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>> Well, 2026 will start with a
roll call.
>> Dean Thornberry.
>> Here.
>> Myrna France, Erik
Oberholzer. Present chair,
Marshall and I'll keep checking
for Councilor Belkot.
>> I, I apologize for any
interruption, but we cannot
hear the I cannot hear the
audio.
>> I've got no audio. I have no
audio either.
>> Can you hear me? Okay. Yes.
Try it now.
>> No. Oh! Can you hear me now?
Yes. I think it just needed to
be turned up or on. All right.
Great. So let's move on to the
consent agenda. So we have the
approval of minutes from July
13th, 2026 and approval of
warrants for 2026. Second
quarter. Are there is there a
motion to approve?
>> So moved.
>> Or did you have any
questions? Okay. Moved and
seconded. All those in favor
say I, I, I thank you. Motion
carries. Then moving on to
separate business. Our first
item is approval of ambulance
rate rates for 2027. And chief
Nora, I believe you're kicking
this one off.
>> Hello. My name is.
>> There we go. There we go.
Hello. My name is John Norman,
fire chief, Clark County Fire
Rescue. And Ccfr is one of the
three fire service agencies
served by the Amr contract with
EMS district two for 2027. Amr
has requested a 10% increase in
the rate for transports. They
are allowed to do so by
contract. They cited the 4.4%
CPI plus an approximately 13%
rise in costs for their other
associated rates like labor,
fuel. All the things that we
tend to notice going up right
now. So the EMS advisory board
met, discussed these reviewed
information from Amr. We gave
them back some questions to
clarify a few items. They sent
us clarifying information. And
the board is recommending that
the full board adopt the 10%
rate increase.
>> Okay. Thank you. Are there
any questions from the board?
Comments?
>> Chair.
>> I have a question.
>> On this. 60. Oh, there you
go. You're good. There's 60.7%
increase in auto insurance. And
I just wondered if that I know
insurance raised us on all of
us. But was there more vehicles
added that it made it up go up
60% over 60%.
>> That I don't know that that
was information was provided by
Amr. I can say that we've seen
across the board in the public
sector some pretty significant
rises in insurance costs. I
would imagine that Amr has seen
the same types of things. Rocco
from Amr is here and could
possibly answer that question
if if if the chair would like.
>> Yes, that'd be great. Rocco,
do you mind coming up and just
addressing that question?
That's fine. Or you can sit at
the table. Okay, I just.
>> Gotta hit the button.
Actually, that's just our
standard. That's got an echo,
doesn't it? At least I hear
echo. I did prepare this
document here that shows
they're actually accident rates
and it shows actually we do a
very good job of managing our
action rates. I provided both
for Clark County as GMR from a
national perspective, and our
aggressive monitoring of our
accidents and how we do our
claims actually shows a
significant decrease in our
overall accidents per 100,000
miles driven. So I'll give this
to Diane and she can share that
with the board. And as you know,
all our vehicles are equipped
with vehicle cameras. We
actually monitor our driver's
behaviors. So anything that's
considered excessive speed,
sudden stops, you know, G force
maneuvers, we actually get
those camera activations and it
allows us to proactively then
coach our employees on safe
driving practices. We've been
very fortunate here that our
accident rate here in Clark
County is extremely, extremely
low. And unfortunately, that's
just the cost. Drivers of just
insurance cost. And, and that
we're experiencing across the
country.
>> Well, I, I kind of assumed
it was because everybody's
insurance was getting raised,
but I just thought maybe you
got an extra vehicle and I am
I'm very happy with all the
times I've dealt with EMS. So
thank you.
>> Yeah, no, I appreciate that.
And I'll I'll leave these with
Diane and she can certainly
share with you. That shows our
accident rates great.
>> And I'm sure all of those
efforts that you're making,
make sure it doesn't go up even
higher.
>> We, we, we, we're fortunate.
We have a pretty, a pretty good
team that manages our safety
and risk.
>> Great. Good to hear. Any
other questions or comments
related to the rate increase?
Hearing none. This is an item
that the board needs to approve.
So I'll entertain a motion to
approve the ambulance rates for
2027.
>> So moved.
>> You need to press the button.
>> So moved.
>> Okay. Thank you. Diane. Is
that off? I think it's still on.
That's better. Thank you. Moved.
Is there a second?
>> Second?
>> It's been moved and seconded.
All those in favor say aye.
>> I I.
>> I motion carries. We're just
fiddling around with the
microphones here. There is a
little bit of an echo but I
think we're going to press on.
