By Olivia Palmer
The Daily Astorian
CLATSOP COUNTY, Ore. 鈥� Clatsop County commissioners have approved amendments to the county鈥檚 Ambulance Service Area Plan 鈥� one small step in an effort toward a more cohesive emergency response system.
The county contracts with Medix, a private ambulance service. The Ambulance Service Area Plan outlines expectations for what that partnership looks like. Justin Gibbs, the county鈥檚 emergency management director, said the amendments fit into three main categories: creating new performance measures, adding administrative corrections to help the plan better align with the existing contract and establishing an emergency medical services peer review committee tasked with analyzing patient care data and outcome measures.
The peer review committee, he added, is the most significant change.
鈥淭he intent of that is to take a more systemic approach on how we evaluate our EMS system, because it is a system, and there are a number of components to that,鈥� Gibbs said. 鈥淲e don鈥檛 have jurisdictional authority over all those various elements, but one of the things that we are required to do through the ASA plan is to encourage the relationships between those elements and for them to be conversing in a continuous improvement process to ensure that we are providing the highest level of service to the patients that are being served in the community.鈥�
The change comes amid recent concerns over Medix staffing levels and communication. In September, the Ambulance Service Area Advisory Committee met with Medix leaders to discuss concerns expressed by the Clatsop County Fire Defense Board, which includes 11 fire departments and fire districts in the county, describing 鈥渄isturbing and alarming鈥� incidents involving the Medix ambulances. A key difficulty identified during that meeting was a lack of coordination across the county鈥檚 emergency response system.
For decades, the county has engaged on and off in conversations around a consolidated 911 system but has not been able to find the support and funding to create a countywide call center. The county has two public safety answering points 鈥� one in Astoria and one in Seaside 鈥� that connect to Medix dispatch, but without a single repeater serving the entire county, communication between ambulance and fire services can be difficult.
Gibbs said he hopes the peer review committee, whose membership will include physicians, nurses, EMS personnel and medical facility personnel, will help move the county toward more standardized protocols and training and increase communication across the system. He鈥檇 also like to see the county move toward an EMS system plan, rather than just an Ambulance Service Area Plan, especially as the contract with Medix comes up for renewal in 2026.
鈥淭hat鈥檚 going to take these relationships to move in that direction, because the state鈥檚 laws and rules are kind of a minimum standard, you know, and we want to really go above and beyond that,鈥� he said.
Fire departments have also expressed concerns over staffing levels, including the number of paramedic-staffed ambulances in the county鈥檚 service area and the impact of interfacility transfers on those numbers.
The plan amendments include language clarifying that interfacility transfers shall not have a negative impact on the provider鈥檚 ability to meet the requirements of the plan. They also add language to the plan鈥檚 performance measures requiring advanced life support staffed ambulance services to be available 24 hours a day and paramedic-level coverage to be maintained to the greatest extent possible. Any time core area coverage falls below the paramedic level, Medix will be required to document the occurrence in a quarterly report.
For response time performance measures, the amendments also add a provision requiring call processing and notification to happen within 90 seconds at least 90% of the time.
County Manager Don Bohn explained that because Medix is privately contracted, the company has to have a robust service model that allows them to pay for emergency medical services.
鈥淭he benefit of the model we have is there鈥檚 no tax dollars going into it,鈥� Bohn said. 鈥淭he juggling act though is to make sure that the EMS side is staffed always, while they鈥檙e still trying to make their balance sheet work by doing interfacility work and or private work. And so that鈥檚 always going to be the challenge.鈥�
Nevertheless, Gibbs said he鈥檚 seen progress from Medix, adding that they may be at a point where they could start phasing out additional ambulance support they have relied on from Washington County. Medix is owned by Metro West Ambulance in Hillsboro .
鈥淚 think we鈥檙e moving in a positive direction,鈥� Gibbs said. 鈥淩esponse times are improving, and I think our staffing levels are improving as well.鈥�
Moving forward, the amended plan will be submitted to the Oregon Health Authority鈥檚 EMS division for review and approval.
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