How to resolve AdBlock issue? On Wednesday, Health Services Director Jonathan Portney issued the news release — which later was edited — stating that his department “is fully committed to ensuring public safety in light of the current challenges faced by the Northshore Fire Protection District (NFPD) and Lakeport Fire Protection District (LFPD) in providing adequate emergency medical services (EMS) coverage expressed by the Northshore Fire Protection District.”
Northshore Fire Chief Mike Ciancio said on Thursday during a special district board meeting to discuss staffing — which had been called on Monday, and not in response to Portney’s statement — that a lot of what was in the news release were “lies, that are not true.”
Lakeport Fire Chief Patrick Reitz on Thursday likewise was critical of Portney and the Health Services Department for making the statement without having discussed it beforehand with him or his agency, explaining that it didn’t accurately portray fire department functions.
“Not only have they not talked to us, they didn’t even CC my department with a copy of the news release,” Reitz told Lake County News, explaining that he found out about it when a member of the community gave him the news release.
Portney’s statement said, “the County of Lake Health Services Department is working with partners and other relevant stakeholders to address these shortages and ensure that the
community receives the necessary medical care in emergencies.”
“How can they say that when they haven’t reached out and had those discussions with their partner agencies and his peers?” Reitz said.
Since the statement’s release, neither Ciancio nor Reitz has had any contact with Portney, leading them to wonder just which partners and stakeholders he’s actually working with. Both have spoken with county officials to register their concerns about the action on Portney’s part.
The news release also suggests that the districts aren’t responding to emergency calls, which Reitz said isn’t true.
“I am not sure what they are trying to insinuate here, other than I don't appreciate it,” Reitz said.
Portney’s news release was posted on the department’s Facebook page. Lake County News did not receive a copy of it through the normal news release distribution.
Portney and Health Services public information officer Dwight Coddington did not respond to questions emailed to them on Thursday afternoon by Lake County News regarding the statement and its distribution.
The first paragraph of the original version of the statement, which can be seen below, said the challenges in providing adequate medical services coverage had been “expressed by Chief Paul Duncan & Chief Mike Ciancio.”
Duncan works for Cal Fire, not the local districts.
“You have a director who doesn’t even recognize the partner agencies or his peers with those partner agencies,” said Reitz of Portney.
Reitz said Portney’s press statement confuses the 911 emergency medical services, or EMS, system with the system that relates to interfacility transports, lumping the two together when they are separate functions. It also asserts that such transports are the responsibility of fire departments, when they’re really the responsibility of the hospitals.
“There is a huge difference between the 911 EMS system and the interfacility transport system and the laws and the regulations that govern both,” said Reitz.
Ciancio and Reitz said Thursday that all of Lake County’s fire districts are challenged with hiring and retention now, but that no emergencies or sudden changes have occurred in their current operations as Portney’s news release suggests.
Ciancio said operations now are as they have been for the last 18 months, with the district running about 3,800 calls a year.
Of Northshore’s 19 paid positions, 13 are filled to cover one of the largest fire districts in the state, at 357 square miles, and covering 44 miles of Highway 20. Reitz said he has a total of 10 positions.
Meanwhile, emergency 911 response “is not an issue,” said Reitz.
Timing of the statement
The timing of Portney’s news release suggests it’s in response to two recent actions taken separately by Ciancio and Reitz.
Ciancio — who had a meeting last year similar to the one on Thursday to discuss the district’s ongoing hiring challenges — said that, keeping in mind the fragile EMS system and being mindful that no one can afford extra work, he’s been working on a plan for the future in an effort to keep positions filled.
He said he’s not short on ambulances, but increasingly it's hard to keep medics, as they can go to other counties and draw six-figure salaries, an issue he can’t easily remedy due to the district having had two failed tax measures on the ballot. Still, his agency runs two ambulances a day and has had help from a volunteer medic.
Ciancio said he discussed his recruitment and retention ideas at a recent meeting that included only the county’s fire chiefs. Less than 24 hours later, he said Portney was requesting that North Coast EMS monitor daily ambulance providers.
The result is that this week — “all of a sudden,” Ciancio said — Health Services became interested in knowing the availability of emergency ambulances in the county.
“I don’t believe in coincidences,” said Ciancio, who thinks Portney reacted to the secondhand information about that staffing discussion at the chiefs meeting, since the last time the chiefs had a discussion with Portney was in September.
Portney’s statement said the Lake Health Services Department “acknowledges the alert raised by the NFPD about the inadequate coverage of paramedics on the North Shore of the County, as well as how these difficulties will impact Sutter Lakeside Hospital in arranging inter-facility transfers for patients requiring a higher level of care due to the unavailability of air-based resources during adverse weather conditions.”