Thank you very much, chief. And
then, Diane, if you could come
up I think you're dealing with
item two, three, four and five.
So approval of the 2027 annual
budget.
>> Thank you. Diane Cortes,
contract administrator for
Clark County. Today, we are
requesting approval of the 2027
budget. This budget has the
proposed increases for the
contract administration that
Amr will be paying. It also
shows our state auditor fee,
the Crescent dispatch fees,
which are considered a pass
through the medical program
director fees, which are a pass
through, and then the contract
administration through Clark
six in Clark County. So I'm
happy to answer any questions.
>> Okay. Thank you. Are there
any questions from the board?
So the revenues where what
what's the source of the
revenues?
>> So that 231,101 is what Amr
is providing to EMS district
two. And part of those
expenditures that are a little
bit below are considered pass
through. So that's part of what
that administration fee is
paying for.
>> Great. Thank you.
>> Yes.
>> Other questions? Go ahead.
>> Did you.
>> You looked like you were
going to ask a question. Okay.
All right. Hearing no
additional questions or
comments. I'll entertain a
motion to approve the 2027
annual budget.
>> So moved.
>> Okay. It's been moved. Is
there a second? Moved and
seconded. Thank you. All those
in favor say I, I motion
carries. Okay. Approval of
amendment number one Amr
contract again.
>> Thank you. So before you as
amendment number one with Amr's
contract. So the major there's
a few minor changes to this
contract. And those have to do
with response time exceptions.
And then also some fee
adjustments. We didn't know
what we didn't know. And so
that's these are kind of
squaring those up. It also is
amending the different
appendices that have the rates
that you previously approved,
as well as that contract
administration fee. And then
per the contract, we could
increase the liquidated damages
4.4%. So it's just updating
those amendments. I do want to
let the board know that Amr is
still reviewing this. So what
I'm asking for today is
provided there's no changes
that the board approves the
chair to sign the amendment
once it's ready. I don't
anticipate any changes, but if
there are, I will bring it back
to the board and a special
meeting. And this amendment is
expected to take place January
1st of 2027.
>> Okay, thanks for that caveat
there. So are there any
questions related to amendment
number one? Hearing and seeing?
Yes, please go ahead.
>> Just to make sure all of the
changes or all of the amend,
the amended stuff is all you've
got. Anything that's been
changed is strike through and
underline. There aren't
anything, anything other than
that.
>> That is correct. So the way
that I did this is if it's an
existing and the existing
contract it's struck through,
and if it's new, it's got that
double underline.
>> Okay. Gotcha. Thank you.
>> Thank you.
>> Okay. And so what we're
looking for now is a motion to
approve amendment number one,
provided there's no additional
changes.
>> So moved.
>> It's been moved. Is there a
second. Second moved and
seconded. All those in favor?
Oh, there's a hand up.
>> Nope. I forgot to take that
off.
>> Oh okay. You have a yellow
background. So it kind of
blends in. All right. So all
those in favor say I. I motion
carries. Okay. And then moving
on to approval of amendment
number two, the Clark Cowlitz
Fire District 6ILA thank you,
Diane.
>> Thank you. Amendment number
two, before you. So the EMS
district two has an interlocal
agreement with Clark County.
Clark County Fire District
number six. And they help us
with our contract
administration. The amendment
before you today is to increase
their rates. The rates that EMS
district two will be paying
them in 2027, their rates did
increase 10%. So it'll be going
up to, I believe it's $33,000
for that one. And so this one
has been approved by the fire
chief and is ready for your
approval today and will be
signed once approved again, it
will not take effect until
January 1st of 2027. I'm happy
to answer any questions.
>> Okay. Are there any
questions?
>> I have a just a quick
question as as Dean just stated
it, it looks like that contract
administration will go up to
33,000, but we have it in the
2027 proposed budget at 38,000.
Is there a reason for that
variation?
>> Yes. Thank you. That's a
great question. There's also
some county administration fees
that are contained in that
contract administration fee of
the 38,000. So just the portion
that goes to Clark six is 33.
And again, the remainder comes
to the county. For my time and
our legal time.
>> Thank you Diane.
>> Thank you. So from the
33,000 to the 38,000 is for the
county fees.
>> Yes. It's some county fees
in there for contract
administration. That is correct.
>> Yes. EMS district two is
getting a really good deal. Yes.
Okay. Thank you. Then if there
are no other questions, I'll
entertain a motion to approve
item four.
>> So moved.
>> It's been moved.
>> Second.
>> Moved and seconded. All
those in favor say I. I. Okay.
