Ashland Ambulance Service May Be Outsourced by the Council — Questionable Budget Cut for Ashland but Huge Money Maker for Some
The Ashland Fire and Rescue provides Ashland residents with excellent ambulance service. Some would say the best in Southern Oregon. However, two city councilors and a council candidate question whether or not Ashland can afford this service and should outsource it to Mercy Flights that would cost the city less, but its citizens individually much more.
Below are questions posed to the Fire Chief regarding the request for a project to analyze the costs of the ambulance service. The reason this has become an issue is that the Cost Revenue Ad-Hoc Committee decided that outsourcing the ambulance service can save money for the city. The Fire Chief clearly presented a cost/benefit analysis to this committee that showed the ambulance service breaks even giving its citizens a life-saving service with little cost to its citizens. This committee didn’t accept his analysis and recommended to the council an audit of the fire department’s services.
Below are citizens questions posed to the Fire Chief regarding the audit of his department.
What does “exclude all data related to ambulance service” in the audit request mean when you refer to the analysis of the service?
Fire Chief: The ambulance service (the actual transporting of patients to hospitals), is something that the fire department provides above and beyond what would be expected of most fire departments across the country. Let’s refer to this as “exceptional” service. When we refer to “excluding data” we are talking about such things as call volume. For example: With the ambulance service, we respond to about 4200 calls a year. 1200 of those calls are outside the city limits of Ashland and are directly related to the ambulance service. As we need to know what our “basic” fire department should look like (firefighting/EMS/all hazards responses), the consultant should exclude those calls that are attributed to the ambulance service. By excluding ambulance related data, we get a clearer picture of what is truly required of us (the basic fire department) as compared to what we are currently doing (exceptional fire department).
Will the quantitative analysis of the service also contain the financial details to the City for ambulance service if we don’t have our own? What will it cost ?
Fire Chief: There is no cost to the City if the service is provided by another entity. Ambulance services receive income (including AF&R) by billing patients for the service. Those costs are monitored and approved by the Jackson County Board of Commissioners. A new provider would be expected to charge similar rates to what is currently being charged.
How will the Staff make sure the Consultants contending for the contract don’t have a bias like “pro keeping the ambulance” or “pro dumping the ambulance”?
Fire Chief: Yes, you are correct in that we really want to find someone who can look at this objectively. We will be grading each of the consultant’s proposals before awarding. The consultants experience, qualifications and references are a significant part of that score. Those who have the ability to show us that they are not biased one way or the other would most likely receive a higher score.
With Covid-19 running around for the near future, keeping the ambulance service disinfected and well run must be key. So which model is better? Our own ambulance service ? Or an outsourced one?
Fire Chief: I would offer that all ambulance providers in Southern Oregon do an excellent job of keeping their ambulances disinfected. As far as which model is better, as this is somewhat of a subjective observation, I would refer you to the video archive of the October 16, 2019 meeting. Both AF&R and Mercy Flights gave a presentation to the Cost Review Ad-hoc Committee regarding the services they offer. In my opinion (and of course, I am biased) a fire department run ambulance service is better, but this service also comes with a greater price as compared to a traditional fire department, one that the City may no longer want to afford. Link: https://videoplayer.telvue.com/player/w9sPsSE7vna3XTN_39bs1rEXjVWF0kfP/media/518951?fullscreen=false&showtabssearch=true&autostart=true
Which choice Mercy or AF&R keeps response time to pick up calls to a minimum?
Fire Chief: As per information provided by Mercy Flights and AF&R, both agencies are similar in response times to emergent calls. AF&R had significantly better response times for non-emergent calls in urban areas.
As I talked about at last nights meeting, I want to make sure we do not get too distracted with response times. They are absolutely important, but only so far as making a difference during life-threatening events. As health care person, I am sure you have seen the cardiac arrest survivability graphs that show onset of event, time of defibrillation and chance of survival. If we can arrive within 2 minutes we have an 80% chance of successful resuscitation. At 9 minutes we only have a 10% chance. The current standard per County ordinance is a 10 minute response from the transporting ambulance for these emergent calls. I brought/bring this up because we need to understand that it is not the ambulance service that is saving lives, it is the first responders. Our Firefighter/Paramedics (and police officers) who have the ability to rapidly respond to a scene of a critically ill/injured patient are the ones who are making the most difference in patient outcomes.
Note: Mercy Flights hired a lobbyist to talk with each person on the Ad Hoc committee. Greg Lemhouse was hired to do the lobbying.
Cost Review Ad-Hoc Committee Minutes — http://www.ashland.or.us/Agendas.asp?SectionID=-1&CCBID=266
Cost Review Ad-Hoc Committee Meeting with Ashland Fire and Rescue and Mercy Flights Presentations —https://videoplayer.telvue.com/player/w9sPsSE7vna3XTN_39bs1rEXjVWF0kfP/media/518951?fullscreen=false&showtabssearch=true&autostart=true