Board of Health continues to examine emergency services' proposals

One person's "teeth" is another person's "penalty" and a third person's "remedy."

"Remedy" won.

These semantics played out Thursday as the Flathead City-County Board of Health tries to obtain the legal clout to get the county's emergency medical services operating on the same page.

The board is sending a draft resolution to Flathead County's commissioners. If passed, that resolution will give the board authority to create a framework to govern emergency medical services across the county.

Right now, at least 29 departments and agencies provide some type of emergency medical services in the Flathead.

However, they operate in a hodgepodge of different jurisdictions, procedures, skill levels and equipment - with no clear-cut idea of which public board is ultimately in charge.

At least two-thirds of the county's emergency agencies have met four times to discuss how to better coordinate themselves.

Their first step was to convince the county commissioners to give the board of health the legal authority to tackle these issues.

They also wanted the county emergency medical director - who works for the board - to have the legal clout to make decisions on county-wide protocols and to enforce them.

Those emergency officials agreed that the medical director's lack of enforcement has been a major hurdle in fixing the local situation.

The board of health is now seeking that coordination and enforcement authority from the county - expecting to send its draft resolution to the commissioners within a few days.

Until Thursday, the draft resolution appeared to be watered down when the enforcement language - with potential criminal and civil penalties - had been removed from the draft by Deputy County Prosecutor Dennis Hester.

That led to e-mails from Kalispell's Fire Chief Randy Brodehl and Kalispell City Council Member Duane Larson, who is also on the board of health - both whom attended the prior emergency services meetings. Their e-mails protested the removal of the enforcement language.

"This seems to mean that the ordinance becomes a paper dragon of feel-good words without the teeth needed to enforce the standard of care," Brodehl wrote.

Hester said that Montana's county governments - unlike its city governments - do not have the legal authority to declare specific actions as crimes. Consequently, Flathead County commissioners cannot create any new crimes not specifically covered by the state.

Hester originally thought civil offenses and penalties faced similar state legal barriers, but further research has convinced him otherwise.

Therefore on Thursday, the board of health revised its draft resolution to seek the clout to designate civil offenses and civil penalties if any emergency agencies defy the county's medical director, who is currently Dr. Rob Bates.

"Without some type of enforcement, it's not worth the paper it is written on. … I'm glad to hear you can write some enforcement into it. I don't care if it is criminal or civil," Larson said.

Some board members balked Thursday at putting the word "penalties" into the sought-after powers in the draft resolution. They were not sure how the board could penalize any agency that defies future coordination rules - other than revoking medical privileges.

However, board chairwoman Nan Askew, health department director Joe Russell and Larson - all of whom attended the four emergency services' meetings - said the "penalty" powers are an important point to those agencies.

Consequently, the board of health compromised to ask the county commissioners for the power to enforce "remedies" on any agency that does not follow the future rules.

Since civil penalties will likely mean going to court, board members wondered if they should create a conflict-resolution process as part of any future enforcement framework.

Reporter John Stang may be reached at 758-4429 or by e-mail at jstang@dailyinterlake.com