Local ambulances in need of new heart monitors, purchase held up by JPA

It has been about 18 months since the Cal Tahoe JPA voted to spend $192,000 on badly needed EKG monitors for the nine ambulances that serve the South Lake Tahoe and Meyers area. As of March 31, not a dime has been spent due to a division between the two fire departments that are part of the JPA.

"I don't want public safety to get in the way of politics," said SLT City Councilman Tom Davis at Thursday's emergency JPA meeting. Davis is one of two Council representatives on the JPA board. The other is Mayor Wendy David.

The meeting room at the Lake Valley Fire Department in Meyers was full of paramedics and fire fighting personnel from both Lake Valley and the City of South Lake Tahoe, the two entities that are represented on the Cal Tahoe Emergency Service Operation Authority.

Two things were on the agenda for the over three hour long meeting, the needed EKG monitors and the City's desire to pull out of the ambulance business.

The heart monitors on South Lake Tahoe ambulances have failed a few times, including two incidents in March, according to the City's medics that were on hand to discuss their desire to buy the Physio model of EKG machines. Lake Valley's personnel want to buy another brand, the Zoll.

Patients died in two recent cases of the monitors malfunctioning in the city, though there is no evidence to say a monitor would have saved them.

But, as Davis said, politics need to be left out of the purchase that was approved in the 2014 budget.

The purchase, or lack of, had previously left the board in a deadlock so they assigned a committee to figure it out. Both sides in the committee still disagree on which brand to buy.

Even the Fire Chiefs are of opposite opinion.

With a four person board there is no-tie breaker built into deadlocks, of which there have reportedly been many. The two members on the JPA from Lake Valley Fire District are Chairperson Bob Bettencourt and Dave Huber.

South Lake Tahoe medics want the Physio monitors because they are what Barton Hospital uses, making it easier to transfer patients when transporting to the emergency room. It is also the same machine that is in all City buildings and in use at Carson Tahoe Hospital.

Lake Valley medics want the Zoll because it is lighter and thus easier to carry into the back country. It is also the same brand Cal Star uses.

One suggestion was made that the three Lake Valley ambulances use the Zoll, and the six City ones use the Physio. It was observed that this may cause issues with the necessary training on two types of machines.

"It makes no sense for us not being able to go with the same monitors as our hospitals use," said SLT Medic Sophie Tetlow. "Sad to see egos getting in the way."

She also added, "There seems to be some misunderstanding and miscommunication."

No decision was made and tabled until their April 11 meeting.

The other hot topic on their agenda was the acceptance of a letter the City submitted, telling the JPA they would no long be in the ambulance service in 30 days. Another split decision 2-2 resulted and the letter was not accepted though the City's members on the board weren't sure why this was an agenda item.

The City submitted the letter on March 16, 2016. SLT Fire Chief Jeff Meston said that they are prepared to remain with current service and won't leave the public without emergency services should Lake Valley and El Dorado County need longer to work out the transition.

The original contract the Cal Tahoe JPA had with the County does not give either the City or the County enough money to cover the ambulance services for the area, a shortfall of about $1.1 million according to both Meston and Lake Valley Fire Chief Gareth Harris. Harris said Lake Valley Fire District has to pay about $400,000 for ambulance services, $700,000 from the City according to Meston.

The Cal Tahoe JPA is funded by property taxes from city and county residents, along with funding from the government. The City wants to remain a voting part of the JPA since they want to watch how their citizen's money is spent according to Davis.

SLT Fire Chief Jeff Meston told the board he has a fiduciary responsibility to the residents to keep fire personnel in the City to protect them, and to use EMS personnel on ambulances as they are sometimes pulled out of town on inter-facility transfers. This move kept the same number of firefighters and medics as before, and he hired temporary EMS staff to run the ambulances. The move was created to make up their annual loss.

Lake Valley Fire, on the other hand, wants a fire-based ambulance service so there are trained firefighting personnel on the ambulances along with paramedics.

In some communities, private ambulance services are utilized and fire departments handle only fires and emergencies, not patient transport. In two California cities, Alameda and Anaheim, the local hospital provides it so they can successfully manage inter-facility transfers with their schedules.

While the JPA arrangement is worked out between the City, the County and Lake Valley, the board will need to meet their previous commitment and purchase the monitors for the ambulances.