Motion carries. And then
finally item five here.
Approval of amendment number
one for the medical program
directors contract.
>> Thank you. Before you today
is amendment number one to the
Medical Program director
contract. And again, the only
change in this amendment is for
the increase in rates for that
medical program direction. And
these rates will start as of
January 1st, 2027. And they're
going up 4.5%, which is when
the CPI was pulled at the time.
And so they're going up to
$74,934. And again, they'll
take place January 1st of 2027.
This one is still with the
medical program director. So
today I'm asking for the
board's pre-approval, provided
that there are no changes to
this amendment. Once approved
by the medical program director,
then authorizing the chair to
sign the amendment again, if
there are changes, I will be
bringing them back to the board
at a special meeting.
>> Great. Thank you, thank you.
Any questions or comments from
the board? Hearing none. Is
there a motion to approve
amendment number one to the
medical program directors
contract pending. No changes.
>> So moved.
>> Okay. Thanks for your motion.
Is there a second? Second moved
and seconded. All in favor, say
I.
>> I,
>> Motion carries. Okay. We're
moving rapidly along here.
Update discussion items EMS
administrative board. And I
think Chief Noah, we're going
to call you back up to discuss
that.
>> So I just want to give a
little update on Amr's
compliance in the second
quarter. So as a reminder, the
high density and low density
areas, those are not defined by
population population density.
They are defined by call
density as the program was
looked at prior to the 2015
contract. So essentially areas
south of 179th Street are high
density except for a carve out
for the city of battleground.
So it'll run up and catch
battleground in high density.
The rest of the of
unincorporated Clark County.
And the small cities are in
what was considered low density.
There's also a portion of low
density on the far east side of
Vancouver's response area. Out
past prep. Still. So during the
second quarter, Amr continued
to do a good job meeting their
priority one and two. Those are
high life threat calls in the
high density areas. They made
it 91.57% of the time. In low
density areas, they made it 90%
of the time. The goal is 90%.
So obviously we're watching
that number there right at the
90 percentile. I'd also like to
remind you that high density
areas get an ambulance in nine
minutes and 59 seconds, 90% of
the time. That is a goal. Low
density areas is 19 minutes and
59 seconds, considerably longer
at 90% of the time on the
priority three and four calls.
Those are something that where
someone is injured, but there's
not an immediate life threat.
They made their high density
calls in nearly 97% of the time,
their low density 95% of the
time, priority fives and sixes,
we tend to call that a lower
priority call. These are people
that aren't going to suffer
negative adverse actions if
they're not immediately
transported to the hospital.
And again, they made their low
density in just under 93% of
the time, excuse me, high
density. And then the low
density at 98% of the time,
inter-facility transports.
That's what's the non 911
routine IFT that is
transferring people generally
out of the hospital to another
location. It might be to home,
it might be to another facility,
a step down facility or
something of that nature. And
they're making those times at
98 and 99% of the time. One of
the caveats in the contract
calls for Amr to not call for
mutual aid more than 3% of the
time. That's when they call on
another ambulance service to
provide coverage for them. They
called for mutual aid six times
in the quarter, and so that is
they are allowed up to 3%. They
were at 0.03%. So they're doing
well there. They gave mutual
aid 198 times. That is either
to Kamea, Washougal fire, North
Country EMS, or to Kfr. I would
point out that a majority of
those calls are to Clark
County's fire rescue, where Kfr
is the first out unit for high
priority calls within our fire
district. If we're busy on a
call and another high priority
1 or 2 comes in, Amr will take
those calls. Amr also responds
to all the threes, fours, fives
and sixes in Ccf's area, but
they'll pick that up for us. So
we're busy in that quarter. And
so Amr picked up a few calls
for Ccfr in that area. Amr can
request an exemption. And so if
they if it meets certain
criteria then a call will be
exempted from the 90% response
criteria or the response time
criteria rather. And so they
requested 24 exemptions in the
second quarter. 23 were granted,
one was denied. And there's
lots of different things that
can cause. That was kind of in
your report there. But if if a
call was originally sent as a
BLS ambulance, so two EMTs
rather than EMT and paramedic,
and they determined that it
needs a higher priority that
allows an exemption because the
an ambulance responded, but it
wasn't necessarily the right
level. And they have to call
another unit there that will
create an exemption for it.
Oftentimes, construction road
conditions or things that are
outside of their control.
Causes a delay and they can
request that. And that's part
of what Fire District six does
is the ambulance contract
coordination is they evaluate
all of those exemptions, one of
many duties they have in
administering that contract.
