Kirkpatrick, Locals Disagree On $400K Plan For Full Time EMS Crew

In the coming months, Clark County will be stationing a full-time Emergency Medical Services (EMS) crew, staffed by a private ambulance company, in the Moapa Valley community. This crew will be in addition to the volunteer personnel at the three local fire stations currently serving the area. The paid full-time crew will be funded from the budget of the Moapa Valley Fire District (MVFD).

All of this is a part of a proposal laid out last week by Clark County Commissioner Marilyn Kirkpatrick during a town hall meeting before an audience of more than 100 people. Tension was high at times in the Overton Community Center during the Tuesday, Aug. 21 meeting; mainly because most members of the public in attendance were opposed to the plan.

Kirkpatrick explained that she had directed County staff to put out a Request for Proposal (RFP) for private ambulance services to bid on the chance to provide the ambulance service in the area. The RFP went out on August 8 and is scheduled to close Sept. 8.

The RFP would require a team consisting of a paramedic and Emergency Medical Technician (EMT) to be stationed in an ambulance in the Moapa Valley community each week from Monday to Saturday during daytime hours. The intention was for the paid crew to cover EMS calls during hours when volunteer availability has traditionally been sparse.

Kirkpatrick said that her plan was in response to a conversation held during a MVFD board meeting last October. “The key things I heard in that meeting were: 1.) you don’t have the recruitment you need to stay fully staffed; and 2.) you are not covering EMT services – that there is not enough volunteers to cover the days when people are working. So I have been working on solving that problem ever since then.”

Kirkpatrick said that the RFP also mandates that the ambulance company provide a training program at the local high school in hopes of encouraging young people to volunteer after graduation.

In addition the company would be required to hire 5-6 local residents to be part of the full-time team, the RFP states. This could include people who already live in the community and work with the company as paramedics or EMTs in Las Vegas, Kirkpatrick said.

Early estimates on the cost of the RFP had been projected at not more than $400,000 per year, Kirkpatrick said. But no hard numbers will be known until companies have come back with their proposals.
“We have budgeted up to $400,000 in your budget for it,” Kirkpatrick said.

She explained that the district currently has nearly $6 million sitting in reserve and has typical annual revenues of about $800,000. Those revenues come wholly from the district’s allocation of State Consolidated Sales Tax.
“You don’t need to worry about your budget today,” Kirkpatrick said. “You have the reserves to do this as a pilot for one year. Then we can reevaluate to see if it makes sense to continue; and the county may have to step in and offset some of it if it moves forward from there.”

Other changes that Kirkpatrick was proposing pertained to the way that the district operates and is governed. She said that county staff has been working on changes to the district bylaws. These revisions would expand the five member fire district board to a seven member board.
“I need to have more community involvement on this board,” Kirkpatrick said. “Ideally I’d even like to see a high school student serve as one of the members of this board.”

A full-time fire chief was also needed to manage all three local stations, Kirkpatrick said.
These and other proposed changes would be aimed at providing better oversight on financial matters, Kirkpatrick added.

Most of the comments from the public were opposed to the RFP plan. Many people in attendance were concerned that Kirkpatrick’s decision seemed to be circumventing the efforts of the MVFD board over the past year.

In March, the board presented an alternate plan. It involved the district hiring a paid, part-time crew of local paramedics and EMTs to collectively cover the daytime hours response.

In addition to that, local chiefs have worked to tighten down their volunteer scheduling in recent weeks. In doing so, they have been able to find a make-shift solution to the lack of availability during daytime hours. As a result, response times have reduced drastically for the district and the community currently has round-the-clock EMS coverage, according to Overton Station #74 Fire Chief Steve Neel.

But Kirkpatrick said that this development had not been communicated to her in enough time to change the RFP process. “I have always been open and honest that we were going to have an RFP,” she said. “That truck has left the station. So I can’t stop the process now.”

The MVFD Board’s alternate plan would also institute a pay-per-call system to compensate volunteers for their emergency calls. This element was intended to incentivize young people in the community to volunteer, thus increasing district recruitment.

The board’s alternative plan came in at a projected cost of $305,000 per year for all of these services.
Kirkpatrick’s plan has also adopted the board’s pay-per-call model. But the cost of pay-per-call would be over and above the budgeted $400,000 maximum cost of the RFP.

Several attendees at the meeting asked why the board’s less expensive plan was not being implemented instead of the RFP for an outside provider.

Kirkpatrick responded it was more complicated than that. “You would have to pay into the PERS system,” she said. “You’d have to pay workman’s comp. It may look like it is easy to you but there is a lot of complexity there. So what we said was that we will start with this (RFP) as a pilot program. Then we can see how to move forward.”

Others were concerned that the RFP only covered a small portion of the calls needed during those hours. The paid crew would only respond to EMS calls. They would not be equipped or qualified to respond to fire calls, remote rescue calls or even simple requests for lift assist.
“What I am concerned about here is the mismanagement of money,” said one attendee in a comment. “You are spending a lot of money hiring people who aren’t really fully qualified to do the whole job needed.”

At that point Kirkpatrick became visibly frustrated. She began referring to a list of expenditures which, she said, the board had approved over the past year and which she had considered frivolous.
“If you want to talk about mismanagement of money, I think it was ridiculous that the district spent $50,000 to repaint all their trucks,” Kirkpatrick said. “I think it is ridiculous that we are spending $25,000 on patches and new uniforms and all of these things. I think we need to get back to what is important: public safety and ensuring that you have a high level of service.”

District financial documents show no record of the district repainting its vehicles. There are, however, records over the past year of decals being replaced on district equipment at a cost of $3,742.42. In addition, the district spent $2,786.88 on new uniforms for all of its personnel and $550 to produce patches to be affixed to those uniforms.

Despite the opposition at the meeting, Kirkpatrick was adamant that the RFP would move forward.
“We are already out in the process right now and I am not going backwards on this,” she said. “You can be mad at me all that you want and think that I could have done it differently. But I have a responsibility to see that this service is provided and that is what I am going to do.”