The County Service Area 38 Advisory Committee is trying to formulate a decision on whether to accept Idyllwild Fire Protection District’s proposal to continue providing emergency ambulance service to Pine Cove. On Friday, the committee sent a list of questions to Bruce Barton, the county’s director of Emergency Medical Services.
At the conclusion of the Wednesday, June 13, meeting, Idyllwild’s interim Fire Chief Mike Sherman said he would re-examine the costs of ambulance service based on response time to Pine Cove longer than the current 12 minutes.
At this meeting, Barton shared IFPD’s request to the county. The official contract is between the local fire district and Riverside County, although the funds for enhanced service to Pine Cove or Zone 2 come from CSA 38. EMS provides supplemental funding for service north of Pine Cove, known as Zone 3.
IFPD has requested an additional $32,309 to extend the current contract, which provides IFPD with $94,905 this year. According to Sherman, IFPD makes about 67 calls annually to Pine Cove. If the patient needs transportation to a hospital or medical center, it is the individual’s responsibility to pay the cost of the transport. But the 67 trips to Pine Cove cost Idyllwild Fire $30,835 more than the contract and ambulance fee revenue it collects, according to its financial analysis.
IFPD estimates that each medical call costs the district about $2,470. Barton described this figure as “absolutely astronomical.” He compared it to AMR cost per call which is about half or $1,200.
“We have the absolutely best ALS [advance life support] service. And we can’t afford to give it away,” Sherman said after the meeting.
If CSA 38 were amenable to a multi-year extension of the contract, IFPD has offered to reduce the single year figure 75 percent. This would cost CSA 38 an additional $24,232 annually or about $120,000 total, plus an annual four percent increase.
If CSA 38 were unwilling to increase the annual payment, IFPD is not in a position to continue its current service, according to Barton.
CSA 38 residents already pay a special fee for the contract cost. This year it is an additional $57 per parcel and generates about $87,500 annually, in addition to the basic share of county property fees.
Options
If the contract were not renewed, Barton told the committee, there were two other options. But he stressed, as did County Fire Chief John Hawkins, an ambulance would be available to Pine Cove residents on July 1 regardless of the status or decision of these negotiations.
Barton confirmed that he has had preliminary talks with American Medical Response (the ambulance service with the overall county contract). And they have agreed to locate an ambulance on the Hill.
AMR’s cost for serving Pine Cove would be about $650,000 according to Barton. However, CSA 38 residents would not be responsible for paying this cost. Instead, AMR would have to raise their overall county rates to recover this additional cost and the Board of Supervisors would have to approve it.
This cost might be less if RCFD permitted AMR to locate the ambulance at Station 23 in Pine Cove.
The county contract for the unincorporated area requires AMR to respond to an incident within 29 minutes and 59 seconds. IFPD is required to respond in less than 12 minutes.
It is this faster or shorter response time that costs Pine Cove residents about $100,000 annually.
Since this service requirement was negotiated nearly 15 years ago, County Fire now staffs each engine with a paramedic, not just an emergency medical technician. The engine at Station 23 could respond to the same call and the patient would begin receiving paramedic care until an ambulance arrived and, if necessary, transport the individual to a medical center.
“You have a paramedic on scene now regardless of the transport agency,” Hawkins said.
“Is the 12-minute response time still important?” Barton asked the committee.
The third option would have Riverside County Fire provide the ambulance service. Hawkins told the committee that RCFD provides this service to several communities in the desert, including Indian Wells and Palm Desert.
Implementing this option would require six to 12 months, according to Hawkins. They would need to acquire the ambulance and staff. But he said it could be done.
Although Barton seemed anxious for a recommendation from the committee, he said they had time. On Friday, June 15, the committee met and formulated a list of questions for Barton, which included “Would a longer response time cut costs?” and “What can AMR offer in the way of a shortened response time and what would the proposed cost be?”
Consequence
Regardless of the decision, EMS has urged IFPD to raise its ambulance fees. According to Sherman, this projected eight percent increase reduced their request for the contract amount.
CSA 38 Chair Jerry Holldber has stressed that if AMR stationed an ambulance on the Hill, along Highway 74, that this third ambulance would benefit everyone, not just Pine Cove or Zone 3.
Separately, IFPD is asking the county for $57,700 more to serve Zone 3 or $43,300 for a multi-year extension for Zone 3. Riverside County would have to provide this funding.
IFPD is evaluating how they will staff its ambulances if the contract is not extended.
