Like Oakridge, the town of Yachats is grappling with the national problem of funding ambulance service

EDITOR’S NOTE: Readers of The Herald know by now that Oakridge ambulance service is in crisis. It’s a growing problem for small, rural towns all across the nation. Yachats is one of them. And although that Oregon coastal city’s ambulance service is set up differently, Oakridge citizens should find the following article instructive. It is published here with permission from Quinton Smith, the owner and editor of YachatsNews.com, the 2-year-old digital news site that inspired the founding of Highway 58 Herald.

By QUINTON SMITH/YachatsNews.com — When there’s an emergency medical call in or around Yachats, the blue and white South Lincoln Ambulance is usually the first to get there.

On board are firefighter/paramedics from the Yachats Rural Fire Protection District.

It’s a situation – a private, nonprofit ambulance service staffed by taxpayer-supported paramedics – that’s unique in Oregon.

Now, as the fire district board seeks to trim expenses and find more revenue, some members are asking if the district and its patrons would benefit by officially absorbing the ambulance service instead of subsidizing it with fire department staff.

That’s meeting pushback from Frankie Petrick, who is the fire district’s longtime volunteer chief and paid administrator, but who also runs the ambulance service and is one of its five board members.

But at least one other coastal department is even questioning why Yachats takes its two firefighters out of service when transporting ambulance patients to hospitals when there could be another ambulance company already serving Lincoln County communities doing that.

The issue came to a head during meetings in February and March as the fire board and Petrick try to find ways to balance the fire district’s budget. As it has for four years, the district is using a yearly $550,000 line of credit this spring and summer to cover much of its monthly operating costs until its coffers re-fill with property taxes in the fall.

At its March board meeting, Petrick surprised the fire district’s board with a one-year ambulance staffing agreement that board members had yet to see. The only thing new was South Lincoln Ambulance offering to double the reimbursement for monthly rent and utility charges – to $150.

The board balked at signing the contract, instead asking for more details of the nonprofit’s finances and other operational details. Petrick asked board members to email her questions that she could respond at its Monday, April 12 meeting.

Drew Tracy, the board’s newest member who has been a police chief and incident trainer on the East Coast, has been pressing the board to seek more money to hire more firefighter/paramedics and put aside money for replacing old engines. And, because the ambulance makes the vast majority of calls, Tracy is also pressing the board to discuss if or how to absorb the ambulance service into the fire district.

“It’s time to have that discussion,” he said at the March meeting.

Board chair Katherine Guenther agreed.

“It’s time to take a much closer look at that relationship,” she said. “… is it a little one-sided?” Guenther asked, adding that the ambulance nonprofit’s $150 a month to station expenses “doesn’t seem right to me.”

Ambulance nonprofit, subsidized by fire department

The Yachats Rural Fire Protection District was formed in 1949, staffed by volunteers who also operated an ambulance. South Lincoln Ambulance was incorporated as a nonprofit in 1966, Petrick said, after fire board members began to worry that its ambulance was leaving the district for medical calls.

To this day, the ambulance’s service district is slightly larger – to the south and east – than the fire district’s.

Lincoln County is divided into five ambulance service districts, overseen by a review committee, which also makes recommendations to county commissioners on who should service the areas. Pacific West Ambulance has the contracts for the four areas ranging from Lincoln City in the north to Waldport in the south, while South Lincoln Ambulance has the five-year contract for the fifth district. That contract expires June 30.

South Lincoln Ambulance has three board members – Petrick as secretary; former Yachats fire chief Steve Hamilton as president; and, fire department assistant administrator Shelby Knife as a board member.

Until this week, South Lincoln Ambulance had three board members — Petrick as secretary, former Yachats volunteer fire chief Steve Hamilton as president, and fire department assistant administrator Shelby Knife as a board member. This week it added two people – Holly Gibbons and Julie Hamilton, who is not related to Steve Hamilton. Knife was selected president and Gibbons as vice president.

In 2020, South Lincoln had $123,350 in income and $81,130 in expenses, according to a profit-and-loss statement Petrick provided YachatsNews, resulting in a net income of $42,222.

South Lincoln Ambulance charges a base rate of $850 plus $14 a mile for its service calls. PacWest’s base rate is almost double that — $1,500.

South Lincoln uses a billing service to seek insurance or Medicare reimbursement. Because of the area’s elderly population, many of the ambulance’s bills are paid by Medicare, Petrick said, which recognizes only $440 of a standard bill and pays 72 percent of that.

