Fire officials looking at options for ambulance shortage

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What if you called 911 for an ambulance and one didn’t come? 

That is a concern rural firefighters deal with everyday across the county and they say the problem will only get worse. 

While Colusa County officials try to work out another short-term fix to keep ambulances running in the community, a stakeholder group is forming to find a long-term solution for ambulance sustainability. 

Enloe Medical Center, which currently provides ambulance services for Colusa County, is pulling its 12-hour ambulance on Nov. 15 due to ongoing revenue losses, leaving just one 24-hour ambulance to provide services.  

“Costs have gone up, as costs have gone up everywhere,” said Vicky Pinette, executive director of Sierra Sacramento Valley EMS, the contacting agency for Colusa County.  

While it is likely local government agencies will pool their money to subsidize the 12-hour ambulance for a short time, officials plan to study possible solutions to what they said will be an ongoing problem. 

Pipette said one consideration is the opportunity for local fire departments to operate basic life support ambulances, which Enloe would supply.

A basic ambulance, similar to what Colusa Fire Department purchased in 2016 and later sold, provides emergency transport to patients that need basic care and monitoring from an EMT while en route to the hospital, but not advanced life-saving care. 

Maxwell Fire Department is the only department so far considering operating its own basic ambulance, given the size of its district.  

“It is something I am just looking into,” said Chief Kenny Cohen. “I haven’t made any commitments yet, but I’m looking at the feasibility of it to take care of people in my district. It wouldn’t be for the county. It would just be for my district.” 

Although basic ambulances require a licensed emergency medical technician, they do not have advanced life-support equipment, thus local emergency dispatchers would have to determine which calls would need which ambulance. 

“The Sheriff’s Department is working with Enloe because Enloe does do (emergency medical dispatch) and code determinants through their system in Chico,” Pinette said. 

Officials said the financial crisis in emergency services is largely due to the low government reimbursement rates for patients with Medi-Cal or Medicare. 

While the reimbursement rates have not been reduced, they have not kept up with the actual cost of riding in an ambulance, although California legislation calls for higher reimbursement for Medi-Cal-related services beginning in 2021. 

“It’s partially payer-mix and partially costs going up,” said County Administrative Officer Wendy Tyler. “It’s also lesser call volumes. It’s currently all of those things.” 

And while the addition of basic ambulances could be of service, some believe Colusa County would still face a crisis that will not go away without long-term funding. 

“I think we need to get back on track in finding the right resources,” said Arbuckle Fire Chief Casey Cox. 

Jeff Carmen, a private consultant working with Reach Air Medical Transportation, advised the Board of Supervisors and local fire officials to take a comprehensive look at the ambulance crisis before applying short-term patches because there are solutions out there, including public-private partnerships and subsidies for rural counties with a high Medi-Cal payer mix. 

“There is some opportunity out there but it will take a collective approach to make that opportunity work,” Carmen said. 

The Board of Supervisors will take the issue up at their Nov. 5 regular meeting. ■