IRRIGON — The Morrow County Health District has asked the county to provide $800,000 from American Rescue Plan Act coronavirus recovery funds.

The health district, which offers many services beyond its ambulance provision, seeks the funds for its clinics. The ask came Wednesday, Feb. 21, during a Morrow County Board of Commissioners meeting in Irrigon, and the intensity of emotions around the county’s ambulance service conflict seeped into the discussion about the funding request.

By the end of the discussion, the county commissioners decided to request further information about the district’s costs before making a decision.

Funds available

In her presentation to the board, Nicole Mahoney, the health district’s chief operating officer and chief financial officer for 26 years, explained a fourth of the funds would be for the four clinics the district runs — Pioneer Memorial Clinic, Irrigon Medical Clinic, Boardman Immediate Care and Pioneer Memorial Hospital’s emergency department.

“In the entire time that I’ve been the CFO, we have not once come to the county for operating support,” she said. “At this point, we don’t have another source to ask and we know you have $2.2 million to allocate to this specific purpose.”

Kevin Ince, the county’s finance director, confirmed the county has $2.2 million uncommitted American Rescue Plan Act funds. He told the board the request fits the guidelines of the fund and would not require particular effort to oversee.

Mahoney asked the commissioners to “set aside your differences with the district” over ambulance services. There is an ongoing disagreement that has led to strife among county residents over whether the health district or the Boardman Rural Fire Protection District should provide for the county’s ambulance service area.

No avoiding the elephant

Commissioner Jeff Wenholz said from what he has seen, the health district’s yearly revenue has increased, except for so far this fiscal year. He asked what happened this year when its public, audited statements don’t show a decrease in business before the last six months.

Mahoney said looking at the numbers doesn’t reflect the increased costs and the loss of funding. She said the health district is considering ways to streamline costs, which should help in future years, but for now it needs fiscal support.

“The ambulance is a money loser, isn’t it?” Commissioner David Sykes asked. “What if you were to shed some of that?”

“I asked you to consider this on its own merit,” Mahoney responded after outcry from the audience. “Now you’re going to try to hold this money hostage over the EMS situation.”

“No, I don’t want to do that at all,” Sykes responded, adding the county’s position is to keep doing it for 90 days until the ASA plan is back from the Oregon Health Authority, then the county can negotiate a five-year contract with the health district.

Attendees spoke out, saying the commissioners were attempting to blackmail the health district. Sykes asked people not to gang up or speak out.

Wenholz asked about getting a more detailed account of spending and what the health district owes to vendors. After some tense discussion about why he wanted it when other applicants for the funding hadn’t been required to provide that information, Mahoney agreed to provide a vendor summary.

In the end, the commissioners voted to table the discussion and decision until after the health district provides the summary.

Adding a new dispute to the list

Before tabling the matter, Wenholz raised the concern of county subsidizing future ambulance services.

The health district has made it clear it wants the county to help cover its losses due to ambulance provision, and even in the interim, he pointed out, the Boardman Fire Rural Protection District needs support from the county to cover costs.

“Especially in the short term, when it hasn’t been budgeted for,” Wenholz said, “I say the ARPA money is going to probably be the source to pay for ambulance services, and that is the one pot of money that we have to go to, to provide for ambulance services for the county.”

But Emily Roberts, CEO of the health district, said she does not believe the county can spend the funds that way.

“That money was intended for COVID relief. That’s the spirit in which we’re requesting it,” she said. “It has nothing to do with EMS. And trying to blackmail us with those funds is wrong. And everybody heard it happen.”

While Morrow County Administrator Matt Jensen does believe the justification for the request is “clearly related to the clinics” and not the ambulance services, he said he can understand why the commissioners made the connection.

Once commissioners see the request with the vendor summary, he said, he expects they will look at it “in full faith,” meaning regardless of what the relationship is with the health district and its ambulance services.

Controversy over interim contract

But a March 12 deadline looms for Morrow County before everything — or maybe nothing — changes.

If the health district vacates its service after March 12, as is the plan right now, the county is required to have a plan in place to make sure its residents still have ambulance service.

The county and the health district say they hope to resolve the issue before that deadline.

Jensen proposed an interim contract with Boardman Fire Rescue District as the sole provider for the ambulance service area starting at midnight March 13.

Boardman Fire taking over ambulance services is a major concern to the health district and its supporters.

After the meeting, Roberts said, “I think that they reopened the ASA at all to give Boardman another chance to bid on it. I think they’ve been their preferred provider the whole time.”

During the comment period, she reiterated the health district’s willingness to extend its services for two years. The county had asked for 90 days. Neither entity was willing to compromise on those lengths at a previous joint meeting.

Quick-response teams hold line

The proposed contract with Boardman Fire would have a similar setup to the health district’s. Like the health district, there would be seven ambulances — four Boardman Fire owns and three the county leases — covering the three regions of Morrow County, two in each and the seventh as a floater.

But the county does not have buy-in from the quick-response teams that provide additional service to the health district when all the ambulances are on calls. At this point, none of the QRTs have agreed to continue during Boardman Fire’s interim tenure as the ambulance service provider.

John Kilkenny, a Heppner resident whose wife is board chair of the health district, said less staffing won’t be adequate to cover the entire county. For example, Boardman Fire has not announced how it would handle calls competing for the same ambulance.

Kilkenny said he is worried that response times will significantly increase, as an EMS team based in Boardman or Irrigon will have to answer calls in the Heppner area, which could take at least an hour to travel to, depending on weather conditions.

“Minutes matter,” he said, “and that’s the big key in response.”

Unless something changes, though, such as the Oregon Health Authority returning the plan before March 12 or the county or health district going back to the negotiating table, the county will hire Boardman Fire to ensure there is no hole in ambulance coverage.