Since 1999, the Nome Volunteer Ambulance Department (NVAD), the only ambulance service in Nome, has been overseen by the City of Nome. But now, another entity in town is considering operating their own ambulance service.
Charlie Lean, retired Chief and former President of the NVAD, recalls the beginnings of the ambulance service.
“Prior to 1978, there was a family that had a panel van that they called an ambulance. They had no medical training that I’m aware of. The hospital and medical professionals were frustrated with the level of care they provided, so they bought an ambulance, our first medical one, and there’s still a couple of people in Nome that were members of the original Nome volunteer ambulance service. We were unpaid employees of the Norton Sound Health Corporation.”
According to Lean, when he joined the ambulance service in late 1981, there were also paid employees from the hospital involved with the service, including a trainer and paramedics.
Lean says this collaboration between volunteers and hospital staff continued until the ambulance service underwent a major change, about eight years after it started.
“The original ambulance wasn’t maintained well, and it was getting tired, costing money. Trying to find a new trainer was a problem; trainers are always scarce. And then they (NSHC) bought another ambulance, and it turned out to be a lemon. So they eventually threw up their hands and divested themselves of the Nome ambulance service, and that was, like, the mid-80’s — maybe 1986, I’m not really clear on the dates anymore — and we were on our own, we felt like orphans,” Lean said in a quiet voice. “We were struggling for membership, and the hospital did let us down softly. They left us with ambulances that needed work and a building that also needed work.”
For about the next ten years, the NVAD ran itself after NSHC dropped its support of the ambulance service. Lean says the department was being run into the ground during those years. The number of responders fluctuated, and the members that were left got burned out. Eventually, five department members held a meeting where the decision was made to fold the ambulance service.
This would have been the end of the Nome Volunteer Ambulance Department, but Lean says because of one individual’s efforts, the ambulance was saved.
“We were on the verge of collapse, and there were five of us in the room that were doing all of the runs, and it was a 3-2 vote to dissolve. Lillian Komakhuk gave this impassioned speech, and basically, she was going to run by herself if she had to. And the question was, if not us, then who? Sounds egotistical, but we were the only hope Nome had of having an ambulance,” stated Lean. “Nobody else had the training, nor the experience, nor the stick-to-it-iveness.”
A few years later, Lean recalls that the ambulance department received some needed assistance from the City of Nome. A memorandum of agreement between the Norton Sound Health Corporation, the NVAD, and the City of Nome was approved and signed on January 25th, 1999. This M.O.A. allowed the City to manage the ambulance department, while the ambulance volunteers also retained rights to all ambulance service calls outside of medevac transports.
The NVAD continues to be overseen by the City of Nome, which has made Vickie Erickson, the current chief of the 19-member department, very thankful.
“And thank goodness the City agreed to take us over. We had a budget then, we had some support, we had someone to do the billing for us, which was very key. So we could focus on training, getting more members, and becoming more professional. We then upgraded to new vehicles, which I was glad of. I can remember standing out at the Nome river raft races out of town one year, and our ambulance caught on fire on us, it was very exciting,” recalled Erickson, “and the old van one, I can remember going down the road with Matt Christian, one of the other founding members, and it just fell apart on us, stopped dead in the road. And I don’t know what Matt did, but he crawled under it and used some bailing twine or something to put it back together so we could get back to the garage. They were in pretty bad disrepair. We actually entered one of them into the ugly ambulance contest in the lower 48, and we won first prize. (Laughter) It was bad.”
When it comes to contests and awards, Erickson points out that the NVAD is the most highly decorated ambulance department in Alaska.
Despite all of their accolades however, Erickson says not all of the department’s problems have been solved.
“I see some of the issues that Norton Sound had, back then, are again the same we have now. It was run by volunteers, struggling for money, looking for grants to build a building or get an ambulance. It was very much the same issues that we sometimes face today, it’s just that, now, our infrastructure is pretty sound; (it) makes life a lot easier. We recruit very hard every year for more people to join the ambulance department. About a year and a half ago, it felt like everybody in the department moved away; I think we lost, like, 18 volunteers in a year and a half, and that was a huge loss for us, and it was a struggle keeping up with our call volume at the time,” Erickson explained, “And at that time, we were doing the medevacs for Norton Sound Health Corporation; we were doing about 800 calls a year with 10 volunteers, so you can imagine what that might mean, working full time. We stopped doing the medevacs except in times of need when Norton Sound’s ambulances weren’t operating, their teams were all in the air or there was a shortage, we’ll come in and help them do those transports.”
In terms of the department’s operating costs, City Manager Tom Moran says the final numbers from fiscal year ‘16 show the NVAD had $64,000 more in expenditures than revenue. But in fiscal year ‘15, the department made $49,000 more in revenue than it spent. For services the ambulance department provides, Erickson says they charge $650 for a life support trip and $100 more, $750, for an advanced life support trip.
City Council member and Norton Sound Health Corporation Board member Stan Anderson spoke as a member of the public during a City Council meeting in February. Anderson took issue with the department’s handling of billing and discussed his concern with Moran.
Anderson: “This is public views in a public meeting. The Board, every one of them, every darn one of them – if you continue billing our people, we will start our own ambulance service. I don’t know how much plainer, it’s not a false, whether the administration wants to get into it or not, they don’t have any choice.”
Moran: “But the Board doesn’t have that say, that’s my point, Councilman Anderson, is that you can’t just start an ambulance service, it doesn’t go like that. You’ve got to get State certifications and licenses.”
When NSHC was asked about their intentions for the ambulance service, the Corporation had no comment. According to Andy Jones, the section Chief of Emergency Programs with the State division of Public Health, there are no statutes or regulations in Alaska limiting the number of entities that can provide EMS services in a given area.
Erickson and Lean are both concerned about the future of the ambulance department and what might happen if the City was no longer supporting it.
Erickson: “You need that support there, because I’ve been there as a volunteer when no one is supporting you, and I don’t want to go back to that. We need somebody there to run this department, and I would hope the community and the region recognizes, ‘Yeah, we need somebody there.’”
Lean: “And that’s my fear, if the City were to drop the ambulance, the infrastructure that I spent a career developing would die from lack of maintenance, would die from nobody holding ownership of it.”
As of March 20th, Jones says his office has not received a formal request from Norton Sound Health Corporation to become a licensed emergency medical services provider for the City of Nome.
Regardless of NSHC’s position, City Manager Tom Moran says the City has no intention of relinquishing management of the Nome Volunteer Ambulance Department at this time.