It also noted, “Health Services Director Jonathan Portney has requested continuous updates on staffing levels and is actively engaging with North Coast EMS, which oversees and ensures adequate services provision (per ordinances) to ensure better communication and coordination.
“The LCHD [Lake County Health Department] is also exploring various solutions to overcome the current challenges, including seeking private support to provide emergency medical services and bolstering the EMS infrastructure. County of Lake Health Services is offering their full support,” it said.
The statement noted that “updates and solutions regarding the ongoing efforts to resolve the EMS shortage and improve emergency response services will be provided during an upcoming Lake County Board of Supervisors meeting.”
Emergency services versus interfacility transports
Emergency ambulances and transport services appear to be an overarching issue at the heart of the matter between Health Services and the fire chiefs.
Ciancio and Reitz said that interfacility transports, which include “priority one” calls for ambulances, are the responsibility of the hospitals, not the fire departments. Such services aren’t even covered in the local fire ordinances or in the fire district taxes paid by Lake County property owners.
Speaking for his side of the lake, Reitz said Sutter Lakeside Hospital cannot get reliable interfacility transport from private ambulance companies, a problem that’s exacerbated when there are weather events or a lack of air resources to move critical patients.
Availability of private ambulance companies is a longtime problem in Lake County which is why more than 15 years ago fire departments had stepped up to try to help fill the breach when an ambulance provider pulled out.
Reitz said the fire districts have wanted to meet with Health Services to try to find solutions.
He said he and his peers in the chiefs association, other partner organizations and agencies, have wanted a seat at the table to work toward a meaningful solution for ambulance services, “and it just hasn’t happened.”
Increasingly, with the districts needing to focus more on taking care of their residents, they’ve been stepping back from interfacility transports, which can take ambulances out of circulation for several hours depending on where they have to go — such as Santa Rosa, San Francisco and Sacramento.
“Is that really fair to our taxpayers when our taxpayers pay for 911 response?” Reitz asked.
Case in point: Reitz, whose district only has one ambulance, said that a few weeks ago Lakeport Fire got a call at 3:50 a.m. for a priority one out of county ambulance transport. He said that despite not wanting to accept the transport, the district did so; he explained that wasn’t the time to raise the issues with resources, when a person needed medical assistance.
Within 10 minutes of accepting it, they had a call in their district that required an ambulance and at that point didn’t have one, meaning that Kelseyville Fire had to cover them.
Reitz said hardly a day goes by when mutual aid isn’t activated in Lake County to respond to calls, as in the case with Kelseyville responding to help Lakeport. “We constantly are crossing borders and backing each other up.”
Two weeks ago he sent an email to county officials about that early morning ambulance call, explaining he didn’t appreciate having to strip his district of its only ambulance to address a situation that is the hospital’s responsibility. Nothing came of that outreach, he said.
On Monday, Reitz sent out a memo explaining that Lakeport Fire was not taking any more priority one calls for interfacility transport indefinitely due to staffing and equipment issues.
Health Services also didn’t respond directly to that email, but Portney’s statement followed two days later.
Ciancio and Reitz said they’ve had few interactions with Portney, who began his job at the start of 2022.
Ciancio said he’s talked to Portney twice in that time, including once last year when Ciancio brought up the issues with ambulance transport. He pointed out that the Board of Supervisors had directed Portney to fix the county’s nearly 20-year-old ambulance ordinance, but that hasn’t happened.
Reitz, who joined Lakeport Fire in November, said he’s spoken once to Portney since his arrival and that they agreed to work together. He said he gave Portney his ideas about addressing the ambulance situation and that while Portney indicated interest, he hasn’t spoken to him about it since.
“When they don’t even come to the table, how are we supposed to address this?” Reitz said.
Ciancio said he’s spoken about the situation with Portney with two members of the Board of Supervisors — EJ Crandell, who represents District 3 and was at the special Thursday afternoon meeting, and Bruno Sabatier, who represents the Clearlake area in District 2 and is one of the board’s members on the North Coast Emergency Medical Service Committee.
Rietz said he did not want to disclose the county officials he spoke to about the matter.
The situation with Portney’s public statement about Lakeport and Northshore followed by roughly two weeks a discussion at the Board of Supervisors in which the Lake County Fire Chief’s Association submitted a letter against the need to spent $20,000 to hire Mike Marsh EMS Consulting for ambulance strike team support through the Regional Disaster Management Services Association.
Under the contract, Marsh’s work included a number of tasks related to interfacility transport and monitoring of the system operations of moving patients from Lake to other counties.
