EDITORIAL: Solve the ambulance challenge

Published 2:00 pm Friday, March 25, 2022

Baker City and Baker County officials have no higher priority than solving the ambulance service crisis, at least temporarily.

Fortunately, there is time to do so.

The challenge is a daunting one, to be sure. The Baker City Fire Department, which for decades has provided ambulance service within the city limits and for much of the time in a significant portion of Baker County as well, doesn’t collect nearly enough from ambulance bills to cover its costs. The vast majority of ambulance calls are for patients who have either Medicare, Medicaid or another type of government insurance that pays much less than half of what the city actually bills.

This isn’t a new problem. But the budget gap in the fire department has grown in the past several years, in part because the city, using a three-year federal grant, hired three new firefighter/paramedics in 2018 to handle an increase in ambulance calls. The federal dollars, which paid more than half the cost of the new employees, are no longer available. As the gap grows, the city needs to spend more from its general fund — which includes property tax revenue from city residents — to cover the shortfall.

Since 2018, when the city accepted the three-year federal grant, Baker County has sent money to the city for ambulance services. The county paid $33,000 per year during the grant period, and has allocated $100,000 in its budget for the current fiscal year, which continues through June 30, 2022.

Under Oregon law, the county is responsible for ensuring there is ambulance service and has the authority to choose ambulance service providers.

In January of this year, Baker City Manager Jon Cannon sent to the county a proposed three-year contract that would maintain the city fire department as the ambulance provider for an area that includes the city and more than half the county, including much of Baker Valley.

County officials, meanwhile, worked on a response to the city’s proposed contract.

Unfortunately, a bureaucratic blunder and a lack of communication between city and county officials contributed to the City Council approving what amounts to an ultimatum. During their meeting on Tuesday, March 22, councilors, after hearing a report from Cannon on the ambulance conundrum, voted to have Cannon notify the county that the city, as of Sept. 30, 2022, intends to cease its ambulance service, including within the city limits.

In his report to councilors, Cannon notes that he believed the county was “working on a response” to the city’s proposed three-year contract.

That response was supposed to be sent to the city prior to Tuesday’s Council meeting, County Commissioner Bruce Nichols said on Wednesday, March 23. But it wasn’t sent.

Cannon said it was a “shame” that the county didn’t get its proposal to the city prior to the meeting. That it was.

Yet if he had called the commissioners’ office before the meeting he would have learned that the county’s proposal was ready. Moreover, Cannon would have learned that the county, although it suggested a one-year contract for ambulance services rather than three years, was offering to contribute $130,000 for that year, just $7,000 less than what city officials projected the city would need for the next fiscal year to continue operating ambulances.

In other words, if commissioners had ensured their proposal had been sent to the city, or if Cannon or city councilors had checked on the status of that proposal, councilors might not have needed to threaten to end ambulance service six months from now. This ultimatum inevitably has worried some city residents, even though the county is legally obligated to find a replacement ambulance service so the issue at stake is not whether we will have ambulances available, but rather who will operate those vital vehicles.

Cannon contends that a long-term solution to the ambulance issue requires a more stable source of revenue. The statistics seem to bear this out, as the city is not collecting enough from ambulance billing to cover its escalating costs. In his report to the city councilors for Tuesday’s meeting, Cannon noted that there is no reason at this point to believe that Congress will boost payments from Medicare and other federal programs enough to solve the problem. That might leave a new local property tax levy as a logical option. Unlike the current situation, in which the only property tax revenue that goes to the city fire department is paid by owners of property within the city limits, a new levy would need to include properties outside the city but inside the ambulance service area that the city fire department covers.

In the meantime, though, the county’s proposed one-year contract appears to be a short-term solution that maintains the city fire department as the ambulance provider.

Financial challenges notwithstanding, that is the best option. Although Baker City will have ambulance service regardless, removing that function from the fire department would force the city to lay off employees in that department, something the city should strive to avoid if possible.

For decades, the city has operated a fire department that responds to all manner of emergencies, from fires to medical issues, with highly trained professionals. That must continue to be a top priority.

— Jayson Jacoby, Baker City Herald editor