The Olympia City Council temporarily deferred taking action on a city-commissioned study that recommended the creation of its Basic Life Services (BLS) program.
In his presentation at the city council meeting held Tuesday, May 24, Olympia Assistant Fire Chief Michael Buchanan said there is decreasing availability of private ambulances to respond to emergency medical services.
Citing the analysis made by the FCS Group, a finance management consulting firm,, Buchanan said the current BLS service level is deficient. It is measured based on the delay or unavailability of BLS units.
The Olympia Fire Department (OFD) contracted with the FCS Group to evaluate the feasibility of establishing a city-owned and operated BLS transport program.
FCS noted that in 2021, there were approximately 3,400 ambulance transports. During this same year, the city experienced decreasing availability of private ambulance providers.
OFD provided data to FCS, including a graph reflecting the percentage of time that American Medical Response (AMR) has been unavailable or delayed in transporting patients to local hospitals or emergency rooms increased from 12% at the beginning of 2021 to 37% by the end of the same year.
AMR is Olympia’s primary BLS provider.
Buchanan said that a call to 911 for a medical emergency requires either BLS transport or advanced life support (ALS).
Thurston County Medic One vehicles and staff handle ALS transportation, while Fire Departments contract private providers for BLS.
Buchanan said when a BLS ambulance is not available, they have to request ambulances further away.
“If ambulance is not available, we request Olympic. If Olympic (Ambulance) is not available, we request other fire districts for transport units. If there is available, it has to travel a further distance,” he said.
Olympic Ambulance is another private BLS ambulance provider in Thurston County.
“What happens is it decreases the response times and impacts the entire system. Patient have to wait longer for a transport that affects patient care,” Buchanan said.
“This has resulted in either increased on-scene times by city emergency response staff while awaiting arrival of BLS units or the necessity of using the city’s emergency response vehicles to transport patients to the hospital.” Buchanan added. “In either case, it means that the city’s emergency response units are unavailable to respond to other emergencies while they either await an ambulance unit to arrive, or the emergency response unit is transiting a patient to the local hospital or emergency room.”
Buchanan also cited the five-year data from the OFD, where the response time for Olympia’s call volume is lengthening and getting longer.
“There’s a reason for that – more incidents, more concurrent calls,” pointed out the assistant fore chief. “The waiting for a private ambulance company to be able to conduct the transport in timely manner can be a portion of this elongation of our response time.”
Buchanan said private ambulance services are not meeting the demand.
He added that decreased ambulance availability results in increased response times to concurrent emergencies and decreased patient care while they wait to be transported.
FCS analysis
On May 18, FCS Group sent a two-page memorandum to Olympia Fire Department Chief Mark John showing the feasibility analysis.
Based on FCS Group’s 10-year forecast and financial analysis, it stated the city could create and operate a BLS program to address the current BLS service level deficiencies.
“While the city can operate a one-unit or two-unit BLS program, a two-unit program is optimal. It would enable the city to respond to forecasted BLS calls for service, improve services to the community, and deploy its emergency response resources more efficiently and effectively,” its report said.
City Manager Jay Burney expressed concern about the lack of private ambulance service to handle BLS support on an ongoing basis but asked the city council to delay action until they have sorted through the concerns that have been raised.
“I would like to take a cautious approach of making sure that I fully understand the concerns that are being raised, and that when we bring this back in front of you, we take all that into account,” Burney said.
Olympia deputy attorney Annaliese Harksen explained to councilmembers the process that would need to take to move forward with establishing a public utility ambulance service.
Under the Revised Code of Washington35.21.766, the city council may establish an ambulance service system if it determines that an existing private ambulance service does not adequately serve the city or its substantial portion.
According to Harksen, the process would involve the publication of the FCS analysis, approving a resolution that would direct the city manager to issue a 60-day notice to the private ambulance services to make improvements to meet the generally accepted medical standards.
After the 60-day notice, Harksen said the Olympia Fire Department and FCS Group would report back to the city council to report further study and determination if the private ambulance services are meeting the reasonable levels of service.
In deferring to take action, Mayor Cheryl Selby said they need a proper amount of outreach. “We have responsibility to our community at large to make sure that everyone’s needs are served and what that picture looks like.”
Councilmember Lisa Parshley said she was concerned about the data and wanted to look for an option. “Even if it is a public-utility ambulance, which helps reduce the load countywide, that might be a positive for everybody. I want everybody to keep their minds open.”
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