But Tara at Fire District six
goes against a set of criteria,
determines whether an exemption
should be granted or not. If
Amr fails to make their times,
they are fined for that. And so
based on this, there wouldn't
be any second quarter fines
because there weren't any. They
were meeting their criteria.
>> Okay. Are there any
questions? I just notice on
this one that was denied. It
was an address change. Was that
something that. Should have
been known or could have been
known?
>> There are times when. So if,
if, if Corissa if the call goes
through nine one, one and crest
takes the wrong address and
then the address is determined
to be mistaken, they may have
been sent to northwest, when in
fact the address was in
northeast, that there's an
exemption given for that. There
are times when Amr takes the
call direct, and they could
they may have gotten the
address wrong, and that that
then becomes on them to correct
that. So I can't speak to that
specific item in there, but
that does occasionally happen.
>> Okay. Thank you.
>> Chief, I have a question for
you.
>> Yes. Go ahead.
>> I'm curious about we added
one exemption to the to the
amended contract here. I'm
trying to look it up. There's a
fourth exemption category now.
>> D Anne is coming up. I think
to fill in fill in the blanks.
>> Dean that is exactly. Or
excuse me, Councilor Thornberry
that is exactly why we added
that in. So this particular one
was. So it's not outlined in
the contract specifically as an
exemption, which is why it was
denied. But in our amendment we
have added that when the when
the. Nine I think it's PSAP,
which is Corissa if they.
>> That's a that's a result of
this one denial that we had
here.
>> Yes, that is correct.
>> All right. Very good.
>> You were very close.
>> Okay. Anything else from any
councilors.
>> Yeah. I'll just voice my
appreciation to Chief Nora and
the administrative staff for
the the work done here. And and
good reporting. The last I have
one just small question. We
spoke about the priority one
and two goal of 90%. And could
you remind me of the goal for
priority three and four and
also five and six.
>> So the the time goals remain
the same. It's it's 959 and
high density and 1959 and low
density. So high density is
everything south of 1/79 Street
and a carve out for the city of
battleground. So it runs
roughly not quite 92nd, a
little bit east of 90, second
up around the city limits of
battleground to the east side
of battleground back down and
then extends on out. So, for
example, Fire District three,
the majority of fire District
three is low density except for
the city of battleground
portion. That's high density.
And those zones were created as
a result of a system analysis
that was done prior to the 2015
contract being put in place.
>> Thank you, Chief Nora, I do
understand we have a higher
senior population. So I can
imagine our our density of call
is higher in the city of
battleground. So now I
understand. Thank you. I
appreciate that.
>> That that leads me to ask a
question to. If this was done
prior to 2015, there's been.
Well, how often is the call
density evaluated?
>> It. It has not been
evaluated since that time. It
we talked about it prior to the
contract going in place on one
one of 25. And at that time Amr
to change the density response
zones would have had to put
more vehicles in service, which
would have raised the cost to
everyone.
>> Okay. Just recognizing that
there's a lot of growth that's
happening.
>> There has. Yes.
>> Okay.
>> Part of part of that reason,
ma'am, is, is the, was the
agreement with Ccfr to do
priority ones and twos within
our area? Because the Ccfr area
is almost wholly within low
density. But as you know, along
the I-5 corridor, we've seen
significant growth. The only
area of Ccfr that is in high
density is a small area down
along Salmon Creek, south of
179th that has very few people
in it, but just happened to
fall within that high density
map.
>> Great. Thanks for that
explanation. Thanks for all
this information too. I don't
think we've seen this for I
don't know when we've seen this,
so it's good to get the details
here. Okay. No other questions
from the board. I don't see any.
Then we'll move right on to
public comment. Is there anyone
from the public who would like
to make a comment? Do we have
anyone online?
>> Nobody signed up. Chair and
nobody's online.
>> Okay. All right then. I
guess just before I adjourn, I
would like to make a couple
comments because this may be my
last meeting. And I would just
unless we have a special
meeting to take care of a
couple of changes that might
happen. But I just wanted to
say I've served on this board
for four years. The first year
not too much was happening, but
since then quite a bit has been
happening. So I want to just
state my appreciation to
everyone who's been involved. I
think we're in much stronger
shape than we were before,
adding to the board itself and
setting up the advisory
administrative board. So I
think there'll be uncertainties
going forward, no doubt, but I
think we're in a much better
shape to deal with those. So
thanks, everyone. And with that,
I'll adjourn this meeting our
next meeting, January 11th.
Thanks, everyone.
>> Thank you Sue.
>> Thank you chair