The new year has brought changes to San Juan Island Public Hospital District 1.
An interim chief for San Juan Island Emergency Medical Services was selected, and a longtime commissioner will remain on the board.
Interim EMS chief
The interim EMS chief was appointed on Monday, Jan. 8, to the disappointment of four EMS staff members who spoke at the public hospital district meeting.
Commissioners appointed Richard Frazer as the department’s interim head, though three of the four staffers who spoke noted the hiring procedure didn’t follow EMS rules and wasn’t transparent.
“I’m confused because there are no guidelines for this position, and there was no communication with the chairman [of the public hospital district board] for two months,” said outgoing Chief Jerry Martin about the process to hire his replacement. “It seems like we aren’t following our own policies and procedures.”
Martin recommended Kylie Davies, a full-time paramedic at the district since 2002, but Frazer was voted in by a 3-2 vote. Commission Chairman Bill Williams and Commissioners Monica Harrington and Anna Lisa Lindstrum voted for Frazer, who will start to train with Martin immediately. Lindstrum was elected in November 2017 to replace former Commissioner Barbara Sharp.
There was no public comment section at the specially held meeting, but Martin and two members of EMS were scheduled to speak and a third opted to talk on the spot. All of them requested Davies to be hired.
Karl Kuetzing, director of EMS operations, noted there was no application for candidates to complete. Weyshawn Douglas Koons, director of EMS Emergency Response, said her job had been threatened twice over her opinions of the hiring process, which made speaking about it at the meeting difficult, though she opted to talk. Harrington later told the Journal that, “No hospital district commissioners have threatened Koons’ job.”
The hiring procedures in question were established by EMS staff members in 2011 and modified in 2015, according to the document provided by the department staff. The procedures in the guidelines were not followed, according to Kuetzing and Koons. These include:
• Emailing open positions to all active agency members at least one week before the deadline to apply.
• Typically filling the position with existing personnel, and if no one is interested, publicly posting the position for a minimum of two weeks.
Martin said he knew of one qualified, former EMS staff member who is interested in the position but couldn’t apply because it was not publicly posted. Instead, a request for letters of interest was announced at a public hospital district meeting and Williams said the open position was publicized by word of mouth.
Harrington said that this interim hire, who will possibly only work until EMS merges with the local fire district, does not require the same procedures as a permanent candidate. Commissioners have been looking into the possible merger to save money.
Williams added that EMS’s hiring guidelines are not set policies and are only used to fill internal candidates, not the department’s chief. The guidelines state that employment is at the “sole discretion of the chief,” who, in this case, is leaving at the end of January.
Martin announced he would leave the department during an October public hospital district meeting and suggested EMS join San Juan Island Fire and Rescue to balance the department’s budget.
Fire districts can collect more taxes than EMS departments, said Commissioner Michael Edwards at that Oct. 25 public hospital district meeting. EMS services could receive up to roughly $1.50 more per $1,000 of assessed property value under a fire district tax levy, he said.
Harrington noted that the department’s culture seemed to dislike outsiders, but one reason the EMS budget is so bleak, she said, is because staffers weren’t careful enough when collecting insurance reimbursements and more oversight is needed.
“The budget is scary,” said Harrington, noting that some paid volunteers might be cut if finances aren’t put in order.
Harrington explained that, for years, no one was overseeing the department’s accounts receivable to ensure what was on the books was actually collectible. This, she said “was bad financial management and made the books look much rosier than they actually were.”
When Martin joined EMS in 2016, he previously said there was $4.1 million in the department’s accounts receivable, which is now down to $950,000. Harrington said all of the $4.1 million was likely never collectible. The majority of EMS patients, she said, pay through Medicaid or Medicare, which typically provide lower reimbursements than private insurance.
“We have a fiduciary responsibility to the community,” said Harrington about the board’s job to oversee EMS finances. “I was never going to hire an interim chief who didn’t have financial experience.”
Frazer has lived on San Juan Island since 2016 and worked for an air medical operation in Colorado called Air Methods for 28 years. He also provided consulting work for Island Air from 2015 to 16, he said. Island Air is a local charter company, which also offers air ambulance services. San Juan Island EMS provides ground ambulance services, but not medevac.
Frazier admitted he has less ground ambulance experience than Davies, but more management and budget expertise.
He also disclosed that he’s “good friends” with Williams, when asked about their relationship by Commissioner Mark Schwinge, who, along with Edwards, did not vote to appoint Frazer. Schwinge also asked if Frazer would take the position if it meant some members of the department would leave. Frazer replied that he would like to know why those individuals would quit because of him.
Davies started volunteering for the island’s EMS in 1999 and is the department’s safety officer and a member of the county’s board of health.
Kuetzing noted that the specially held public hospital district meeting, in the middle of the day, prevented many of the public from attending. EMS staff, he said, has been left in the dark.
“We’ve been told there’s a plan in place, but we haven’t been told the plan,” said Kuetzing.
Later, Williams explained that there is no set plan to merge with the fire department or even for the duration that the interim chief will be in place. Lindstrum admitted that there should be more transparency going forward, including notifying stakeholders of scheduled meetings.
Incumbent remains on board
Edwards is keeping his seat on the commission, although he didn’t run for re-election last November. He was first appointed in 2005.
“I love EMS so much,” said Edwards. “I’m sticking it out after 13 years because there’s a lot to be done.”
Pam Hutchins, the public hospital district’s superintendent, and her assistant found a legal precedent to allow Edwards to remain in his seat when the winner of the position, Peg LeBlanc, chose not to be sworn in by the start of the new year.
LeBlanc ran unopposed for the seat and won in the November 2017 election. Before the vote, she told the Journal she had dropped out of the race, but her name had already been printed on election ballots.
Previously, Hutchins told the Journal that if LeBlanc did not want the position, a replacement would be appointed by the remaining commissioners after public interviews.
Edwards will serve two years of the seat’s six-year term and the position will go to the ballots in 2019, for the elected commissioner to start serving the following year.
