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Dallesport, Skyline At Odds Over Ambulance Service

Changes in procedures coming

By JESSE BURKHARDT

The Enterprise

The tension was apparent during a special public meeting last week with Skyline Hospital officials, representatives of the Dallesport-Murdock Fire & Rescue Department, and about 50 community members.

Klickitat County Commissioner David Sauter, whose district includes Dallesport and Murdock, explained the reason for the April 23 meeting at the Dallesport Community Center. Sauter said there was a perception in the community that Skyline's ambulance is often away from Dallesport and not available for emergency calls.

"Whether accurate or not, I've had several concerns voiced to me in the community," said Sauter, who moderated the meeting. "Klickitat County has no jurisdiction over the hospital or the Fire Department; however, this is my district and we are charged with health and safety. If there are concerns, they are my concerns."

One of the key complaints from local residents revolved around why the ambulance is often used to transport patients from one medical facility to another.

"With the limited number of crews, why do you provide transport to Portland? Why not let someone else transport them?" one resident asked. "Basically, it sounds like you're running an ambulance service in addition to running an emergency service in this county."

Skyline officials said they made approximately 150 patient transfer runs in 2008.

Cindy Rosen, EMS chief for the Dallesport-Murdock Fire & Rescue Department, pointed out that Skyline's patient transfer runs take the ambulance away from the community too often.

"We are hearing from the community: Why are we seeing Skyline ambulances on the highway so much?" said Rosen. "When you're transporting somebody out like that, then you have only one crew for basically the western end of the county. That's being understaffed, don't you think?"

Skyline Administrator Mike Madden, who attended the meeting, pointed out that even though the ambulance is stationed in Dallesport, the emergency crew based there has to cover a wider area.

"The Skyline Hospital District covers several fire districts and a huge area," Madden said. "The ambulance here is not assigned just for Dallesport and Murdock, and it is paid for with taxes from the entire district."

Skyline currently has two ambulances and crews on duty around the clock -- one is based in White Salmon, and the other is in Dallesport.

According to Skyline officials, the ambulance based in Dallesport is primarily to handle emergency calls for the area that includes Dallesport, Murdock, Lyle, High Prairie, and Appleton.

Madden explained that the cost of stationing an ambulance and emergency crew in Dallesport was $456,972 a year.

"EMS levy funds from the Dallesport area amount to about $22,000 a year," Madden said.

Rosen pointed to one recent case in which the Klickitat County Sheriff's Office dispatcher in Goldendale paged the Skyline ambulance crew in Dallesport at a time when the ambulance and crew were out of the area. As a result, time was lost before mutual aid from The Dalles could be paged.

"This is life and death, and minutes really count," Rosen said. "We can't be paging out the wrong people."

Madden said the ambulance crews have notified the KCSO dispatch office when they are out of the district and unable to respond to calls, but nevertheless sometimes the initial page still goes to the Skyline crew.

"We always call dispatch to let them know we're out of the district, so if an emergency call comes in, they should immediately call The Dalles," responded Madden.

However, some in the crowd wanted Skyline to prioritize being on standby for emergencies rather than transporting patients.

"When you're doing all those transfers for other hospitals, that puts the people you are supposed to support the most in jeopardy," explained a resident. "Right now, you're running too many places and too many miles, and that's not good for Dallesport. You told the community that if the EMS levy passed, you would approve a second ambulance to provide better service for citizens in the hospital district."

Darren Lacock of the Dallesport-Murdock Fire & Rescue Department said the situation needed to be fixed.

"Since Skyline put the ambulance in Dallesport, they are never here, they are gone on transfer runs," he said. "It's a growing problem in the community. We see the ambulance from The Dalles more than we see Skyline's ambulance in Dallesport."

Another citizen said she believed the two sides were not working together to effectively resolve any problems.

"I'm seeing animosity instead of finding a solution that is best for us," she said. "I'm seeing defensiveness and combativeness, and that's not going to solve anything. Find a solution and quit pointing fingers."

Klickitat County Undersheriff Erik Anderson said KCSO dispatch would be willing to alter its procedures to ensure that Dallesport's emergency crews know when Skyline's ambulance is away from the Dallesport area.

"As long as it's clear, and as long as it's something we can do with our people and our equipment," Anderson said. "Keep it simple so we can follow it. It has to be agreed on."

Anderson added that the public had a right to be concerned about emergency call procedures.

"You'd be surprised how little written procedure there is from the fire districts about what they want done. A solution waiting to happen is clear -- written directives," Anderson said.

One citizen said the meeting did not leave him feeling reassured.

"I've lived in this area over 55 years. I felt safe until tonight," he said. "You people need to get together and figure this out. The public should be concerned if we have an adequate system or not."

"I don't want people here going home thinking we don't work well together, because we do," responded Dallesport Fire Chief Rhet Howard. "We just need to communicate better."

After the meeting, Commissioner Sauter said he believed good progress was made.

"At least we've got dialogue going on," Sauter said. "There has been tension. I don't know if it's resolved, but we have people working on it."

On Monday, Robert Guinn, manager of Skyline Hospital Ambulance, said a meeting had been scheduled for April 28 to resolve the concerns. Expected to attend were representatives of Skyline Ambulance, KCSO dispatch, Mid-Columbia Fire & Rescue, and the Dallesport/Murdock Fire Department.

Further, Guinn said he had taken immediate action to make sure emergency crews knew the status of Skyline's Dallesport ambulance.

"We will contact KCSO dispatch, and whenever we leave the district, they contact Mid-Columbia Fire & Rescue dispatch in The Dalles so emergency calls should automatically go there," Guinn explained. "Dispatch was told this earlier, but now we literally say it on the radio."

Guinn added that Skyline will also significantly reduce the number of transfer calls it will accept.

"I contacted Klickitat Valley Hospital, Mid-Columbia Medical Center, and Providence in Hood River -- we will only do `Code 3' emergency calls from now on. That means we will transfer only a truly emergency patient," Guinn said. "And by cutting out transfers, we shouldn't be gone much anyway."

The meeting was held April 23 at the Dallesport Community Center. About 60 citizens in attendance.

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