Enloe Medical Center has determined that it must reduce ambulance service in Colusa County after the organization continues to lose an estimated $300,000 a year in direct service costs.
“As a rule of thumb in EMS, for the current rate of reimbursements for ambulance service, 1,000 patients are needed per year to pay the direct costs of one 24-hour ambulance,” said Christina Chavira, an Enloe Representative, “In Colusa County, Enloe runs about 1,200 to 1,300 calls with the two ambulances.”
Currently, Enloe provided two ambulances 24 hours a day, seven days a week in Colusa County, on March 29, 2015, the service changed to just one ambulance being 24 hours a day and a second ambulance being 12 hours a day. The Colusa and Williams ambulances operate from 9:00 a.m. to 9:00 p.m. and just the Williams ambulance operating from 9:00 p.m. to 9:00 a.m.
“This situation has caused a lot of anxiety with first responders,” said Victoria Pinette of the Sierra-Sacramento Valley EMS, “however, we have not had a negative outcome yet – though we are only just a few weeks into the new service Schedule.”
Pinette also commented that in the event both the Williams and Colusa ambulances are extended, then the Willows Ambulance will be dispatched to County the Line to serve both counties if needed and if the Willows Ambulance is unavailable then Butte County EMS will be dispatched to cover. Additionally, Bi-County Ambulance or AMR can be dispatched for mutual but they are not obligated to respond.
In addition to service call delays, the reduction in ambulance service has impacted hospital transfers.
“This impact the hospital because now we can only manage so many intensive care patients at a time, and any new admits that walk through the door, I can not take because I am holding an ambulance transfer,” said Colusa Regional Medical Center Nursing Administrator, Katherine Hugh.
With the reduction of service comes the increase of response times and delays. According to Enloe Medical Center during the month of March the City of Colusa had a total of 26 calls with six of those calls delayed, the City of Williams had a total of 13 calls with three of those calls delayed.
“Both cities have a response time of eight minutes and with the service reduction we could see response times increase to ten minutes or more.” Said Pinette.
Pinette commented that Enloe Medical Center will provide the Board of Supervisors with the total number of calls, and response times for that current month.
With Enloe lacking the service requests needed to maintain two full-time ambulances in Colusa County, the committee discussed funding alternatives and service contracts.
“I think as we go along we are going to be looking at how this one and a half ambulance scenario works in the long term,” said Colusa County Supervisor Denise Carter, “In general based on our number of call we really are where we need to be, so to speak, as far as coverage; however our problem is that we are a rural area and our coverage is so widespread.”
Pinette reiterated that Colusa County does need two ambulances due to its Geography.
“The issue at hand is that if were to issue a request for proposal for two ambulances, we can not do it without some subsidy,” said Pinette.
Marty Marshall, director of Enloe Emergency Medical Services, commented that currently the organization received about 100 membership applications for its Ground Ambulance program.
Marshall also commented that Enloe will continue to adjust the service hours as needed to fit the demands.
“If the 9AM to 9PM coverage isn’t optimal then we will change that and balance our resources,” said Marshall.
Colusa County Supervisor Mark Marshall commented that maybe the committee should approach the two cities and ask for a contribution so that the financial burden doesn’t fall on the county.
However, Williams Fire Chief, Jeff Gilbert comment that although he doesn’t foresee an issue with the City of Williams wanting to contribute; however the service numbers provided in the report are a mix between Williams City and Rural and with City of Colusa and Sacramento River.
“We need to get an accurate account on the financials and numbers to get a sense of what the subsidy needs to be,” said Gilbert.
Hughes commented that there might be a possibility of the hospital looking to help contribute.
“If we can get both cities to participate and the hospital and maybe the county could pull enough resources together,” said Carter, “or our other option would be to look at a .25% sales tax increase.”
Chief Gilbert commented that he believed the Sales Tax option is the better choice.
“The .25% sales tax option is the better way to go as we have a lot of people traveling on the highways using our ambulance service. They buy gas, goods and stay in our hotels, and they would be helping pay for the service and reducing the burden on our residents,” said Gilbert.
Whether the county seeks a tax incentive, seek assistance from other governing bodies or have support from the hospital, Supervisor Marshall only wants one thing, to get the task accomplished and as quickly as possible.
“We’ve been talking about this for some time and I am a ‘get it done kind of guy’ and who is at risk here is our citizens that we serve,” said Supervisor Marshall, “I don’t think that anyone wants to reduce services and the sooner we can implement the same level of service we had previously the better.”
Supervisor Marshal also commented that from a board standpoint he is comfortable in saying that the board would like to move this along.
The Ambulance Subcommittee will gather the necessary financials, numbers, and documents needed to make a decision at its next meeting.
In the meantime, countywide ambulance services are reduced after 9:00 p.m. and Enloe continues its commitment to providing quality service to the county.
“We are committed to providing the same high level of service, clinical quality and response standards to the people of Colusa County.” Said Marty Marshal, Director of Enloe Emergency Medical Services,” However, there will be times when people will have longer wait times for an ambulance, and we will do our best to balance resources with demand.”