Stanislaus County leaders voted Tuesday to leave a five-county partnership regulating ambulances, but could return if they don't find a better option in 18 months.
In other health action, county supervisors agreed to pay Doctors Medical Center more money to care for uninsured psychiatric patients, in an attempt to settle a $2.37 million dispute.
The county wants to leave the Mountain-Valley Emergency Medical Services Agency because it pays far more than its four smaller partners combined, while enjoying no more control. Officials from the small counties -- Calaveras, Mariposa, Alpine and Amador -- reacted with surprise, though all players said ambulance services will not be disrupted.
"We're paying the freight for these other four counties," said Jim DeMartini, board chairman. Stanislaus County has about 527,000 people compared with little more than 100,000 in the others combined.
Mary Ann Lee, the county's Health Services Agency managing director, said Stanislaus pays as much as $750,000 of Mountain-Valley's $1.2 million budget. "There has been a level of dissatisfaction," she said.
But leaving the partnership would require hooking up with other counties or going it alone. The county has yet to check with neighboring San Joaquin and Merced counties, the most likely to form a new joint powers agency.
Running its own emergency medical services agency might cost Stanislaus County more than it spends now. The county will spend as much as $80,000 on a consultant who would present options.
"This project could cost $300,000 more of money we don't have," Supervisor Bill O'Brien said. "I need more facts before we say absolutely, 'This is goodbye.' "
The Mountain-Valley agreement requires six months' notice for termination. The county is setting its tentative exit 18 months out to give all five counties time to plan their next moves, leaders said.
About a dozen people in emergency medical uniforms attended Tuesday's meeting, though no one spoke when given the opportunity. They represented American Medical Response, Patterson Ambulance District and Pro Transport-1.
AMR spokeswoman Cindy Woolston said the group will monitor the transition "to see how things play out."
"We've had a good relationship with Mountain-Valley, and we look forward to working with them or whoever overtakes the role," Woolston said.
Supervisors also voted to negotiate a new contract with Doctors Medical Center for uninsured psychiatric patients, paying $974 per patient daily instead of $799. The agreement would apply to those covered by MediCal as well, and may increase the county's annual costs of about $2.54 million by $1.24 million per year.
The hospital is unhappy because the county, which reviews claims based on state criteria, has denied 40 percent of claims amounting to $2.37 million since DMC bought the county's psychiatric hospital a little more than two years ago.
The county will coach the hospital's staff on improving claim documentation, according to Tuesday's vote.
Rick Robinson, the county's chief executive, said his staff may explore setting up its own psychiatric health facility, which would not offer medical care. DMC would be notified, he said.
Bee staff writer Garth Stapley can be reached at email@example.com or 578-2390.