner of the district.

“I’m tired of it. It’s a delay tactic,” Bang-Knudsen said.

Up for bids

At the center of the dispute is Morrow’s attempts to pursue a “request for proposals,” or RFP, for companies that would handle transport services.

Bang-Knudsen noted the fire board has consistently supported a new contract with the BIAA, and it appeared that Morrow was stalling the completion of the contract until 2014, when a new majority will take over the board of fire commissioners.

“I don’t think it’s fair for one commissioner to use his chairdom ... to continue to delay this process. In the last meeting, he said he’s not going to vote for this contract no matter what,” Bang-Knudsen said. “He said he is only going to do an RFP.”

Commissioners have voted twice to continue the relationship with the ambulance association, he said.

The BIAA has a storied past on Bainbridge, with a history of service to the community that goes back many decades. Bang-Knudsen, as well as BIAA officials, said the organization shouldn’t be viewed as a vendor under contract to the fire department, but a proven partner in emergency services.

The volunteer model used by the BIAA is the appropriate one for the fire department, Bang-Knudsen said.

“This nonprofit is supported by the community very deeply,” he said.

New terms in contract

Officials from the BIAA told the commissioners that the nonprofit had bent over backwards to accommodate the new terms that have been added to the proposed agreement. Those include a requirement to have a fully staffed basic life support unit, including an ambulance driver and EMT, at the fire department’s Station 21 within 15 minutes of dispatch.

The new contract also includes punitive damages that would be paid by the BIAA to the fire district if the ambulance association fails to meet the required response rates.

BIAA officials noted they had “philosophical and legal issues” they were willing to ignore in the new contract in order to keep the relationship intact.

“Our sole reason for existing is supporting the fire department,” said Dr. Gregory Keyes, a member of the BIAA board.

“We do not see ourselves as a vendor for services,” he said. “We look at ourselves as a partner.”

He drew a distinction between what the nonprofit BIAA would do, and what a for-profit ambulance company.

“Our job is to support the community and to support you, and that’s our primary motivation. That’s all we’ve ever done and that’s all we will ever do,” he said.

Keyes said the nonprofit could provide better services at a better cost than an outside entity. And he also said the association had clearly gotten the message from the fire department that response times need to improve so patients are not waiting too long for transportation to the hospital.

“We’ve heard things loud and clear that we need to be there within 15 minutes of tone-out,” Keyes said.

As of Jan. 1, he said, the association will have full-time ambulance drivers for 12 hours each day, from 6 a.m. to 6 p.m., every day of the week, “that are ready to go at a moment’s notice.”

When the first crew goes out, full-time staffers will come in to replace them, he said.

Keyes noted the fire department was demanding increased service at a lower cost. The BIAA has a goal of meeting the new response rates fully by June, but officials said it will take some time to hire more employees to meet the demand.

“We know we’re not the only option,” Keyes told fire commissioners.

“We want to be the best option. And we want you to be totally convinced that we’re the best option. It’s our commitment to work in that direction,” he said.

No turning back

But Keyes also said that without its partnership with the Bainbridge department, the ambulance association would cease to exist.

“It’s, in a sense, a one-way street. If the ambulance association goes away, it will not come back,” Keyes said.

Morrow, however, repeatedly questioned how he could justify the BIAA as being the best service providers if he were asked.

Keyes noted the nonprofit’s 60 years of quality service on Bainbridge. And he added that the association recently reviewed the number of complaints, formal or informal, from patients over the past five years.

They found none, he said.

“I received one,” Morrow quickly said.

“It didn’t go as far as getting to us,” Keyes responded.

The question of transport rates also came up. The BIAA charges $550, an increase from its earlier rate of $400.

“Our costs have to reflect what we pay day in and day out,” Keyes explained, “and replacing equipment every two to three years.”

A new ambulance costs anywhere between $125,000 to $145,000, he added.

“And that cost is going up,” Keyes said.

Some on the commission pointed out that for-profit companies charge more, and said BIAA rates were not out of line.

“Their rates are competitive,” said Commissioner Maureen Halligan, who is also leaving the board at the end of 2013. “I think any of us would say that.”

She said she was hesitant to approve a contract that would set up the BIAA for failure.

Bottom-line questions

Morrow, however, said the association had been “incredibly profitable.”

In response, Keyes said the nonprofit has been saving money for decades in hopes of paying for a facility.

“We’ve been incredibly frugal for over 20 years,” Keyes said.

The talk of rates prompted Bang-Knudsen to again loudly vent at Morrow.

“This is not a vending machine we get to swap out at the end of the day,” he said.

“I too have seen their financial reports. They are not socking away too much money. Do you know how much land and equipment and vehicles cost? You have to be prudent and frugal,” he said.

“Why are you even attacking this gentleman when you are not going to vote for it, no matter what?” Bang-Knudsen asked.

“I object to the personal attack. We disagree,” Morrow said.

“It’s not a personal attack, it’s a fact. You’ve got an ax to grind for some reason,” Bang-Knudsen said.

Despite their concerns over the contract, BIAA officials said they were ready to sign off on the contract. They suggested slight revisions, and offered the commissioners a slightly revised contract that contained “99 percent” of what the fire department had sought.

Decision put off

But with commissioners seeing the revised contract for the first time at their Dec. 18 meeting, the board voted to table the contract until the new year.

Bang-Knudsen declared it a huge victory for Morrow. He called the punitive damages in the contract “ridiculous” and the terms of the agreement “insane.”

He also said he hoped the new fire board would keep the partnership in place.

“Why throw away something we’ve been investing in?” Bang-Knudsen asked.

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