Oceanside Gives County Trauma Deadline : City Says Supervisors Have 2 Weeks for Transport Solution--or Else

Despite the serious reservations of several members, the City Council on Wednesday grudgingly agreed to give county health officials two more weeks to resolve a long-festering dispute over the transportation of Oceanside’s trauma patients.

If the county fails to come up with a satisfactory answer by Sept. 25, however, Oceanside officials vowed to renew their policy prohibiting paramedics from transporting patients outside the city limits--an order that forces the emergency medical personnel to violate county trauma rules.

“I will go along with an extension one more time,” said Councilman Sam Williamson, a major critic of the county trauma system. “But I’ll tell you I won’t do it again, and I want to see the county get off their buns and get to work.”

Similar grumbling came from Councilman Walter Gilbert: “Out of deference to (my colleagues), and in the interest of the unity of this body, I will go along with this vote. But I’m not doing it for the other side.”

Meanwhile, county officials said a key part of the earlier tentative agreement--the stationing of a private back-up ambulance in North County--may not be economically feasible.

“It looks doubtful because we’re not sure there are sufficient excess cases in the area to warrant (an ambulance company) investing the money to make it work,” said David Janssen, assistant county administrative officer. “We had two companies interested, but both stipulated they needed a certain minimum amount of service, which we don’t appear to have.”

City officials, however, said they would continue to negotiate for a back-up unit and reiterated their suggestion that the county pick up the tab for the additional ambulance.

“We don’t think the door is closed on that one,” said Assistant City Manager Bill Workman, a key player in negotiations with the county.

Two weeks ago, the council approved a tentative accord with the county in the trauma transport war, which raged throughout the summer and resulted in the county suspending--and subsequently reinstating--an Oceanside paramedic.

Under the agreement, described as a six-month experiment, the county would have to erase evidence of any disciplinary action against the suspended paramedic, David Snyder. In addition, the pact stipulates that a Life Flight helicopter would be stationed permanently in North County and that a back-up ambulance unit would also be based in the area.

In return, Oceanside officials agreed to permit their paramedics to transport patients to certified trauma centers, all of which are outside the city limits. During July, the council prohibited city ambulances from leaving Oceanside with critically injured patients, arguing that the absence of a paramedic unit left the city vulnerable in the event of another emergency.

When they approved the tentative truce last month, council members gave the county until Wednesday to get the agreement in place. Although the plan has not been implemented, Mayor Larry Bagley said the county has been making “good faith efforts” toward that goal. He urged his colleagues to grant the extension.

“The county has worked diligently to try to get this agreement in place,” Bagley said. “Where they have failed has not been their fault.”

City Manager Suzanne Foucault echoed such comments; she said progress on the trauma front included:

- Paramedic Snyder’s record no longer bears any sign of temporary decertification.

- Life Flight officials are evaluating several possible sites as locations for a North County helicopter. The three sites being considered as a base station are Oceanside Municipal Airport, Palomar Airport in Carlsbad and Tri-City Hospital.

- County officials have agreed to reexamine the medical scale that paramedics use to determine whether an injury merits care at a trauma center or can be treated at a conventional emergency room. Foucault said officials “within two weeks will evaluate (the scale) more conservatively, which may reduce the number of cases that would be transported out of the city” to trauma centers.

- A meeting between trauma physicians at Scripps Memorial Hospital in La Jolla, the certified trauma center closest to Oceanside, and Tri-City Hospital, which has failed repeatedly to win inclusion in the county’s emergency medical care system, has been arranged to “help foster better contact” between the two parties, Foucault said.

The city manager said the meeting might make trauma physicians “more comfortable” about instructing paramedics to transport accident victims to Tri-City Hospital in certain cases.

Janssen, reached after the meeting, said the county is working on placing basic life-support services on Astrea helicopters, which are run by the Sheriff’s Department.

Further, he said, Supervisor Paul Eckert next week will propose the formation of a task force to address problems, policies and other issues surrounding the county’s fledgling emergency medical system. Janssen said that, if approved by the board Tuesday, the panel will include supervisors, city representatives and fire chiefs.

“It will be a forum to discuss just the kinds of issues Oceanside has faced and address the problem on a broader scale,” Janssen said.