County Manager Tom Stolz Statement on EMS
To the Board of County Commissioners and the Citizens of Sedgwick County:
I have made some decisions regarding EMS operations this week, but before covering that, I would like to take some time to discuss a more comprehensive picture regarding the evolution of this matter that was not fully covered in the extensive Wichita Eagle articles. It is not my intent to disparage anyone in this statement but rather to set the record straight and put out facts regarding the challenges in handling this matter.
On May 6, 2015, the Sedgwick County Commission approved a contract for Dr. John Gallagher to serve as County Medical Director. It was a four year contract worth a total of $193,576 salary per year including a $47,732 buyout of an existing contract. When you calculate cost of living raises and other contract stipulations, this contract exceeded well over $800,000 for the four year period. The contract was voted on unanimously by Commissioners Ranzau, Peterjohn, Unruh, Norton, and Howell.
On September 18, 2018, Scott Hadley retired from EMS. Dennis Mauk was named as Interim EMS Director. In my opinion and assessment, Dennis served in this role in an exceptional manner. I received no formal complaints from EMS regarding Dennis' leadership during this entire time period; however, in the early summer of 2019, I received random anonymous complaints from employees indicating a cultural "good ol boy" system was in place where promotion was based on friendships instead of through merit of work. At the time, employees could not provide me with enough detail to substantiate such an environment.
When Mr. Hadley left the county, County Manager Mike Scholes requested an analysis be completed to review other models of EMS deployment and service including a physician-led model. Dr. Gallagher completed a report, and Mr. Scholes discussed the model with at least some Commissioners to my knowledge. It was discussed as a staff in the fall of 2018, and we began looking at pros and cons of this model. There were many positives about this model, and it was being deployed in a few jurisdictions in the country but was viewed as a professional and innovative model that could curtail historical conflicts between the clinical and operational sides of EMS. But before Mr. Scholes could implement the new model, he separated from Sedgwick County as part of a settlement with the County Commission. The review of EMS operations was put on hold during this time, and Dennis Mauk continued in his interim role.
This above situation involving the Manager was resolved late in December of 2018, and in February of 2019, the discussions of EMS modeling resumed. On June 12, Sedgwick County Communications put out a press release that stated the county was looking at a new model of EMS operations.
I've attached that press release copy to this report. During that same time period, Mr. Leeds, Dr. Gallagher, and I attended meetings with EMS employees to hear their concerns. A large majority of employees spoke negatively against the new model and against Dr. Gallagher. I know Commissioners met with some employees during this time as well. Many EMS employees made it clear the existing model was their preference, but at the same time, some employees spoke in favor of Dr. Gallagher, and I received five correspondences from employees who indicated they supported Dr. Gallagher but had to do so anonymously, as there were attempts toward them internally to get them to sign a circulating petition that spoke out against Dr. Gallagher. One of these employees also told me of a culture of sexual harassment toward women in the department. She stressed she was telling me this in confidence and not to bring her name up but asked that I looked further into this. By August, we thought we had vetted this potential organizational change as fully as possible, including discussion with community stakeholders such as our hospital partners and the medical society, all of who supported the concept of a physician-led model. As such, the decision was made to move to the physician-led model for the following reasons:
- The growing complexity of EMS operations in the field. It was clear the EMS clinical role in patient care had significantly evolved over the years; no longer were they simply a transport system, they were now extending the boundaries of the hospital emergency room to the streets and homes where they were making calls. It just seemed to make sense to have a physician lead this changing environment.
- To stop the constant historical conflict between clinical care and EMS operations. From a management perspective, putting both components under one roof made sense in terms of efficiency and service to the community. This shift would also help employee training (which had always been a struggle) to advance to the next level to improve outcomes for citizens.
- To put an outside influence into the organization to kill any type of cultural favoritism or discrimination that had been alleged. I spoke directly to Dr. Gallagher that this was his first priority and to work with our Human Resources Department regarding both issues.
- To improve communications between EMS and the rest of the county organization, specifically Human Resources and the Finance Departments. Staff from both of those areas stated that historically, they had struggled to get information from EMS leadership.
In a public staff meeting held in August, 2019, we again vetted this model and the reasons why we were proceeding. The body of the Commission seemed favorable to the new model with the exception of Commissioner Howell who spoke out against it. Any suggestion that this "reorganization process was somehow hidden or not publicly discussed is disingenuous and wrong."
