EDITORIAL: A future for city’s ambulances

Published 2:00 pm Monday, April 11, 2022

There was some welcome optimism last week in the issue about ambulance service in Baker City and more than half of the rest of Baker County.

The Baker County Commissioners, who by Oregon law are responsible for choosing the ambulance provider, offered to contribute $150,000 from county coffers to the Baker City Fire Department, the current ambulance operator, for the fiscal year that starts July 1, 2022. That’s $50,000 more than the county budgeted for the current fiscal year.

Baker City Mayor Kerry McQuisten and Councilors Dean Guyer and Johnny Waggoner Sr. expressed hope that city and county officials can forge an agreement that both maintains the city as the ambulance provider for at least the coming fiscal year, and at least begins to address the financial problems the city has incurred as a result of operating ambulances.

That’s what should happen.

And based on the city’s budget, it can happen.

Yet City Manager Jonathan Cannon seems resigned to ending ambulance service. In his April 8 weekly newsletter, Cannon wrote that he and Fire Chief Sean Lee have met with county officials to discuss the “transition of the ambulance service.”

Although the county would have to find a different provider were the city to cease ambulance service Sept. 30, 2022, the date listed in a notice the City Council voted to send to the county on March 22, both city councilors and county commissioners have said they prefer to have the city fire department continue the role it has had for several decades.

That’s vital not only with regard to ambulance service.

Were the city to stop operating ambulances, the loss of revenue — projected at about $1 million for the current fiscal year — would force the city to slash its firefighting staff. That’s not acceptable.

A million bucks is a significant sum, to be sure. But that represents only about half the amount the city actually bills for ambulance runs. And the percentage of billing the city has collected has risen from 32.7% in calendar year 2019, according to the city.

The problem is that most of those ambulance bills go to people who are covered by Medicare or Medicaid. And those federal programs pay only about 20% of what the city bills.

This is not a new issue. Nor is it one that city and county officials have missed. They have talked about the financial challenges of operating ambulances for several years. It is true that neither the city nor the county has made fundamental changes needed to deal with the situation in the long run. In the absence of a major revision in how the federal government reimburses ambulance providers — something that doesn’t appear to be pending — the money will have to come from local sources. A levy that boosts property taxes throughout the ambulance service area — both inside Baker City and outside — seems to be the most plausible, if not politically palatable, option. Ultimately the county will need to put that question to voters.

In the meantime, though, there is the Sept. 30 ultimatum that the City Council has tossed down. The question, then, is whether the city, with the $150,000 from the county, can continue to operate ambulances — and avoid severe cuts to its fire department staff — for fiscal year starting July 1.

Based on the city’s budget for the past few years, including the current fiscal year, the answer seems to be that it is indeed possible.

If the ambulance billing crisis had become so severe that gutting the fire department is necessary, then it’s reasonable to wonder whether the city has been plundering other parts of the general fund to try in vain to stanch the financial bleeding in the fire department. But that’s not the case. Indeed, the most expensive department in the general fund — police — has had its budget grow by about 26% over the past three fiscal years.

That’s not to suggest that the city can continue to operate ambulances with a comparatively paltry contribution from the county and the residents outside the city who benefit from the service. But there’s nothing in the city’s recent budget history to suggest that maintaining the status quo for another fiscal year — a status quo that, to reiterate, has not wreaked havoc on the general fund — would suddenly eviscerate that fund.

The greater risk is to cease ambulance service Sept. 30 with the resulting layoffs in the fire department. Running ambulances is expensive, and because of the meager federal reimbursements, that service can never break even. But subsidizing the city’s ambulance service also makes possible a bigger and more capable fire department. We’ve been fortunate to have both of these services for decades. We can surely have them for at least another year while city and county officials investigate possible long-term solutions.

— Jayson Jacoby, Baker City Herald editor