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File #: 21-1642   
Status: Agenda Ready
File created: 11/4/2021 In control: Clark County Board of Commissioners
On agenda: 11/16/2021 Final action:
Title: Receive a report from the Fire Department for revised boundaries of the Ambulance Franchise agreement; and direct staff accordingly. (For possible action)
Attachments: 1. Staff Report, 2. Meeting Handout 111621 Item No. 43.pdf
Date Action ByActionResultAction DetailsMeeting DetailsVideo/Audio
11/16/2021 Clark County Board of Commissioners Approved

Agenda note: DOCUMENT(S) SUBMITTED: 1. Unincorporated Clark County Call Efficiency Analysis (18 pages), submitted by Applied Analysis SPEAKER(S): Present DISCUSSION: Following introduction of the item, the Board was addressed by Deputy Fire Chief Wyatt who presented the proposed map which addressed that the southwest part of the Valley experienced an increased call volume, a nationwide staffing shortage, and compliance with the franchise agreement; added a Zone eight; Zones seven and eight proposed to move to Community Ambulance; Zones one and two will remain with American Medical Response (AMR); and Zones five and six will remain with MedicWest; and the zones were divided into equal call volumes as much as possible; and each franchisee within the agreement was given approximately 33 percent. Commissioner Naft advised that the proposed was fair in response to the data provided by Clark County Fire. Commissioner Kirkpatrick expressed concern regarding topics including constructing hundreds of homes with the lack of services, insufficient resources, and the workforce shortage. Discussion continued regarding topics including monthly studies reports; diversion reports; the call volume increased approximately six percent every year; the franchise agreement; check for compliance on a yearly basis and rezoning; hospitals are the patient’s choice; shortage of resources, including staffing; the pilot program and franchisee performance; and meeting the needs of the community. Deputy Fire Chief Wyatt advised that the fire department was a hazard response entity and responds to all incidents; calls were prioritized into five categories which determined the speed, lights, and sirens needed to respond to the incident site; and used Computer-Aided Design (CAD) to reduce the patient wait time for transportation to the hospital. Damon Schilling, Government Community Affairs Manager for AMR, advised of participating in the pilot program which resulted in AMR failing to meet the minimum standards, while Community Ambulance did not take part in the pilot program; the stakeholders and administrators never evaluated the data from the pilot program, AMR conveyed the data to Applied Analysis for review; staffing challenges and sick employees added to the challenging situation; dividing the zones based on call volume was fundamentally flawed as other factors needed to be taken into consideration; recommended that the territory should not be divided, the pilot program had unintended consequences, and the data suggests alternatives to improve the system and patient outcomes; and further advised that AMR was working to recruit staff and experienced difficulty obtaining ambulances and other assets. In response to Commissioner Miller, Damon Schilling advised that the four additional minutes to respond were applied to lower acuity calls; and recommended that the response time not be changed, the resource requirements be changed, and lower acuity calls be directed to Emergency Medical Technician services. The Board was addressed by Brian Gordon, from Applied Analysis, who advised that the issue was defining priorities, including priority four calls going without lights or sirens; call volumes; time spent on cancelled calls; inefficiency; reallocation of resources; analyzed the amount of time spent on cancellations related to the reclassification of those calls and the additional capacity that would exist in the system; and the excess time beyond compliance specifically for those priority four calls and the time it translated into, which was approximately 122 hours overall, in the amount of inefficiency in the system. Discussion followed regarding topics including diversification of the map zones; recruiting and retaining employees; cancelled calls; how the pilot program impacted the inability of the companies to meet the criteria; examine dispatched resources and alternatives; priority four calls; and the increased volume of cancelled calls. Damon Schilling expressed that the division of the response area was not the solution and recommended a reallocation of the resources dispatched to calls as an alternative solution. Deputy Fire Chief Wyatt advised that there is no way to know the severity of the call or if a patient will want to be transported via ambulance until the unit is on scene; need to respond to all calls regardless of the priority; discussed types of cancelled calls; and recommended proceeding under the franchise agreement with reallocating the zones. Commissioner Kirkpatrick advised of various factors influencing the calls including growth, social-economic, areas with higher traffic, and ability to pay; and recommended reviewing more frequently. Staff was directed to provide the Board with updated numbers for the previous month as available.
Pass Action details Meeting details Video/Audio Video/Audio





Randall J. Tarr, Deputy County Manager



Receive a report from the Fire Department for revised boundaries of the Ambulance Franchise agreement; and direct staff accordingly.  (For possible action)





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Additional Comments:




The Fire Department will provide a report for revised boundaries of the Ambulance Franchise agreement.