On August 20, 2019, County Communications put out a press release announcing this change to the physician-led model (attached). A 3:00 p.m. press conference was scheduled so staff could address the logic of the model and openly discuss concerns stated by EMS employees in the previous weeks. Not a single media outlet or citizen showed to the press conference.
On December 4, 2019, Dr. Gallagher was signed to a new contract taking on the additional role of EMS Director. His salary was $222,142.65 in the new contract which represented a 3% raise over what his previous contract had been paying. This contract was placed on the consent agenda as it represented an extension of his existing contract signed in 2015 with increased duties of EMS Director. The final draft for this agenda went to the Commission and general public on Tuesday, November 26, a week where all Commissioners were present and working.
It was discussed and put out for all the public to see more than a week in advance. For anyone to indicate that this contract was "buried" on the consent agenda is false.
As anticipated, after the new management team took over EMS, a sexual harassment claim came forward by an employee within EMS and was investigated by the Human Resource Department. After investigation, the matter was sustained and immediate job actions, including a termination, were taken against those who had committed violations in regard to that policy. Similarly, I had a supervisor reach out to me anonymously and advise "I never would have been promoted under the old system."
Of course, the pandemic hit in March of 2020, and the entire county organization reacted. All of County Management, including myself, had to put down our day-to-day operational jobs to deal with the COVID management of crisis operations, obtaining PPE, testing, distribution of CARES funds and ultimately vaccine management. For example, Public Safety Director Rusty Leeds became the lead of Emergency Management of COVID operations and acquisition of basic Personal Protective Equipment which was in national short supply. This emergency status lasted for the remainder of 2020 into 2021.
In October and November of 2020, Commissioner Howell began verbalizing complaints regarding Dr. Gallagher's leadership and wanted him removed from his position. He advised me he was getting complaints from numerous EMS employees. I asked Commissioner Howell to have these employees come see me, Mr. Leeds or Ms. Sheena Schmutz, our Chief Human Resource Officer with Sedgwick County. He told me he would have employees contact me or would forward emails to me that indicated their concerns. I received nothing, and no one from EMS came to talk with me, Leeds or anyone in HR. These conversations between Commissioner Howell and I continued throughout the winter with my repeated requests for employees with specific complaints to talk to me, Leeds or HR. He continued to say he would try to make that happen; however, no communication happened that I was made aware of. During this same time, Commissioner Howell began sending me complaints regarding EMS calls and staffing issues. Though I would ask him where the complaints were coming from, he would not divulge, simply telling me to "check them out." On every occasion, I did check them. In the vast majority, if not all, my findings through 911 or EMS supervisors contradicted the information that had been relayed to me by Commissioner Howell. The email Commissioner Howell forwarded to the Eagle regarding my reaction with what appeared to be (what I termed) a "witch hunt" was borne out of frustration from this continued misinformation complaint process while we were trying to manage a pandemic. I asked him repeatedly to bring forth employees to talk with me. Even in the midst of managing COVID testing, vaccine planning, and other COVID related issues, had anyone brought forth a complaint directly from EMS to me, I would have initiated an investigation. Because of limitations regarding in-person meetings, in hindsight, I wish I would have proactively sent a survey or made some type of outreach to employees. That was a mistake on my part.
In mid-April, following up another complaint about mismanagement of EMS operations, I met with Commissioner Howell, Dr. Gallagher, Paul Misasi, Major Kevin Lanterman, Rusty Leeds, Elora Forshee, Chairman Meitzner, and Tania Cole to discuss the logistics of what Commissioner Howell had termed as poor response from EMS on a specific call. At the end of the meeting, where we again found no tangible operational problems with the EMS response, Commissioner Howell again requested that I remove Dr. Gallagher as the director and reassign him back as the Medical Director.
I requested that Commissioner Howell help staff to resolve conflicts within the team and to give this model a chance to work for a reasonable time period, especially now since there was some indication we may be coming out of the pandemic. He advised he would not and advised if I did not immediately remove Dr. Gallagher, that he would go to the news media to discuss the situation.
I asked that he help to build the team up rather than try to destroy it and that I could not take actions on complaints with no employees coming forward to tell me about specific complaints involving Dr. Gallagher's leadership. In the days following this meeting, we began receiving numerous KORA requests from Eagle reporter Chance Swaim, which we were happy to give as the organization is transparent in this regard. We were down staff and EMS calls were increasing, and we knew the data was reflecting that.
