EMS levy failure fallout

Fire District 4 reduces ambulance service after voters turn down levy

CUSICK – Pend Oreille Fire District 4 Fire Chief Robert Webber announced at last week’s Cusick council meeting that because of the FD 4’s Emergency Medical Services levy failing, the district was mothballing two of its four ambulances.

He said it wasn’t financially viable for FD 4 to continue use fire money for ambulance service without additional funding.

“The Fire District has not been able to purchase much needed firefighting equipment or appropriate personal protective equipment for most of my staff because I use the money taxed for fire protection to pay for the expenses incurred having a great ambulance service,” Webber said in a news release. “I just can’t and won’t do it anymore because it would just kill me if one of our volunteers got injured or killed because of it. The liability of that is just too much to risk, so I made the decision to proceed in the direction of just being a fire district like we are paid to be.”

He said the district receives $36,000 annually from ambulance billing, while paying $40,000 a year for cardiac monitors.

“That’s just the heart monitors, nothing else, so the rest of our EMS service is paid for by taxes levied for fire protection, and the domino effect for that means that needed firefighting equipment just can’t be purchased, and one of our firefighters will eventually get hurt because of it, and that’s unacceptable,” Webber said.

Fire District 4 will put another levy before voters in the General Election. That levy is for 50 cents or less per $1,000 assessed property valuation for six years, the same as the previous levy. It would raise about $150,000 annually, Webber said. The levy needs 60% support of voters to pass. It failed by three votes in August, with 58.99% of the 573 votes cast.

If the voters want Fire District 4 to provide ambulance service, they need to vote for the levy in November to keep the ambulances in service, Webber said. If the levy passes, the district would put two ambulances back in service and would be able to buy the firefighting equipment.

But for now, in addition to mothballing the two ambulances, FD4 will also be scaling back paying stipends to volunteer EMTs and drivers to stay at fire stations overnight and on weekends. Instead, responders will be coming from home to the fire station to get an ambulance, and then respond to the scene of the dispatched emergency.

While FD 4 will respond to all EMS calls within its district, there will be an impact from the changes.

“The fallout from taking these cost saving measures will be longer response times as well as the possibility of our ambulance not responding at all on occasion,” Webber said. He said Fire District 2 will have to pick up some calls. Webber told The Miner that he thinks Fire District 2 is doing “a tremendous job,” but that he doesn’t think it’s sustainable.

“We will be relying on ambulances from District 2 more often, but that may end up having really extended response times due to how busy they are,” Webber said in the news release. “Three times in the last couple of weeks, District 2 had no ambulances available for District 4 calls, and sooner or later that will mean that a Fire District 4 EMT will be on scene with a critical patient for as long as an hour waiting for an ambulance to get on scene.”

If the levy fails in November, Webber says he will mothball his last two ambulances and recommend the Fire District 4 board scrap the ambulance program.

Pend Oreille County commission chair Robert Rosencrantz went door to door to try to get support for the August FD 4 EMS levy. Rosencrantz said that commissioners have promised to vote on forming a county-wide EMS district by Dec. 31 if all the fire districts support it.

“The only district that has not indicated it will do so is SPOFR,” Rosencrantz said.

SPOFR expressed reservations earlier this year about adding another tax without knowing the costs. SPOFR did apply for and receive the second Advanced Life Support License granted by the state March 15, and has been hiring paramedics and EMTs. Two ALS licenses are authorized for Pend Oreille County. Fire District 2 has the other.

Differences between ALS and Basic Life Support ambulance licenses include the level of care, the training required, the equipment used and the treatment setting.

For example, BLS focuses on giving immediate care at the scene in order to stabilize and support life functions through basic techniques like CPR (Cardiopulmonary Resuscitation), rescue breaths or the use of an AED (automated external defibrillator) until help arrives. ALS, on the other hand, requires a higher level of care, like advanced airway management, IV access, medication administration and advanced cardiac life support.

County commissioners can vote to form a county- wide EMS district, but voters must set the property tax rate that will fund the district. County commissioners, including Rosencrantz, have been reluctant to form a district. Pend Oreille Emergency Medical Services, the latest private ambulance company forced to close its doors because of low reimbursement rates from Medicare and Medicaid, stopped operating last year.

Fire District 2 has picked up much of the slack, hiring EMTs and paramedics and serving the south county, Webber said.

Fire District 2 Fire Chief Chris Haynes has said that the district is operating at a $45,000 a month deficit, Webber said.

“I don’t know of many businesses that can do that for very long, so I need to keep the ambulances we have so that they are here already when they are needed again,” Webber said in the news release. That’s why he’s mothballing rather than selling the ambulances.