A joint meeting between the Public Hospital District and Fire District ended abruptly after a vulgar statement was made by a fire commissioner.

“Roll the eyes, you bitch,” San Juan Island Fire Commissioner Frank Cardinale said during a conference call on July 28.

The San Juan County Public Hospital District No.1 and SJIF&R joint meeting was the first for the two boards since four all-new commissioners joined the PHD in January. The comment brought ire from the Public Hospital District as it was likely directed toward the commission’s chairperson Anna Lisa Lindstrum.

“This is deeply troubling,” PHD Commissioner Trish Lehman said. “How can we have trust if this kind of behavior is occurring? That’s unacceptable.”

The alleged eye-roll occurred just after Cardinale was suggested to be the representative for the fire district on a steering committee working toward integration. Cardinale has served on the existing steering committee since it formed in April 2019.

“Our community deserves better than this. We have asked for cooperation. … This is really hard when you don’t feel respected,” Lindstrum said. “We’re trying to do the right thing for our community and we’re trying to do the right thing for our staff. … It’s very hard to move forward when there is this type of animosity.”

Following Cardinale’s statement, the PHD commissioners noted they would like him to be removed from the steering committee and they were questioning the merger’s future.

“I’m deeply troubled. I have serious concerns about a vindictive, misogynistic statement like that occurring in a conversation like this,” PHD Commissioner Kyle Loring said. “I don’t know how we can feel comfortable with EMS integrating with an organization that has that kind of leadership.”

Turmoil between the two commissions has simmered over the last few months since the PHD board voted to suspend the integration between the island’s emergency medical services and fire departments during its May 5 meeting. The fire department responded to the news with disappointment.

“Good relationships are the foundation of this process and I realize it’s been a bumpy road. I would hope everyone is doing their best but we need good relationships with all of our partners,” Lindstrum said in response to Cardinale’s statement. “This kind of thing does not have a place in this process.”

Up until the last seven minutes, during the approximately 76-minute meeting, the two boards had discussed the next steps toward resuming the integration process.

“Given the stress on our agency, we suspended integration work in May,” Lindstrum said. “Big changes are really difficult in the best of circumstances.”

Lindstrum noted there were several questions left unanswered prohibiting the integration from advancing. She questioned what a combined agency would look like, how it would be structured, and how the budget and staffing would reflect that structure.

“[EMS] would represent 80 percent of the call volume,” Lindstrom said. “So there are answers that we need before we can make a decision about how to move forward.”

Fire Commission Chairperson Bob Jarman replied that the steering committee was pursuing the next steps and working to answer those questions before taking a break earlier this year due to COVID.

“[Fire Chief Norvin Collins] is still in the process of putting that together. Until we have those answers, we can’t really answer really much of anything else,” Jarman said. “We’ve taken the steering committee’s advice, we’ve got plenty of talent in the fire side and what we’ve been looking for is what the organization is going to look like? We don’t have the answer to that yet.”

Lehman asked for a road map from the steering committee to help direct both commissions in continuing forward in the integration process. She stated that the PHD asked for a budget, while Jarman contested it had not. Jarman said a budget is not possible without knowing how the organization will be structured.

“We need to know what the organization will look like first before we can budget for that organization,” Jarman said. “Until we know what the organization is going to look like, we’re spinning our wheels.”

San Juan Island Emergency Medical Services Interim Chief Karl Kuetzing responded, saying the steering committee — of which both he and Collins were a part of — had been using a document known as the CAG Report for guidance. The Citizen’s Advisory Group was created in April 2018 by the two boards and the town. Each of the three entities selected someone to represent its organization and two additional at-large members were chosen. CAG released its 117-page report, and a suggestion to progress with the merger, to the two commissions in April 2019.

Kuetzing said questions still remain unanswered regarding the area covered by the districts; how licensing would work; tax structure levies; and organization.

“The answers to those questions would then lead the organization model further down the road,” Kuetzing said. “The organization model would help define what the budgets and the spending would be. So it was a matter of prioritizing what we felt were the things that needed to happen first.”

Prior to the COVID pandemic halting progress, the steering committee was at a point where it was ready to start realigning boundaries, Kuetzing said. While EMS provides services on San Juan Island, as well as Brown, Henry, Pearl, Speiden, Johns and Stuart islands, the fire department only provides to San Juan, Brown and Pearl Islands.

Friday Harbor is contracted with the fire district and therefore it isn’t included in the district’s property tax levy, it is paid for by part of the town’s property taxes. The proposition to annex the town into the fire district was originally supposed to be placed on the April 2020 ballot but was postponed due to COVID. No date has been determined for when that annexation vote will occur.

It was suggested that a new steering committee continue the work started by the previous one. Lindstrum said the committee should include both fire and EMS staff — not just administration or executive staff, but firefighters and emergency medical technicians; a member of the public; a member of the CAG; a representative of the town; and someone from both boards.

“Whatever happens within the steering committee, decisions aren’t made there, they’re suggested and that then goes back to the boards for approval,” Lindstrum said, adding that she got a sense that the previous committee process was “out of control” and that the boards were not involved with having final approval.

As of February 2020, the steering committee was comprised of Collins; Kuetzing; Town of Friday Harbor Administrator Duncan Wilson; Cardinale; and Lindstrum, who had taken over for former PHD Commissioner Rebecca Smith for just two meetings before the COVID pause.

Cardinale disagreed with Lindstrum’s assessment that the steering committee had free reign.

“There’s no basis for that. You make the statement but don’t back it up with any real evidence. I don’t understand the out of control part,” Cardinale said, noting he didn’t think the people involved in the steering committee needed to change. “I think it needs to keep moving forward.”

A suggestion was made to add EMS Medical Program Director Dr. Josh Corsa to the committee which was agreed upon by everyone.

Lehman added she believes the steering committee needs to be driven by a partnership between the two boards, noting she felt that the fire department had been leading the process thus far.

“We would like it to be an equal partnership,” Lehman said. We have a tremendous organization … we want to see that [health care] is a priority.”

Cardinale disagreed with Lehman’s allegation that the fire department was dominating the discussion. He noted that Collins, who has more than 30 years of experience working in integrated emergency service departments, was selected by the steering committee to lead.

“I’m getting a bit tired of all the abuse that has been centered towards our chief. I’ve heard nothing but derogatory things said about him and I’m fed up with it,” Cardinale said. “I don’t want to hear any more about it. He works for the fire commission, he does not work for the hospital board.”

Wilson said both commissions have probably said or heard things that bothered them about the other regarding the merger. He noted that if they continue to argue about things no common ground could be found.

Loring agreed, and added, “I implore both of the boards to stop the bickering that’s happening right now. I don’t think it’s helping.”

Collins said he respects the request to have input from staff. He noted he thinks the steering committee needs to include himself; Kuetzing; Wilson; a commissioner from both boards; CAG member Chuck Dahldorf; and PHD Superintendent Pam Hutchins. Jarman reiterated that Corsa should be included.

The next steps for the steering committee are to outline necessary tasks needing to be performed to complete integration and a timeline.

“Having a plan forward that then comes back to the boards … would be what I would like to see come out of the steering committee,” Loring said.

Wilson said he’d like an integration task list and timeline to bring before both commissions by the End of August. He noted that the steering committee already had a list, it just needs to be reviewed and validated.

“A lot of the leg work has already been done, it just needs to be formalized and presented to us,” Jarman said.