A few days after this, Commissioner Howell contacted me advising there were employees willing to meet with me but only with specific conditions:
- Only Mr. Leeds and I were invited from staff-Dr. Gallagher, Dr. Periera, and other certain management from EMS could not attend.
- Only Commissioner Howell and either Commissioner Cruse or Commissioner Lopez could attend.
- They would not meet individually or in smaller groups. It was two large groups based on X and 0 shift staffing or there would be no meeting.
I agreed to these meetings even though I thought it was unjust not to include all Commissioners, Dr. Gallagher, and Dr. Pereira to hear complaints about them.
On April 26 and April 28 of this year, we held the meetings at the Extension Center. There was a tremendous turnout from EMS supervisors, paramedics, EMTs as well as some former employees. Those that spoke were all against Dr. Gallagher. Though some complaints were nonspecific -they simply did not like him personally -there were several which cited exact reasons and examples that had occurred since August of 2019 that caused concern to me. After the meeting on April 28 concluded, Mr. Leeds and I talked in the parking lot of the Extension Center and agreed there was enough information here that warranted further investigation. Knowing the intensiveness of this effort and that we had well over a hundred interviews to conduct, we decided an outside and impartial party review would serve the county best.
After internal discussion and due to the speed in which we wanted this done, we opted to go with the auditing firm of Allen, Gibbs and Houlik who had historically provided excellent work to the county regarding internal audits and who promised to turn an investigation around in roughly 3 weeks (middle of June). This intention was forwarded to EMS employees, and I advised the Commission of this path forward. Soon though, Commissioner Howell informed me there were concerns over use of this company since Paul Allen is a member of the Greater Wichita Partnership, as are Chairman Meitzner and I, due to our roles with the County. An insinuation was made that somehow the investigation would be tainted or biased because of this relationship.
Though I sit on a board with Mr. Allen, I have never spoken to him except to greet him with a hello when I see him at the start of meetings. To indicate or disparage his credibility or his company's credibility is unprofessional and wrong.
I was somewhat stunned by this accusation until a staff member forwarded me an Eagle article from 2016 where Commissioners had a disagreement in the public newspaper regarding a contract award between his company and the county during that time (article attached).
Regardless of what caused this concern using AGH, I felt it best to find another 3rd party to help us with the investigation since our intention was sincere to get an unbiased analysis. I consulted County Counselor Mike Pepoon, and he suggested that he hire an independent legal firm to conduct this review. Mr. Pepoon reached out and contacted the law firm of Hite and Fanning who agreed to conduct the investigation into this matter. This transition in investigation set us back in time by at least 3 weeks, but we felt it was worth it to take away doubt or skepticism that we wanted a thoughtful and true investigation.
Once again, employees and Commissioners were made aware of the use of Hite and Fanning. After a short delay, the firm began interviews with almost 120 Sedgwick County employees. I stated from the beginning that we would await this report before making a final decision on the way forward from this investigation.
Last Friday, I put out an organization-wide note regarding the EMS matter and other matters within the county (attached). This note went to all county employees, including EMS and the Commission. Also on Friday, I talked with Dr. Gallagher and let him know of my decision regarding a change in Directorship and that it would take effect Monday. At 3:00 p.m. on Monday, July 19, I formally placed Dr. Gallagher on administrative leave with pay and placed Deputy Director Paul Misasi and EMS Colonel Bill Robben in charge of EMS operations on a temporary basis. The following actions will now be taken:
- An interim EMS director will be named as soon as possible.
- We will again separate EMS operations from the clinical branch.
- Though Dr. Pereira has resigned, she has remained committed to working until September so she will now serve as medical director. This gives us more than a month to obtain a contracted physician to serve as temporary medical director through a competitive process.
- We will immediately stand up a citizen review and advisory board for EMS services. This advisory board will be made up of health professionals (Doctors, nurses, paramedics, and EMTs) and citizens from the community we serve.
- We are crafting policy which will enhance communications regarding complaints that employees may be having in the workplace for help in resolution. This policy will be presented to the BOCC as soon as it is finished.
When the organization stabilizes, we will immediately begin a regional search for a new EMS director. We will involve the medical and public safety community as well as EMS employees in this process.
A lot has been said about EMS privatization. I have gone on record stating my opinion that a public EMS service is the right model; but some Commissioners have also stated that we must provide some level of service to the community, and they are correct. If we continue to lose paramedics, it would be negligent to not consider other options to provide this community with an ambulance service. It is my true hope that it does not come to this.
