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Facing questions over the long-term sustainability of its current emergency medical services contracts, Blaine County publicly reopened discussions of valleywide EMS consolidation on Monday during a special meeting of the commissioners with local mayors and fire chiefs in attendance.
In their ex-officio role as the Blaine County Ambulance District board, the county commissioners are responsible for setting a budget for emergency medical services, which, locally, means contracting out to area fire departments to answer calls.
Blaine County primarily contracts with Ketchum Fire and Wood River Fire and Rescue for EMS calls, which far outnumber fire calls. It also maintains a much smaller contracts with Carey and the city of Sun Valley.
For fiscal 2023, those agreements total almost $4 million.
The current system is primarily paid for by property taxes allocated to the Ambulance District, with revenue from services and other small streams making up about 20% of the current balance. After that, the county drew in about $665,000 in cash carryover to pay for the current contract, but that amount is getting drawn down each passing year.
That means the approach may not be financially feasible going forward, Commissioner Angenie McCleary said during a review of individual EMS contracts this week.
“We saw that this amount that we’re spending yearly is not a sustainable model,” McCleary said. “There is a need for some changes, and I think we were very clear last year and as a board that we’re going to have to make some changes moving forward. I think that is also why this has prompted a lot of discussion.
“I recognize our financial model is not sustainable right now, but the service we provide as a community—we want to have exceptional service for our residents.”
According to the board, the county simply does not have the funds to continue to maintain separate contracts with EMS providers across the Wood River Valley. Officials didn’t get into specifics this week, though McCleary suggested that a single, countywide consolidated EMS service might offer efficiencies that could entice voters to fund the program down the line.
In the future, a levy could fill gaps, McCleary said, though she is skeptical it could get voter approval.
“I don’t think right now—according to survey gathering—that were are at a point where the public would support a levy,” McCleary said. “Perhaps with more education they would, I think maybe much more active support if they though there was coordination of services. That’s what really brought me to the idea of consolidation.”
No action was taken this week, though the commissioners look to continue the discussion, especially before setting the budget for next fiscal year. McCleary suggested another meeting with elected officials and fire chiefs in February.
“We need to find out individual entities’ timelines and what steps we can take into those timelines,” she said. “I’d like to have more of a roundtable with all the parties.”
Commission Chair Muffy Davis agreed
“We have to make some decisions for the next fiscal year, and I’d like to continue the conversation as to how we move forward into the next fiscal year,” Davis said. “I don’t want to come to budget season not having a plan.” 
Jim and Tom are both spot on. Consolidation of all fire departments is sorely needed. As a community we are wasting money and other resources by this age old refusal by departments to consolidate. It is time to get past the tribal nature of this situation and do what is best for for the community and for our emergency responders. With a consolidated EMS/Fire system more resources could go to affordable housing units for EMS/Fire personnel, better response times, better equipment, and so forth. The people who have obstructed consolidation need to get out of the way. The upcoming responders WANT consolidation. Get the politics out of this and get it done. Hopefully the Ambulance District Commissioners can lead the way.
My comment last night did not add any information to the conversation. Here we go with a more thoughtful comment….
Blaine County Commissioners are duty bound to create and maintain an Ambulance District. Just like the School District or Recreation District, it is a separate taxing district. The County Commissioners have appointed themselves as the acting Ambulance District Commissioners. They could appoint more commissioners or different commissioners. It might be a good idea to add a couple more commissioners.
Fire service is provided separately by the cities and county fire districts (Ketchum, SV, Hailey, Bellevue, Carey, North Blaine County, Wood River Fire and Rescue, Smiley Creek, West Magic.) Nine fire services in our county. Hang on to that thought.
Back to the Ambulance District. The Ambulance District could deliver services in several ways. They could build a “stand-alone” ambulance service that is run by county employees. They could award the contract to deliver services to a local hospital. They could award the contract to a private ambulance company. Or, they could award the contract to the local fire departments. The later is called “fire-based EMS”. I am a supporter of the fire-based EMS model for a number of reasons. The most important is that when joined together, the funding from the ambulance contract helps the fire side be more fully staffed with full time 24/7 professionals (for the fire departments that get the contract, currently Ketchum and Wood River).
Splitting the contract between two fire departments creates competition between those two agencies for funding. Not good. It is also inefficient as there are two sets of administrative staff that have to be funded so the costs go up. I think the County Commissioners are realizing this is not the best way to do things. They are thinking of one contract to one service provider. Will they choose a stand-alone system? Will they choose to award the contract to a hospital such as St. Lukes? Will they give the contract to EITHER Wood River OR Ketchum? Or will a private ambulance contractor come in and provide the best bid for services.
I don’t want to see our community lose the benefits of fire-based EMS. The funds that Wood River Fire receives from the ambulance contract allows the cross-trained fire fighter/EMT/Paramedics to staff the station in the south valley 24/7. The additional funding that Ketchum receives provides for 24/7 staffing in the north valley. Without this funding it is quite likely that the fire service in Ketchum and Wood River Fire would go dark at night and only be on call during those hours (just like Hailey and Bellevue). Why? The public does not want to pay for 24/7 fire service. But they DO want to pay for 24/7 ambulance (which we currently have and will always have, so don’t worry about that). It would be nice to maintain this fire-based EMS situation. When professionals are staffing the station 24/7 that means a fire at 3:00 am will have a quicker response time.
If the fire side could get together (consolidate) and create more efficiency in delivering fire service, they will also create more efficiency in delivering ambulance service and thus assure the ambulance contract is placed always with a fire service provider.
It’s a little complicated, but the politicians make it way more complicated by not acting in the public’s best interest. They tend to listen to the advice of their fire department chiefs who of course have a dog in the fight. Time to get their heads out of their own fire departments and into serving the public.
