Paying for ambulance service a conundrum
By Kathryn Reed
A shared resource or a subsidy? Being able to answer that question is what the financial disagreement over ambulance service on the South Shore is coming down to.
The Cal-Tahoe JPA, which has two board members from the South Lake Tahoe City Council and two from the Lake Valley Fire Protection District board, has a little more than one year left in a five-year contract with El Dorado County to run the ambulance service in their jurisdictions. There is then the possibility to renew the contract for five years in one-year increments. The county pays the JPA $2.06 million a year to do so. That money comes from a parcel tax assessed to property owners ($500,000) and fees paid by patients or their insurance companies (the remainder).
The contract deals with response time and says there will be five available ambulances, with access to a sixth.
Who pays for the cost of ambulance service is being debated. Photo/LTN file
The problem is the fire departments believe three ambulances are needed at all times to meet the response times. But the amount paid by the county never covered that level of coverage. The city and Lake Valley at the time agreed to share that expense.
This contract also calls for a flat fee for taking patients to out of area hospitals, which is often a loss for the JPA.
The city is also absorbing dispatch expenses that went from $65,000 to $95,000 to $150,000 per year. The city calls this a subsidy to the JPA and wants reimbursement from the county.
But the contract says otherwise. The county pays a flat fee for X amount of service whether that is medical care or dispatch.
On the flip side, the county only has to pay for ambulance service – not when a fire truck rolls with the medic unit. That is where the shared resource aspect comes into play.
Most of this was brought up at the monthly JPA board meeting on March 11. The four board members spent the bulk of the meeting in closed session to discuss how to respond to a Feb. 12 letter from Don Ashton, director of the county’s Health and Human Services Department. There was no reportable action.
Board attorney Dave Hale claimed the way to go into closed session was to call it potential litigation. The board agreed this was logical and not a violation of the Brown Act.
The departments are going to look at what all the real expenses are to run the ambulance service. This means looking at what it costs to store ambulances at the fire stations, the use of phones and other office related expenses. Those numbers will then be presented to the county.
Per the contract it’s possible to revisit issues. This first was talked about last summer, with the initial formal meeting between the JPA and county in October. JPA Executive Director Ryan Wagoner and Ashton with the county met Wednesday after the JPA meeting.
In the past it was disclosed that not all residences are paying the ambulance fee, but Wagoner said that is not true. He told Lake Tahoe News condos and mobile homes are in a different category, but still contribute to the cause.
El Dorado County was a bit put off by last month’s presentation by South Lake Tahoe Fire Chief Jeff Meston to the City Council regarding ambulance service. Ashton said as much in his to letter Wagoner last month.
Wagoner insists discussions are going the way the contract states that they can, everyone is playing nice and that talks are progressing. But he underlined how the county and the West Slope ambulance agency have been negotiating for 1½ years, so these things take time.
The next JPA meeting is April 13 at 9am at Lake Tahoe Airport.