Exeter Ambulance hires new manager Stuart Nickels

Exeter District Ambulance hires former Delano Ambulance Service operations director Stuart Nickels, an 11-year veterans of EMS

EXETER– When former district manager Peter Sodhy resigned following the Exeter District Ambulance’s Nov. 4 meeting, he was followed out the door by the district’s law firm and the oxygen in the building. 

Adam Pfenning, Exeter District Ambulance (EDA) board president, announced the district was not only looking for a new manager and law firm, but that “all options were on the table,” including contracting with another provider for ambulance coverage, employee layoffs, obtaining management and financial assistance from the county of Tulare and even consolidating with the Kaweah Delta Health Care District, which could have meant the end of the former Exeter Hospital District as a public ambulance provider. Those options were still on the table as recently as EDA’s Jan. 10 meeting, according to minutes of the meeting.

Instead, EDA decided to hire a new district manager with prior emergency medical service (EMS) experience and find out if their financial troubles are signs of a fatal problem or just a blip on the EKG. 

In February, Exeter District Ambulance hired Stuart Nickels, an 11-year veteran of EMS, as its new district manager. For the past three years he has worked as operations director for Delano Ambulance Service in Kern County. Nickels left Delano after the company was purchased by Hall Ambulance last fall. After approval by the Kern County Board of Supervisors in October, Hall is now the paramedic provider for nearly all of Kern County, with the exception of Liberty Ambulance in Ridgecrest. The move all but ensures a single-provider system in Kern County’s future. 

Nickels said he enjoyed his time working for the exclusive area provider and its involvement in the community, something he looks forward to continuing in Exeter.

“I want our crews to shine their boots and attend local events, and be a part of this community,” Nickels said. “I want people to know our first responders are public servants and want people to see them similar to how they see a firefighter or a cop.”

In his first month on the job, Nickels has stabilized the ailing public ambulance company’s finances, mostly by changing the schedule to cut down on overtime costs. Nickels said this will buy the company time to collect on insurance reimbursements currently lagging by 180 days but typically fall within 90 days. In his estimation, that should be enough for Exeter Ambulance to finish the year in the black. 

Prior to Nickels’ arrival, the district was struggling to meet response time standards in Lindsay, to find paramedics to work the rigs, and was forced to pull $50,000 from its reserve account just to cover bills and payroll as the district ended last year $66,000 in the hole.

“The only reason we made it last year was because of COVID money,” Paramedic Shift Lead Brian McCoy told the board in January. He was referring to the $250,000 lifeline EDA received in Coronavirus Aid, Relief, and Economic Security (CARES) Act funding from the county at the end of 2020.

Growing up in a family of firefighters, Nickels said he is proud to work for a public ambulance company which sees people more as patients and less as patrons. He credited the Exeter Ambulance’s staff for sticking together and sticking it out with the public ambulance company which has been embroiled in board politics, labor disputes, misconceptions and mismanagement for years. The publicly funded ambulance district has been rumored to close, dissolve or be absorbed into other districts no fewer than seven times in the last 20 years. Nickels says he hopes to put all of that in the rear view mirror and focus on moving Exeter on the road to recovery. He said the pride he and the current staff have for public service will be the driving factor for the turnaround. He said there are at least nine EMT/paramedics on a waiting list to join EDA as soon as it has the finances to responsibly refill its ranks and former coverage area.

“There are a lot of people with a lot of pride for what we do here and they are out there showing they are ready to help people everyday, regardless of what else is going on,” Nickels said. “We know we have an image problem, and we are going to have to change that one thing at a time and that all starts with the people who are here.”

Shifting Coverage
EDA is currently running three shifts during the week. Ambulance units are stationed in Woodlake and Exeter for all three shifts and an additional unit in Lindsay for the third shift. This means EDA has pulled back much of its coverage in Farmersville and Lindsay, two areas now being served by other providers. Pfenning said the Lindsay unit may shift to Farmersville because the majority of the calls in Lindsay are being handled by Imperial Ambulance out of Porterville and Lifestar Ambulance in Tulare. EDA and American Ambulance pick up calls in Farmersville from posts outside of the city due to the short distance between the three cities.

“We are committed to this schedule for two more months and then we will look at the budget to see if it is sustainable,” Pfenning said. “If it isn’t sustainable, we will either adjust the schedule or cut back on the number of units.”

Pfenning said the district is still stationing one ambulance in Woodlake every day, despite conflicting accounts late last year that EDA had to pull the ambulance out of Woodlake and return to posting in Lemon Cove because it was unable to meet its response times to Three Rivers. 

EDA and the other four primary ambulance companies in Tulare County are overseen by the Central California Emergency Medical Services Agency (CCEMSA), which also oversees ambulance service in Fresno, Madera and Kings counties.

Dale Dotson, EMS Coordinator for CCEMSA, said the call volume to Three Rivers and Woodlake both average to about two calls per day, sometimes slightly more in Woodlake, meaning there is no coverage advantage to having an ambulance post in Woodlake over Lemon Cove. And while his agency does not tell the county’s ambulance providers where to post ambulances or how to run operations, it does enforce quality control measures such as response times. He said EDA and American Ambulance’s response times to Three Rivers have been inconsistent since moving its post to Woodlake in May 2020.

“Generally, when Tulare County struggles to meet response times it is in the Three Rivers area,” Dotson said in an interview last year.

Pfenning said EDA and American Ambulance are keeping their ambulances in Woodlake, at least for now, and plans to make the location work for responding along the Highway 198 corridor to Three Rivers, a notoriously difficult place to reach quickly and somewhat remote from the nearest hospital. 

“CCEMSA, the county, the city of Woodlake and the providers are all working to remedy the response time issue in Three Rivers,” Pfenning said. “We are going to stay in Woodlake until plans change or we are directed to do something else.”

Lack of Quorum
The next major hurdle for the public ambulance district will be refilling the ranks of its oft-vacant board. At its March 28 meeting, Pfenning said EDA board member Juan “Bobby” Martinez announced he was resigning from the board and board member Diana Mendez announced she would be stepping down prior to the next regular meeting on April 25. Martinez was appointed to the board in July 2020 and Mendez in January 2018. The Tulare County Board of Supervisors makes appointments to special district boards within 60 days of the vacancy unless there is an election during that window.

That leaves EDA with just two of its five seats filled. Public boards must have one more than half of its board present, known as a quorum, in order to hold a public meeting and vote on actionable items in accordance with the Brown Act, California’s open meeting law. It is a familiar scenario for EDA which has struggled to keep a quorum of seats filled for the last five years. The special district has had at least one vacancy on its board since 2017 and did not hold a meeting between April 27 and Aug. 31 in 2020 for lack of a quorum. 

Pfenning is asking anyone in the community interested in serving on the board to call the EDA office at 559-594-5250, send an email to [email protected] or stop by the office at 302 E. Palm St. in Exeter to leave their name, address, phone number and email address. Interested parties also have the option of going down the Tulare County Registrar of Voters and filling out an application for appointment.

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