Ambulance issues continue to face ( News Iowa )

Washington County Attorney John Gish is speaking to the Board of Supervisors about options for a new interim ambulance service in light of recent resignations and suspensions. (Kalen McCain/The Union)

WASHINGTON – Of the eight agenda items discussed by the Washington County Board of Supervisors on Tuesday morning, six were related to ambulance services.

The vacuum left by Interim Ambulance Director Pat Curl’s resignation last week, with several negotiations over the ongoing service, has put the county in a difficult position.

The suspended director, in the meantime, abandons the unsuspecting replacement

With no ambulance director in place, the county faces a void in service leadership.

“I believe the next step in the chain of command will be the field supervisor,” said County Attorney John Gish. “They are . . . equal in rank, which begs the question of who occupies the directorship in the meantime.”

Gish said one of those field officers was named in a letter to the board calling for a “vote of no confidence” against director Jeremy Peck, while two others signed the same letter.

Meanwhile, the director of hiring from outside the department suggested ways to avoid a possible conflict of interest related to that letter.

“From a thinking leader’s perspective, I think it’s best to have outside help rather than internally to promote that position in the interim,” he said.

County Supervisor Jack Seward Jr. – The report board of supervisors for the ambulance service – said that they reached three possible candidates in the last week. One of them did not answer, the other refused, and the third happened unexpectedly in a family matter. That leaves the county with few quick options to fill the gap.

“Still without a director outside of the interim,” Seward said. “If we find someone in the meantime to fill that emergency spot… we’re thinking of a special meeting just for that.”

County Supervisor Stan Stoops said he is concerned about internal conflict in the interim.

“The four field commanders are something between them,” he said. “Hama should be the head, it should be, as I think, of someone who can do it. You can’t have four of them disagreeing.

Appointing the field commander among the few legitimately strong, Gish said he had no specific suggestions.

I know that there are certain things going on there, and I don’t know what these four are suitable for, he said. “I don’t have a recommendation, not a legal one, anyway.”

The board will face accusations of micromanagement

County officials accused some of over-managing the ambulance service with Peck’s suspension.

Dana Peck – who is Jeremiah Peck’s mother – spoke during the comment period at the public meeting.

“Washington County Supervisors are destroying the Washington County Ambulance Service,” he said. “The details…indicate the micromanaging of the ambulance department and the waste of Washington County taxpayer money on personnel handling matters.”

County officials said they didn’t want to extend the department’s decisions, but that they lacked better options as the department continued without a director for now.

“These people are prepared to see some micromanaging if we don’t have an outside director in the interim, and if these four field supervisors can’t get it done,” Seward said.

Lack of leadership exacerbates existing problems

The deaths of other ambulance-related incidents on Tuesday morning highlighted the impact of a leader’s absence and lost knowledge with managers suspended or resigning.

Supervisors discussed the changes to the employee’s job description for 20 minutes, before giving that employee time for a new appointment for a recommendation from the service.

“We don’t want to change this job description … We’ve talked about doing this, but it was the previous administration,” Supervisor Mark Fedler said. “Now we are in a kind of flux, as we remind and wait for the future administration, whatever they are like, to decide how they want to run their parts.”

A similar tone was struck in discussions about the new ambulance chassis, for which county officials said they did not have an expected delivery date due to financial reasons, and did not know how to find one. He had the same conversations about the time director of the campaign, with no suggestions provided by the previous interim before the resignation.

The controversies of previous weeks also remain on hold as the department awaits new leadership. Officials said they still lack information about the ambulance transport service, which then-Interim-Director Pat Curl said they were looking for in the weeks before its exit.

A third part of the payments is excluded, some consolation

The county’s willingness to hire outside doctors for ambulance operations varies from one event to the next.

In public comments, Dana Peck criticized his board of supervisors for discussions of hiring third-party legal consultants and criticized Human Resources consultants for ongoing investigations at the ambulance department.

“We have a paid county attorney, why is the board wasting money to hire another attorney?” she said. “The county also gives the attorney a human resource, but finds it necessary to hire someone else… Why are you wasting more taxpayer money?”

Later in that meeting, Seward said he came to a similar conclusion, offering the board no recommendations for HR consultants after reaching out to such contacts last week.

“At the time, we thought we would have someone who could focus more fully on the issues that come up in this ambulance department,” he said. “But as things have developed now, I don’t know that we can depend on someone else outside of HR to come in and solve the problem we had… I don’t think it would be a good use of our tax money.”

Seward said the company will be working with an HR consultant from Des Moines that it has contracted for several years, although that work is limited to “high-level management,” not specific research questions.

In other businesses, the county shows greater openness to outside work. In addition to investigating a new ambulance directory in the meantime, bosses have approved plans for an independent audit of the service’s billing practices.

Seward said a third-party audit is the industry standard.

“Ambulance services usually … every so often have an extra audit of their bills,” he said. “It’s just that nothing is slipping through the cracks, and everything we’ve been waiting for is going to happen.”

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