Prosser-Area Ambulance Service on Life Support

By Craig Troianello

d# “Interactive Map: Find ambulance stations near you:”:http:// www.yakimaherald.com/page/maps

The problem: Prosser Memorial Hospital is losing money providing ambulance service to a wide area of the Lower Valley

The proposed solution: Forming a taxing district to collect 25 cents per $1,000 of assessed value — or about $25 per year for a $100,000 home

How it would happen: Yakima and Benton County commissioners would have to agree to form the districts and at least 60 percent of the voters there would have to approve the tax

By ROSS COURTNEY

YAKIMA HERALD-REPUBLIC

GRANDVIEW — The radio dispatcher’s voice interrupts a boring afternoon of paperwork. A woman in the 500 block of Wine Country Road is suffering complications from a leg surgery.

The three-person crew quickly checks the map before pulling out of Prosser Memorial Hospital’s ambulance station.

Jeff Fitzgarrald, a paramedic, drives. Sheryl Wright, an emergency medical technician, sits shotgun, silently reviewing what few details are known, planning for the worst.

“Get mentally prepared,” she calls it.

Justen Berg, a paramedic student, rides in the back.

Six minutes later, they arrive at the Gran Villa Mobile Court and calmly but purposefully stride into the home.

After a few minutes with the woman, they whisk her off to Prosser Memorial.

Quick and efficient.

But it might take longer in the future.

Without financial help, Prosser Memorial officials say they’ll have no choice but to cut back ambulance services, resulting in longer response times.

In Grandview, the average wait will double to 16 minutes. In Prosser, it would rise from seven to 13 minutes.

But that’s life in much of rural America. Small-town ambulance carriers don’t make enough calls to make a profit.

“The only way you can do it … is to go out to the taxpayers,” said Jim Tavary, Prosser Memorial CEO.

That’s what he’s asking.

Here and elsewhere, private ambulance carriers have largely given up on small towns.

In the first half of the last century, undertakers in the rural West often doubled as ambulance drivers. Prosser was no exception.

In 1966, a volunteer firefighter named Rusty Holmes opened American Ambulance in Prosser, replacing a funeral home business. But within a decade he foresaw struggles.

“A lot of rural areas will probably be looking to tax-based districts to provide ambulance service — perhaps through fire departments or through contractual agreements for operating,” he told the Herald-Republic in 1975. He still lives in the area but did not return messages left with family members.

Prosser Memorial bought the fleet in 1999 just to keep it from closing, Tavary says.

Entrepreneurs have tried private services in the Sunnyside area with little luck, as well.

To the north, Yakima is served by two private businesses.

American Medical Response is a national chain with four full- time trucks in Yakima. Locally owned Advanced Life Systems has 10 ambulances, five that run full-time. They serve Yakima and the entire Upper Valley.

Much of the problem in rural areas is blamed on Medicare policies, whose reimbursement rates for ambulance service are considered too low.

But even in the more populated Yakima area, Advanced feels the Medicare pinch, too, said owner Woody Woodcock.

The difference is the volume of calls. Advanced gets 400 to 600 calls per month inside the city Yakima alone. That brings in enough revenue to break about even with Medicare losses, he said.

“We’re not getting fat by any stretch, but we’re able to survive,” Woodcock says.

He’s certainly not interested in starting a private service in Grandview and Prosser. “We’ve got our plate pretty full here.”

Medicare, the federal insurance program for those over 65, decides what ambulances should charge based on zip codes, then pays 80 percent of that. Ambulance services can bill the patient for the other 20 percent.

But Medicare reimbursement rates are usually less than the cost of operating the ambulance, especially in rural areas with fewer calls.

For years, Prosser was spared Medicare’s lower rates through a special exemption for rural areas, but that exemption has been curtailed by the federal government.

Because of the Medicare shortfall, Prosser Memorial Hospital estimates it’s losing $425,000 annually running its four-ambulance fleet in Grandview, Mabton and Prosser and the surrounding portions of Benton and Yakima counties.

For a short-term fix, the public hospital persuaded Prosser and Grandview to sign one-year contracts. Mabton and the two counties are still deciding.

For the long term, the hospital wants to create a special levy district to collect funding through property taxes.

Yakima County Commissioner Rand Elliott says he supports the contract and the levy district. But Benton County commissioners aren’t so hot. They would rather hand the ambulances over to Prosser Fire District 3. Other Benton County fire districts already operate ambulance services.

Prosser Fire Chief Doug Merritt estimates it would cost $558,000 a year plus up to $220,000 in start-up costs. To pay for it, the fire district might seek its own emergency medical levy.

Ambulance carriers across the country are trying to persuade Congress to make a change, but until then they’re stuck with Medicare rates, said Michael Marchand, a Seattle Medicare spokesman.

“It’s not an opinion or anything like that, it’s just math,” he says.

Ross Courtney can be reached at 930-8798 or rcourtney@yakimaherald.com.

(c) 2008 Yakima Herald-Republic. Provided by ProQuest Information and Learning. All rights Reserved.