“We feel the County of Lake should not be financially responsible for the request of those
resources when it is clearly the responsibility of the sending facilities to arrange transportation for their patients,” the chiefs association letter said.
The letter said the services Marsh was to complete also were redundant with work the chiefs association already is doing, and that the money would be best spent to extend an EMS liaison position held by a current employee.
Despite those concerns, the board unanimously approved spending realignment funds to pay Marsh’s contract.
“He is not what Public Health needs, unfortunately. He is not,” Ciancio said of Marsh.
Ciancio added that when he brings up Marsh in other EMS circles, “they just say good luck with that one.”
A rocky tenure
In addition to the issues with the county’s fire departments, Portney’s 15-month tenure has not been smooth.
In that time, he’s been the focus of seven closed session performance evaluations — the most recent one on Tuesday — with the Board of Supervisors. That’s more than any other county department head, who usually are evaluated once or twice a year. More frequent closed-door evaluations have historically been a precursor to a department head’s departure.
He clashed with former Sheriff Brian Martin over the jail medical program. Health Services has been involved in that program for decades but last year Portney didn’t issue a request for proposals for the program and stated his belief that his department shouldn’t be involved. The supervisors formed an ad hoc committee to address the situation and later approved a six-month medical services contract extension in June and a new four-year, $3.9 million contract with California Forensic Medical Group in December.
Portney also has come under fire for turnover in key positions and for hiring as director of nursing an individual without the required public health nursing credentials, and he’s been criticized for hiring consultants like Marsh based on personal friendships.
In December, nine Health Services staff signed a letter of no confidence against Portney, blaming him for plummeting morale and for alienating community partners including fire departments, the sheriff’s office, Social Services and Behavioral Health, as Lake County News has reported.
That letter signaled all was not right between Health Services and the fire departments.
“This department has a long history of cooperation with law enforcement and fire departments. Our County's State of Emergencies with Destructive Wildland Fires, COVID, PSPS etc, over the last 5-6 years, had built a team of cooperation, respect, and ‘Doing the Right Thing’ for the safety of all county residents. Director Portney has all but destroyed these relationships,” the letter said.
Portney himself circulated that letter to dozens of county staff and said that it was submitted to the Board of Supervisors by Cal Fire Chief Paul Duncan, who he had incorrectly named in his original Wednesday statement on the fire department staffing.
On Feb. 17, more than two months after Lake County News published an article about the letter of no confidence, Portney contacted the publication to ask that it take down “all articles highlighting myself and the Health Services Department staff members.”
He added, “I believe this good-faith action will be the best option for all parties involved. I appreciate your consideration, and with your support, we can continue building a robust and healthy Lake County. If you choose not to take them down… when appropriate investigative materials are available, I trust that you will update the community and the articles accordingly to reflect all findings?”
When Lake County News asked what purpose would be served by this action and precisely how that would contribute to a “robust and healthy” Lake County, Portney didn’t respond to the question.
Portney’s statements
The full revised version of Portney’s news release is below, along with an image of the earlier version.
·
Health Services Department Ensures Commitment to Public Safety Amid EMS Shortage
LAKE COUNTY, CA (March 29, 2023) — The Lake County Health Services Department is fully committed to ensuring public safety in light of the current challenges faced by the Northshore Fire Protection District (NFPD) and Lakeport Fire Protection District (LFPD) in providing adequate emergency medical services (EMS) coverage expressed by the Northshore Fire Protection District.
The County of Lake Health Services Department acknowledges the alert raised by the NFPD about the inadequate coverage of paramedics on the North Shore of the County, as well as how
these difficulties will impact Sutter Lakeside Hospital in arranging inter-facility transfers for patients requiring a higher level of care due to the unavailability of air-based resources during adverse weather conditions.
In response to these concerns, the County of Lake Health Services Department is working with partners and other relevant stakeholders to address these shortages and ensure that the
community receives the necessary medical care in emergencies.
Health Services Director Jonathan Portney has requested continuous updates on staffing levels and is actively engaging with North Coast EMS, which oversees and ensures adequate services
provision (per ordinances) to ensure better communication and coordination.
The LCHD is also exploring various solutions to overcome the current challenges, including seeking private support to provide emergency medical services and bolstering the EMS infrastructure. County of Lake Health Services is offering their full support.
The Health Services Department is committed to addressing this critical situation and ensuring the well-being and safety of our community. Updates and solutions regarding the ongoing efforts
to resolve the EMS shortage and improve emergency response services will be provided during an upcoming Lake County Board of Supervisors meeting.
Email Elizabeth Larson at This email address is being protected from spambots. You need JavaScript enabled to view it.. Follow her on Twitter, @ERLarson, or Lake County News, @LakeCoNews.
