Emergency agencies try to work it out

County medical personnel meet to discuss goals, improvements

Someone or something has got to be in charge of Flathead County's hodgepodge of emergency medical services.

It could be an official board. It could be a less-formal committee. It could be a coalition that routinely meets.

But it must be something with real clout, something is a legitimate grasp of the high-end politics and in-the-trenches work of the county's emergency response picture.

That's what a gathering of roughly 20 Flathead emergency medical agencies concluded Thursday.

A thread of frustration goes through the county's 19 fire departments, half-dozen ambulance providers, four dispatch centers and several other emergency organizations. The overall system sort of works, but not as well as it should, many emergency service officials said Thursday.

Communications and coordination among agencies - in planning, in training and in emergencies - does not mesh well, officials said.

A related problem is that communication is spotty up and down various chains of command in Flathead County. Emergency technicians talked about waiting in the field for decisions on where send injured people. They also complained about spotty communications with their own medical directors - doctors volunteering to make technical decisions about field protocols and other medical matters.

Flathead County's head emergency medical director, Dr. Rob Bates, doesn't receive many complaints from the field until problems fester into bigger troubles. And his post does not have much legally-backed clout to solve those issues.

Many fire and emergency service chiefs felt out of touch with the Flathead County Commissioners, with the Flathead City-County Board of Health and with the city-county 911 administration board. People in individual departments rarely communicate with those boards, and weren't sure which board is in charge of what. And no one appears to have the authority in Flathead County to make binding emergency medical protocol decisions that everyone has to follow, many emergency officials said.

"There isn't a whole lot of structure," Bates said.

So when 32 leaders and members of the Flathead's emergency service mapped out five-year goals Thursday, setting up some county-wide structure with actual authority was on the list.

Thursday's suggestions included creating a county emergency services board, setting up county-wide emergency protocols, making sure each emergency service supports the others in a clearly defined way, or merely having all agencies meet regularly to work out issues.

No details were worked out Thursday.

The fire and emergency representatives plan to meet at 5:30 p.m. next Thursday at the Flathead City-County Health Department to discuss the next steps in addressing their mutual concerns and goals.

Other goals that surfaced Thursday include:

. Overhauling and upgrading the county's emergency dispatch capabilities and procedures.

These would include having clearly-defined universal protocols, up-to-date equipment with better location-finding capabilities, better coordination of the different emergency response skill levels in different parts of the county, and making the dispatcher an independent agency. Dispatchers currently work for the Flathead County Sheriff's Office and the county's three police departments.

Also, better radio equipment is needed, several chiefs said.

Flathead County, Kalispell, Whitefish and Columbia Falls have agreed to merge their four 911 centers. But few details have been worked out, and a location has not been nailed down.

. Setting up a county-wide system to provide money and training to all the emergency services. Many chiefs said a stable and sufficient funding system should be worked out with the county commissioners - eliminating gambles on getting grants from elsewhere.

Some suggested emergency service impact fees be considered. An impact fee is a one-time charge against a new residence to cover the costs of expanding services to serve it.

Some suggested a retainer-like fee for ambulance services be explored.

Many local emergency officials are frustrated that a bill that would increase a state-destined phone fee - a proposed hike intended to send more money to emergency dispatch services - has stalled in the Montana Senate with apparently little support from Flathead legislators.

. Improving communications and outreach efforts with communities and the media.

. Getting the county commissioners, city councils and planning boards to look at the impacts of new housing developments on ambulance services - and to address those effects.