A Capitalism Success Story

Several years ago the Tulare Board of Supervisors were faced with a dilemma. A major ambulance provider had decided to close their doors. How were they going to ensure that the people of the county had adequate emergency services?
They did something that I believe is too rare in politics today…they got out of the way.

The choice they had to make at that time was simple. Do they take the county to a single provider (essentially killing the other smaller units in the county) or turn it over to the remaining providers to see if they could come up with a solution.

The issues identified were as follows:
* No performance standards for ambulance responders
* You could not assure the closest ambulance responded to a request for help
* Rotation of ambulance providers on ambulance requests in the cities of Visalia and Porterville (This led to scheduling confusion and lower response times)
* Ambulance provider agreements were weak and unenforceable

The Tulare County Board of Supervisors directed staff and county EMS to work with the ambulance providers to achieve an ambulance response system that provided all the following:
* A system that was seamless
* A system that assured that the closest ambulance was always sent to an ambulance request
* A system that included strict performance standards
* A system where ambulance costs were consistent throughout the county

At the February 1st board meeting county EMS staff gave statistics showing ambulance response times and how this public team of people had addressed each of the items the Supervisor’s had requested. The one example that stood out for me was when they talked about the closure of one of the providers. On August 17, 2010 the Three Rivers Ambulance Service closed its doors. Three Rivers is a remote community located in the foothills of the Sierras.

In the absence of this service, four of the surrounding ambulance companies stepped in providing personnel and equipment. The area now has a full time paramedic and much improved response times.

The Tulare County EMS system has evolved into a modern emergency response system, consisting of highly trained paramedics, a centralized ambulance dispatch, simultaneous helicopter response, advanced first responders, a trauma center, a cardiac center, and an aggressive ambulance response system. It has been growing and improving over the past 2 years because the Board was wise enough to set the goal, and get out of the way.

You can find the detailed agenda here:
http://bosagendas.co.tulare.ca.us/MG313646/AgendaFrame.htm (Agenda Item 2)