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Public workshop to target ambulance service

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The public will have an opportunity to weigh in on options to fund paramedic transport services at the next Ramona Municipal Water District meeting on Tuesday, Dec. 8.

The meeting will start at 2 p.m. in Ramona Community Center, 434 Aqua Lane.

Options for ambulance service, as well as several other Ramona Fire Department-related issues, including contracting with the San Diego County Fire Authority for fire prevention services, were discussed during the water board’s three-hour meeting Nov. 10. The Ramona district’s contract with Cal Fire to staff fire and paramedic services increased about half a million dollars this year.

“There are three ambulances nearing the end of their useful life,” said David Barnum, the district’s general manager.

All three will need to be replaced in the next three years, he said. Two of the ambulances are advanced life support and one is a reserve.

To transport a patient down the hill to a hospital requires a two-hour commitment, said Ramona Fire Department/Cal Fire Battalion Chief Burke Kremensky. For Fire Station 80, which averages four transports a day, that is a commitment of eight hours per day, he said.

Option 1 would be to continue paramedic transport services as is and replace all three ambulances over the next three years, which would cost about $630,000 plus financing. The board may then consider going to the public for a vote to raise the annual $188.52 fire EDU (equivalent dwelling fee), which has not changed since 1996. The fee pays about half the amount for the service, with property tax revenues making up most of the difference. In the past, the district has received grants from the Indian Gaming community to help purchase ambulances, but in 2014 Governor Jerry Brown suspended that grant process due to state funding shortfalls, according to the district.

Option 2 suggests subcontracting with a private ambulance service and staffing each fire engine with a paramedic. That could result in cost neutral operational costs and potential savings of $630,000 in capital costs, the district said. The fees charged to patients by the subcontractor would be determined by the level of service and could potentially be increased from the fees currently charged by the fire department, the agenda memo states.

If the district contracts with a private firm, an ambulance and paramedics would be at each of the fire stations and they would respond to medical calls and provide transport to a hospital if necessary, said Kremensky. They would not respond to fire calls or vehicle extrications.

Board president Darrell Beck said he wants to bring this item to the public.

“We want to know what level of service they’d like to pay for,” he said.

To change the fire EDU fee requires a public vote, Beck noted.

“After we hear from the public, I’d like to consider going to a vote of the people,” he said.

In another agenda item, the board approved setting up a vehicle replacement fund for the fire department. Kremensky said the district has three fire engines — six, seven and eight years old — and a 25-year-old reserve engine.

When one of those three breaks down, Kremensky said, “we rely on a 25-year-old fire engine.” Replacement of engines will need to start in 2021, he said. A new fire engine costs about $600,000.

Director Jim Hickle questioned the current fiscal impact of approving a vehicle replacement fund, as a scheduling chart on the agenda memo showed allocating $600,000 for the 2015-16 fiscal year. Barnum said that was wrong, there would be no fiscal impact now and the board will have the opportunity each year to approve an amount for the fund.

The board unanimously agreed to enter into a contract with the county fire authority for fire prevention services at potential annual savings of $150,000. The Ramona Fire Prevention Bureau traditionally has been staffed by two employees, but after Fire Inspector Jeremy Davis left to work for the fire authority, Fire Marshal Steve Foster assumed his duties. The fire prevention bureau handles plan reviews and inspections for new construction within the district boundaries. The agreement could lead to savings for future vehicle replacement costs, vehicle maintenance and fuel, according to the district.

The board also approved:

An agreement between RMWD and Cal Fire for reimbursement of fire engines on fires in state responsibility areas. The new agreement reimburses the district for up to 24 hours per day, an increase from the former 16 hours daily, at a rate of $90 per hour.

An agreement with the county for cost reimbursement of approximately $25,000 annually for providing emergency medical services.

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