“We’re lucky to get a $400 payment on the total bill,” she said.

If a person is uninsured or has no money, Petrick said she tries to negotiate a small, monthly repayment plan and uses fundraising and donations — $6,400 last year – to help pay those bills.

“I don’t think under the rules of the district they could do that,” she said. “There’s a lot of nuance to billing in particular cases. I don’t want to hurt anybody.

“It’s unique,” Petrick said of the ambulance nonprofit. “There’s nothing like it in Oregon.”

Other districts regularly respond to Yachats

Petrick said South Lincoln Ambulance operates “as a community service.”

But neighboring fire districts aren’t so thrilled. Here’s why.

Yachats Fire has two firefighter/paramedics on duty 24/7. Two are needed to run the ambulance, so when there is a medical call there are no firefighters at the district’s main station along U.S. Highway 101 on the north edge of Yachats.

If there is another call, under a mutual aid agreement with Central Oregon Coast Fire & Rescue in Waldport, an engine from there responds. If COCF&R is also on a call, then an engine comes from the Seal Rock Fire Department, which is now sharing personnel and equipment with the Waldport-based department.

Central Coast fire administrators say Sunday, March 28 was a good example of what can happen when Yachats firefighters are used on a South Lincoln Ambulance call.

At 12:30 p.m. that day, South Lincoln Ambulance staffed by two Yachats firefighter/paramedics responded to a major automobile wreck on Highway 101 at Big Creek, six miles south of Yachats. Because Yachats responded with only an ambulance and under its mutual aid agreement for serious traffic accidents, Central Oregon Coast Fire & Rescue sent an engine and two incident trucks from Waldport.

The two Yachats firefighters then had to drive the ambulance with one person injured in the wreck to the hospital in Florence.

Over the next 90 minutes there was a water rescue call in Alsea Bay, which also calls for Yachats and Seal Rock departments to respond, and two medical calls in Yachats. Yachats was unable to help on all three calls because its firefighters were still dealing with the injured person in Florence.

Instead, Central Coast used its volunteers to respond to the water call. During that response, Central Coast responded to the first Yachats medical call an engine and a PacWest ambulance based in Waldport. It responded to the second Yachats medical call with another engine and a second PacWest ambulance that came all the way from Newport.

The short version – because Yachats firefighters were staffing the ambulance and transporting a person to Florence – no one from Yachats was able to respond to one mutual aid call in Waldport and two medical calls in Yachats.

If South Lincoln Ambulance was separately staffed or PacWest held the contract, Central Coast and Seal Rock firefighters say Yachats firefighters could respond to accidents or fires with an engine with firefighters on it and not constantly rely on mutual aid from their similarly short-handed departments or have PacWest send ambulances from Waldport or Newport.

The issue is important because the majority of emergency calls – up to 80 percent or more – to local fire departments are for medical issues. There just aren’t that many fires anymore.

In December, for example, Yachats crews responded to 98 calls – 65 of which were medical in nature, 10 mutual aid calls mostly involving the ambulance, and six car crashes. There was one fire.

Will fire board set money aside for ambulance?

Other than offering low-cost ambulance service, Petrick says her worry about the fire district absorbing South Lincoln Ambulance is that finances have been so slim that the fire board is not regularly putting money into reserves to replace equipment.

“There’s no way for the fire district to guarantee ‘safe money’ for fire equipment and the ambulance,” Petrick told YachatsNews. “I understand they may see it (the ambulance) as a revenue source. I’m just reluctant to say it’s a good idea.”

The state requires ambulances be replaced every 10 years. South Lincoln spent $117,700 in 2017 to purchased a refurbished ambulance. According to its latest filings – for 2018 — with the Internal Revenue Service, the nonprofit had assets of $154,900.

In March, Petrick told fire board members that they are “very nice” but that “another board could come along and change everything.”

Fire district board member Don Tucker asked in March if it is possible to integrate fire and ambulance services “with protection to the ambulance side of the equation.”

“We really need to look very hard at how we can reduce the cost of business,” Tucker said, pointing back to the fire district’s financial issues.

Betty Johnson, who has been on the fire board for 15 years, said there have been questions about the fire and ambulance relationship for years … “and there are still questions that aren’t thoroughly understood.”

Petrick asked board members to send her questions about the ambulance service’s operation “and why I should consider giving the assets of South Lincoln Ambulance to Yachats Fire … so I can address those as we try to move forward.”

Guenther said the board needs to better understand the working relationship between the district and nonprofit ambulance.

“It’s not a hostile takeover,” she said.