king county medic one als study

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King County ALS Study

King County EmergencyMedical Services Division

December 2016

TeamNikiah Nudell, MS, NRPChief Data Officer / Project Manager+1.760.405.6869nnudell@paramedicfoundation.org Fred Morrison, BSBA, EMT-PCEO / Co-Project Manager+1.970.390.3733fmorrison@paramedicfoundation.org Gary Wingrove, EMT-P (ret.) President+1.202.695.39-1-1wingrove@paramedicfoundation.org

Paul Anderson, MS, NRPHealthcare Consultant Andrea Corage Baden, PhD, MPHSocial Scientist Robert McNally, MSGIS Analyst David ShraderEMS Systems Consultant Davis Patterson, PhDSocial Scientist

Study Purpose1. Determine the optimal number of ALS agencies in King County 2. How many medic units are appropriate for each to operate3. Develop a regional process for: • responding to any changes to the current ALS agency configuration • configuration meeting county needs for the next ten years

Data Sources & Methodology• Qualitative data from stakeholder interviews (provide context for

quantitative analysis)• Paramedic reports & dispatch records from last ten years• Financial analysis from EMS Division & Seattle Fire Department

provided cost data from last five years• Demographic data from King County demographer & US Census• Census tracts assigned to closest ALS stations (2014 Census)

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KCEMS Census Tracts

KCEMS Demographics

Paramedic Agency

Paramedic Units

Paramedics Service area(s)

Service Area Population

(2014)

Service Area

Density (2014)

Seattle Medic One 7 73 Seattle 690,151 8,225

King County Medic One 8 71

Auburn, Black Diamond, Burien, Covington, Des Moines, Enumclaw, Federal Way, Kent, Maple Valley, Pacific, Renton, Seatac, Sea-Tac Airport,

Skyway, Tukwila, White Center750,157 670

Shoreline Medic One 3 29 Bothell, Kenmore, Lake Forest Park, Shoreline 161,143 3,354

Bellevue Medic One 4 37 Bellevue, Issaquah, Mercer Island, North Bend,

Sammamish, Snoqualmie 314,075 332

Redmond Medic One 3 31 Duvall, Kirkland, Redmond, Woodinville 199,180 526

Vashon Medic One 1 7 Vashon and Maury Island 10,946 16

Total 26 248 2,125,652

Economy of Scale

Agency & # Medic Units

2015 ALS Costs

ALS Responses

ALS Transports

Cost per response

Cost per transport

Annual

Unit Hours

Cost per UH

Cost per

Capita

VIFR 1 $2,063,247 506 150 $4,078 $13,755 8,760 $236 $189

SFD 3 $6,801,262 4,394 2,241 $1,548 $3,035 26,280 $259 $42RFD 3 $6,349,125 3,723 1,019 $1,705 $6,231 26,280 $242 $32BFD 4 $8,604,502 5,382 2,171 $1,599 $3,963 35,040 $246 $27

SFD 7 $16,812,533 19,897 6,484 $845 $2,593 61,320 $274 $24

KCM1 8 $17,472,315 17,214 4,185 $1,015 $4,175 70,080 $249 $23

Salaries & Benefits Contribution to Cost

Agency#

Medic Units

Salaries & Benefits per

UH*Vashon 1 $209.56

Redmond 3 $215.14Shoreline 3 $228.84Bellevue 4 $203.72

KCM1 8 $190.99

0 1 2 3 4 5 6 7 8 9 $170 $180 $190 $200 $210 $220 $230 $240

Salaries & benefits per unit hour (2015)

Seattle data not available

# Medic Units

Economic Impact to EMS Levy

For every medic unit operated by an agency the: p-valueCost per capita decreases -$18.05 0.22Cost per response decreases -$353.42 0.05Cost per transport decreases -$1,055.73 0.14Cost per unit hour increases +$3.15 0.2

Cost per Capita

Seattle Bellevue Redmond Shoreline KCM1 Vashon0

2015 KCEMS Cost per Capita and # Medic Units

Costs Viewed by # Medic Units

0 1 2 3 4 5 6 7 8 9$0

$1,000

$2,000

$3,000

$4,000

$5,000

Cost per response (2015)

# Medic Units

0 1 2 3 4 5 6 7 8 9$0

$5,000

$10,000

$15,000

Cost per transport (2015)

# Medic Units

0 1 2 3 4 5 6 7 8 9$150

Cost per unit hour (2015)

# Medic Units

0 1 2 3 4 5 6 7 8 9$0

Cost per Capita (2015)

# Medic Units

System costs are greatly reduced by having fewer agencies operating more units per agency

• Reduces redundant administration and operational support increasing the economic efficiency of the system

• It is untenable, both economically and operationally, to operate a single medic unit

• It may be unrealistic for any agency to operate fewer than three medic units yet still maintain the capacity to absorb and respond to logistical, operational and system demand issues

From an efficiency and financial perspective, the optimal number of ALS agencies countywide is one • Consolidating into one ALS agency countywide is not likely to be

politically feasible in the near future• Consider a more acceptable short term approach such as a move towards

consolidating agencies operating in Zone 1 (Northeast King County)

• Consider opportunities to improve the operations, finances and performance of the system • Increase standardization, reduce duplication, and facilitate the portability of

paramedics from one agency or area to another

Formal changes to the current configuration of ALS agencies should follow a process

• Start with interagency communication, cooperation, coordination, & collaboration

• Process should demonstrate a clear determination of community need, impartial facilitation, and consensus

• Proposals must include a business case outlining costs, impacts, public value, and how the change would either improve the system or fix an existing problem

Questions, comments, discussion• Thank you for taking the time to participate and sharing your

thoughts with our team

king county medic one als study

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