Create one single fire department/EMS service. we don't need 4 or 5 chiefs, letterheads, duplicate equipment. consolidate & be efficient. pass that savings on to the firefighters/ems folks. these people are the most important public servants in our county. everyone needs them & uses them.
i live in chocolate gulch. if i need fire support it comes from sun valley/elkhorn not the much closer hulen meadows fire station. that's crazy. i hear about things like this up & down the valley.
were all in this together. let's be smart about this & don't worry about boundaries.
and build more housing at the hulean meadows site. that's highly desirable, it 's free public land like greenhorn & it's public benefit for everyone. i imagine 4-8 more units could easily fit int there without our being a eye sore.
let's support the firefighters/ems folks we all need with strong living wages, quality housing & one integrated department.
Take it one step further. Create a Blaine County Fire Department. We have five entities that duplicate services and day to day management in a small geographic area. EMS responses make up the majority of calls. With the additional growth coming to this area in the next decade, service requests will be increasing not decreasing. Folks really don't care what the lettering on the side of a Fire Engine or Paramedic Ambulance says. They want fast response times, professional and caring service from highly trained personnel and equipment designed to do the job. Emergency Medical Service makes up 70% of Fire Department responses.
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Jim and Tom are both spot on. Consolidation of all fire departments is sorely needed. As a community we are wasting money and other resources by this age old refusal by departments to consolidate. It is time to get past the tribal nature of this situation and do what is best for for the community and for our emergency responders. With a consolidated EMS/Fire system more resources could go to affordable housing units for EMS/Fire personnel, better response times, better equipment, and so forth. The people who have obstructed consolidation need to get out of the way. The upcoming responders WANT consolidation. Get the politics out of this and get it done. Hopefully the Ambulance District Commissioners can lead the way.
My comment last night did not add any information to the conversation. Here we go with a more thoughtful comment….
Blaine County Commissioners are duty bound to create and maintain an Ambulance District. Just like the School District or Recreation District, it is a separate taxing district. The County Commissioners have appointed themselves as the acting Ambulance District Commissioners. They could appoint more commissioners or different commissioners. It might be a good idea to add a couple more commissioners.
Fire service is provided separately by the cities and county fire districts (Ketchum, SV, Hailey, Bellevue, Carey, North Blaine County, Wood River Fire and Rescue, Smiley Creek, West Magic.) Nine fire services in our county. Hang on to that thought.
Back to the Ambulance District. The Ambulance District could deliver services in several ways. They could build a “stand-alone” ambulance service that is run by county employees. They could award the contract to deliver services to a local hospital. They could award the contract to a private ambulance company. Or, they could award the contract to the local fire departments. The later is called “fire-based EMS”. I am a supporter of the fire-based EMS model for a number of reasons. The most important is that when joined together, the funding from the ambulance contract helps the fire side be more fully staffed with full time 24/7 professionals (for the fire departments that get the contract, currently Ketchum and Wood River).
Splitting the contract between two fire departments creates competition between those two agencies for funding. Not good. It is also inefficient as there are two sets of administrative staff that have to be funded so the costs go up. I think the County Commissioners are realizing this is not the best way to do things. They are thinking of one contract to one service provider. Will they choose a stand-alone system? Will they choose to award the contract to a hospital such as St. Lukes? Will they give the contract to EITHER Wood River OR Ketchum? Or will a private ambulance contractor come in and provide the best bid for services.
I don’t want to see our community lose the benefits of fire-based EMS. The funds that Wood River Fire receives from the ambulance contract allows the cross-trained fire fighter/EMT/Paramedics to staff the station in the south valley 24/7. The additional funding that Ketchum receives provides for 24/7 staffing in the north valley. Without this funding it is quite likely that the fire service in Ketchum and Wood River Fire would go dark at night and only be on call during those hours (just like Hailey and Bellevue). Why? The public does not want to pay for 24/7 fire service. But they DO want to pay for 24/7 ambulance (which we currently have and will always have, so don’t worry about that). It would be nice to maintain this fire-based EMS situation. When professionals are staffing the station 24/7 that means a fire at 3:00 am will have a quicker response time.
If the fire side could get together (consolidate) and create more efficiency in delivering fire service, they will also create more efficiency in delivering ambulance service and thus assure the ambulance contract is placed always with a fire service provider.
It’s a little complicated, but the politicians make it way more complicated by not acting in the public’s best interest. They tend to listen to the advice of their fire department chiefs who of course have a dog in the fight. Time to get their heads out of their own fire departments and into serving the public.
jim is right on.
Create one single fire department/EMS service. we don't need 4 or 5 chiefs, letterheads, duplicate equipment. consolidate & be efficient. pass that savings on to the firefighters/ems folks. these people are the most important public servants in our county. everyone needs them & uses them.
i live in chocolate gulch. if i need fire support it comes from sun valley/elkhorn not the much closer hulen meadows fire station. that's crazy. i hear about things like this up & down the valley.
were all in this together. let's be smart about this & don't worry about boundaries.
and build more housing at the hulean meadows site. that's highly desirable, it 's free public land like greenhorn & it's public benefit for everyone. i imagine 4-8 more units could easily fit int there without our being a eye sore.
let's support the firefighters/ems folks we all need with strong living wages, quality housing & one integrated department.
tom pomeroy
ketchum
Take it one step further. Create a Blaine County Fire Department. We have five entities that duplicate services and day to day management in a small geographic area. EMS responses make up the majority of calls. With the additional growth coming to this area in the next decade, service requests will be increasing not decreasing. Folks really don't care what the lettering on the side of a Fire Engine or Paramedic Ambulance says. They want fast response times, professional and caring service from highly trained personnel and equipment designed to do the job. Emergency Medical Service makes up 70% of Fire Department responses.
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