Private ambulances operating in Olympia still not meeting medical standard services, says fire chief

"Private ambulance services in the city did not meet the generally accepted medical standards and reasonable levels of service," Olympia Fire Chief Todd Carson reiterated at the city council meeting on Tuesday, September 13.

On June 27, through a city council resolution, city manager Jay Burney issued a 60-day notice to private ambulance companies to improve their services.

The action was in response to Olympia Assistant Fire Chief Michael Buchanan's report of decreasing availability of private ambulances in the city.

Fewer ambulances, more calls

Carson said the impact on OFD is increasing on-scene times, which leads to inefficiencies within their response system.

"Due to the decreased availability of private ambulance, we are less available to handle concurrent or multiple calls within the same response area. The result is increased response times, and it creates a negative impact on our service levels. This problem is then compounded by increased call volume," Carson said, adding the current call volume is now almost 16,000.

In a presentation on Tuesday, Carson said they had seen improvement in ambulance availability – a 25% increase in July and a 21% increase in August, but 80% of response time is still at 10 minutes.

He said the OFD staff would continue the work plan to establish a city-operated Basic Life Support Transport program.

FCS study

Olympia has commissioned FCS Group to do two feasibility analyses on establishing a city-owned BLS (Basic Life Support) program and creating a CARES (Community Assistance, Referrals and Education Services) program.

The FCS study stated that creating a city-owned BLS and operated CARES program can augment Olympia's emergency response services.

Other community benefits include:

• Improved services to the community
• Fully address the present level of ambulance transport demands (two-unit BLS)
• In the long term, overall positive financial operations are forecasted (having a two-unit BLS is likely to achieve a positive financial performance)

The CARES program is a community paramedic model of delivering health care services to low-acuity patients.

The CARES services and community benefits include:

• referral to primary and preventive care
• provide wellness interventions within the medical home model
• decrease emergency department utilization
• healthcare cost savings
• improve patient outcomes using emergency medical service providers in an expanded role

Martin Chaw, senior project manager at FCS Group, said it is feasible for Olympia to operate the CARES program. He said the program's operational benefit would avoid or delay the cost of additional emergency response units.

Chaw cited other areas that have the CARES program, such as Texas, which avoided the cost of adding another ambulance. He said San Diego, California, reported EMS encounters declined by 38%, EMS charges declined by 32% and inpatient admissions declined by 9%.

BLS

According to Chaw, Olympia could operate the BLS program to address the deficiencies of the BLS service level.

He said the benefits of creating such a program would provide greater control over services and costs and improve service reliability and timeliness in responding to emergencies.

The FCS presented Olympia's 10-year forecast financial performance, having one BLS unit with the CARES program and two BLS units with the CARES program.

Chaw said the one-unit BLS program has limited ability to respond to calls for service and its operating margin is very small because of a limited number of ambulances.

He added that Olympia could start with one unit, but it should add a second one soon.

The FCS project manager said it could respond to current BLS calls for service for BLS two-unit configuration.

"The likelihood of positive operations is greater due to the larger number of BLS responses under a two-unit configuration," Chaw said. 

After the presentation, the council members agreed to delay action on the proposal of creating BLS and the CARES programs at a later date.