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Thurston County, Washington

Medic One

​Thurston County's Medic One / Emergency Medical Services (EMS) System was established in 1974.  It was the first public, county-wide, tiered response, EMS system in the United States.

  • The Medic One/EMS System provides a fire services based basic and advanced life support emergency medical and trauma care and transport to over 281,700 residents within the county's 727 square miles.
  • The EMS System responded to 37,837 EMS calls during 2021.
  • The Medic One System’s paramedic units responded with a countywide average response time of 6.86 minutes.
  • The paramedic units accomplished an overall 94% county-wide response goal achievement for response goals of 10 minutes urban, 20 minutes suburban and 30 minutes rural classified areas.

​The approach is to involve all jurisdictional entities as participants in the system rather than a sole provider approach.

  • Twelve fire departments/districts are providers of Basic Life Support (BLS) and are certified at First Responder or Emergency Medical Technician (EMT) levels.
  • All Fire/EMS agencies function with one or more Aid vehicle (55 BLS units provide countywide coverage), averaging 6.75 minutes countywide.
  • All BLS agencies have been auto-defibrillation capable since 1986 and carry epinephrine for severe allergic reactions.
  • Most fire agencies are primarily volunteer with the exception of the larger municipal departments.
  • Olympia, Tumwater and Lacey Fire District # 3 are integrated as county-wide providers of Advanced Life Support (ALS) staffing seven units.
  • Paramedic transport units are dual-role (EMS and fire services) personnel and staffed with two paramedics.
  • Two private ambulance companies, Olympic Ambulance and American Medical Response (AMR), provide basic life support EMS and inter-facility transport.  Falck Ambulance also provides inter-facility transport.
  • Private ambulance companies provide four full-time BLS transport units and additional for peak load times.
  • The System is further supported by a private non-profit EMS helicopter service, AirLift Northwest, stationed at the Olympia Airport.
  • ​Medical communications is over cellular phone and/or HEAR (Hospital Emergency Administrative Radio).
  • Two hospitals are designated to receive EMS patients, Providence St. Peter Hospital and Capital Medical Center.
  • Both hospitals and TCOMM have compatible radio equipment to insure greater than 90% communication coverage county-wide.
  • The Thurston County EMS System participates in a state wide Trauma Center system.
  • In 2012, Thurston County implemented a program to be included in a statewide Cardiac and Stroke center system.
  • Cardiac and Stroke patients meeting state criteria may be transported to cardiac and stroke specialty centers.
  • Implemented in 2005, was an in-vehicle data system linking ALS units with the Dispatch center and county hospitals via digital radio modem.
  • Private ambulances are capable of hospital and system communication.
  • Disaster situations are coordinated on a designated VHF (very high frequency) band.
  • ​The Emergency Medical Program Director (EMPD) is staffed and paid by the Medic One office.
  • The EMPD provides medical direction and authorization for system function.
  • Prehospital standing orders/protocols, dispatch protocols, certification, training, testing standards, medical quality assurance and medical disciplinary actions are the EMPD's responsibility.
  • In 2012, EMPD medical support was initiated to Thurston County SWAT. 
  • ALS & ​BLS agencies use an Electronic Patient Care Reporting (ePCR) software called ESO to document all EMS patient care.
  • ePCR's may be internally reviewed at the Medic One office for quality assurance and quality improvement under a state approved QI plan.
  • Since 2014 all ALS & BLS agencies have been on electronic reporting.
  • As of 2018 Medic One has integrated all ALS and BLS ePCR's through ESO, allowing for an improved and more efficient quality assurance and improvement program across the county EMS system.
  • ​The policy making body is the Thurston County Board of County Commissioners (BoCC).
  • Advisory to the BoCC and the Medic One office is the Thurston County EMS Council.
  • The EMS Council is made up of 16 members:
    • a citizen-at-large from each County Commissioner's district
    • one citizen-at-large countywide physician
    • a BoCC representative
    • three Fire Commissioner representatives
    • a City of Olympia representative
    • a City of Lacey representative
    • a City of Tumwater representative
    • a Fire District # 3 representative
    • a south county Mayors representative for suburban/rural cities
    • an emeritus position
    • and non-voting members; the Chair of Operations Committee and the EMPD

​The Medic One office staff is responsible for developing and implementing system policies and procedures, recommended by the EMS Council and authorized by the Board of County Commissioners.

  • The Medic One office is responsible for county-wide:
    • system coordination
    • county to region system integration
    • equipment/supply purchase
    • staff support to the EMS Council/committees
    • EMS provider initial BLS training
    • EMS continuing medical education
    • system quality management (QM)
    • ambulance licensing
    • system financial administration
  • The office provides county-wide citizen CPR training and system education.
  • In 2011, Public Access Defibrillator (PAD) training was added to the citizen CPR classes.
  • The CPR program was enhanced in 2013 to add High School CPR training.
  • PAD trains citizens how to use a public automatic external defibrillator (AED) as part of the CPR programs.
  • In 2007, the Medic One system implemented a county-wide SafeKids (national childhood trauma prevention program) by partnering with Thurston Child Care Action Council.
  • SafeKids provides child car seat fitting/education, bicycle helmet fitting/education, water safety education and other child trauma prevention programs.

​The full-time Medic One staff is composed of:

  • Director
  • BLS Program Manager
  • BLS Training Coordinator
  • Medic One Training Assistant
  • ALS Program Manager
  • Business Applications Administrator
  • Business Applications Technician
  • Fiscal Manager
  • Administrative Supervisor
  • Medic One Purchasing Specialist
  • Senior Office Assistant

The part-time Medic One staff includes:

  • Emergency Medical Program Director
  • CPR Outreach Coordinator & Instructors
  • Cardiac Arrest Review Coordinator
  • EMT/OTEP Instructors

​The 2023 Medic One/EMS System is funded by:

  • $18 million county-wide regular EMS levy
  • rate @ .3005 cents/$1,000 assessed value
  • this covers the county-wide EMS program
  • $787,293 in other funding

The funding is used across the System with emphasis on full-time paid paramedic response and transport coverage.

The current Medic One/EMS program budget is dispersed as follows:

  • 72% to Advanced Life Support (ALS) activities
  • 13% Basic Life Support (BLS) activities - 6% of the BLS support budget is dedicated to CPR/Public information activities
  • 5% to administration
  • 3% Data support - supports ALS and BLS components of electronic patient records data system
  • 7% ER&R - Equipment Repair & Replacement fund