In the last few weeks I have been called by physicians from the region telling me that patient care of EMS patients has gotten measurably better in the last several years with Dr. Gallaher's presence. Those types of calls have made these decisions difficult, because to me, patient care of our citizens is extremely important. The issue perpetuated by the Eagle regarding the tragic suicide call is unjust and unfair. That matter has been reviewed by physicians regarding Dr. Gallagher's decisions that day, and despite what the paper reports, neither Mr. Leeds nor I tried to "convince" Commissioners or citizens of the findings of the medical society. That is not accurate. We simply informed of the letter sent by the Medical Society. I neither sought nor requested it. There is no investigation by the Board of Healing Arts, the Sheriff, the DA, or anyone else in authority that I am aware. There in an ongoing investigation by the State Board of EMS regarding the conduct of our paramedics and firefighters on-site that day, which we are aggressively defending.
I was given a personal interview with Chance Swaim in June, during which I gave him permission to record. We talked for several minutes, and he told me he was running an article regarding EMS. I was forthright and honest with him, and we talked about some of the issues in this document I am reading from today. Very little of it made one of his numerous articles. I would request that Mr. Swaim put my entire interview on line for the public to read.
So in summary:
- For reasons stated, we went to a physician-led model in August of 2019. We knew many employees were concerned and spoke out against this model. We owned it. It was my personal hope that professional leadership in conjunction with professional staff would rise to the occasion and create an atmosphere of superior service for the citizens of Sedgwick County. I have been part of three similar mergers in the past. One merging the City and County forensics labs, one involving the merger creating the Exploited Missing Child Unit between Wichita PD and the Sheriff, and a third involving the merger of City and County building codes department. In each of those cases, there was a large majority of employees who were unhappy with the changes being presented, but in the end, they worked out the differences, and the citizens of this community ended up with a better service model then before. Unfortunately, that did not happen in this endeavor for which I am sorry. We will again split operations from the clinical branch of EMS and do our best to work through the challenges that historically existed. I feel confident we can make that work. These decisions rest with me, and I take full ownership of them.
- The specific decision to remove Dr. Gallagher as director also solely rests with me. I did so after much thought, investigation, and proper due process. I apologize for what many saw as delay in this matter, but it is important to me to be fair and not succumb to newspaper or social media pressure, or even pressure from individual Commissioners. I will also state that during the investigation, I offered a chance for an outside mediation as a last ditch effort to resolve the conflicts. That is the nature of my role as a manager and my personal belief-let's communicate to resolve the problem. Dr. Gallagher and his team welcomed that opportunity, but two spokespersons for the paramedics declined, advising that too much damage had been done.
- Since we went to the new model in 2019, I had not received a single formal complaint from EMS workers regarding Dr. John Gallagher until the late April meetings. I know Commissioners reached out to Dr. Gallagher and encouraged him to work to improve morale within the department, and in the middle of this, we dealt with a COVID crisis.
- Nothing in this process has been a secret. We were transparent in going to the new model. We were forthright that we had many EMS employees who were concerned with the change. We even held a press conference to discuss that with media, but no one showed up to attend. The first actual "in person" complaints we heard from current EMS workers were on April 26 and 28 of this year, not even 90 days ago. I've laid out the timeline since then. Investigations of this nature take time.
To the media partners in this room, I have always given my pledge to be forthright and transparent regarding county operations. My door is always open to you. County Communications staff and I meet with you on a quarterly basis, and I always ask the question "what can we do better" regarding getting proper information to you to do your jobs. Those meetings will continue.
To the citizens of this community, EMS staff, and to the Commission, I apologize for this concern in our public safety services. I feel it is my moral and ethical obligation to hear all sides in regards to the formal complaints made at the April meetings. I do not react to social media comments or newspaper allegations when it comes to these types of investigations, nor do I manage under mob rule. I will not react impulsively or emotionally to these types of matters. Though I understand that EMS personnel's main issue was regarding their leadership, their message was clear in this investigation. As we move forward, there are still issues that will need addressed within EMS and do not immediately dissolve with an interim director. We still have critical paramedic shortages that are concerning with increased call loads. We still need to address compensation as other communities quickly hire away our talent for better pay as we struggle to keep our local talent. We are working to address compensation in the 2022 budget and have enacted 10% critical pay status for paramedics for now. As I stated in my email to the organization last Friday (attached), our EMS professionals deserve good leadership from within their department, from Director down to first line supervisors. We will continue to work through what is best for the EMS Department, the Sedgwick County organization, and the citizens and visitors of this county.