County government has responsibility over a wide array of issues, many of which citizens don't know about and many of which are written about in bureaucratic language that's difficult to understand. One is these subjects is oversight of ambulance services — referred to as "pre-hospital emergency services" — including the all-important issue of response times.
Stanislaus County has two efforts under way that literally could have life-or-death consequences for residents.
• First, it is negotiating new agreements with the half-dozen private and public ambulance providers serving the county. Stanislaus County is part of the Mountain Valley Emergency Medical Services Agency and that agency's new executive director has the lead role in negotiating the new agreement.
Stanislaus County threatened to drop out of this joint powers group in 2011, and it is getting a lot more attention as a result. Stanislaus is the largest among the five counties in the agency.
Stanislaus supervisors want improved performance by the ambulance companies, including better compliance with response time standards. Currently, ambulances are expected to arrive "on scene" in less than 7.5 minutes in urban areas, 11.5 minutes in suburban areas, 19.5 minutes in rural areas and as soon as possible in so-called wilderness areas, where there are fewer than seven persons living in a square mile.
That issue isn't as simple as it sounds, because the definition of "on scene" is subject to debate and interpretation. Firefighters often respond first to medical calls and press the "on scene" button, regardless of when the ambulance firms have arrived.
The county also wants the ambulance providers to have partnerships with the fire departments about what kind of help is provided and when — and who pays for it. Currently, the ambulance companies get free help from the firefighters (either volunteers or those paid by the taxpayers), but it's the ambulance companies that collect from the insurance companies.
The current five-year agreement expires Oct. 31. Richard Murdock, Mountain Valley executive director, told us he thinks negotiations will be completed in November for another five-year agreement.
The county is proposing a cap on fees that the ambulance providers can charge, but price is largely an issue between the ambulance providers and the insurance companies, at least for those patients who have insurance. The large number of uninsured residents is yet another complicating factor in this discussion.
• Second, the county is looking at how to improve the way in which 911 calls are handled. Currently, a call from a cell phone to 911 might be handed off three or four times, which obviously slows the response time. Most cell phone calls made in Stanislaus County currently go first to the Merced office of the California Highway Patrol, which is OK if they have to do with traffic accidents on roads and highways that the CHP patrols. But if a cell call is for a medical emergency within Modesto, for instance, the call could be transferred to two other dispatch centers before an ambulance is actually sent.
The situation will be improved when the dispatchers are at least looking at the same computer screens — even if they are in different locations. That's referred to as virtual integration. Ultimately, the county would like to have a fully integrated dispatch center, inevitably an expensive proposition. The Board of Supervisors last month OK'd hiring a consultant to provide advice on how to achieve a more integrated dispatch center — and therefore get ambulances more quickly to people with life-threatening medical emergencies.
We applaud the supervisors for pushing for quicker ambulance response times and for looking for ways to improve dispatch. Residents with comments on either of these subjects should contact their respective county supervisor.
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