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Board hears history of EMS District 2, oversight model and response-time results
Summary
At the March 9 meeting, Doug Smith Lee reviewed EMS District 2's formation, litigation that shaped franchise contracts, oversight structures and performance measures (response times and clinical outcomes), and described recent decisions to return regional oversight to the district after the City of Vancouver's earlier stewardship.
The EMS Service District 2 board on March 9 heard a lengthy historical presentation from Doug Smith Lee of the Clark Regional Emergency Services Agency about the district's legal and operational model, performance measures and the reasoning behind using a franchise contract for ambulance service.
Doug Smith Lee traced the district's origins to a 1987 ordinance and described litigation in the early 1990s (Buck Medical Services) that prompted the parties to adopt competitive allocation via an RFP and franchise contract rather than a call-rotation approach. He said the settlement and state enabling legislation (RCWs referenced without specific citation in the presentation) allowed the district and participating cities to set standards up front and award market rights through competitive proposals.
Smith Lee described six design areas that guided contract terms: service area, regulatory/oversight structure, medical oversight, control-center operations, first-response relationships and the provisions governing ambulance service (response times, levels of care and equipment). He said the system prioritized calls and implemented a priority dispatch system and that the district independently downloaded response-time and clinical data from the contractor for outcome analysis.
"We were generating those reports on our own," Smith Lee said, noting the district's ability to measure outcomes such as return of spontaneous circulation and door-to-needle times for STEMI patients. He cited performance that, as of the last available review in 2024, remained above national averages and said the district had used more than $3 million in funds to enhance community health and safety, including purchase and deployment of AEDs, mobile computing devices and simulation training.
Smith Lee recounted that the City of Vancouver assumed contract oversight in 2014, then more recently signaled a desire to manage only city-level oversight; the district opted to resume regional oversight and, in 2024, chose to base its procurement on the city's prior RFP to maintain a single regional provider and avoid duplicate service areas.
A board member asked about behavioral-health calls and whether ambulances or police most often respond. Smith Lee said the district is developing data on this and described co-response initiatives (police with mental-health co-responders), partnerships with Scribe Connections, and local CARES teams pairing paramedics with mental-health counselors.
The presentation provided historical and technical context as the board moves forward with a reconstituted EMS administrative board and renewed contract oversight responsibilities.
