Published: May 08, 2006 11:59 pm         

Financial issues facing ambulance services threat to rural areas, public

Staff and wire reports



Financial problems facing some emergency ambulance services are so severe it may get to the point where rural 911 callers are given basic care instructions and told to take the patient to the closest hospital.

“This is a very real threat in the most rural parts of the state, where transport times are already very long and resources stretched very thin,” said R. Shawn Rogers, emergency medical services director for the state Health Department.

In the Enid area, where several rural ambulance services have shut down, response time to Garber, an area now being covered by Life EMS in Enid, is between 18 to 20 minutes.

“It’s quite a long time,” said Life EMS office Manager Debbie Smith. “We’re stretched pretty thin.”

Enid Life EMS covers an area as far east as Garber, as far west as Lahoma and as far north as Pond Creek, Smith said. Life EMS also has taken control of ambulance services in Hennessey.

A state task force report indicates lives already are being jeopardized because lack of funds, and manpower shortages have slowed response times. Initial findings of the report were released to the state Board of Health. A final report is due Oct. 1.

Ten ambulance services — in sizable towns such as Wynnewood and Vinita and the smaller hamlets of Kemp and Quapaw — recently have closed. Other towns that have lost ambulance services are Picher, Com-merce, Barnsdall, Kremlin, Garber and Wakita. Others are in jeopardy.

Oklahoma has 160 ambulance services.

“We definitely have a crisis on our hands in emergency medicine,” said Jimmy Johnson, president of Life EMS, a private ambulance service. Johnson is a task force member.

Some Oklahoma ambulance services are hospital-based, while others are taxpayer-subsidized or are private, for-profit businesses.

Medicare cuts for emergency care, uninsured patients, a rapidly aging population and funding shortfalls are among the reasons for the problems.

Uninsured or under-insured patients account for more than 30 percent of ambulance runs in Oklahoma City and Tulsa, said Rogers, who is overseeing progress by the governor’s task force.

The past fiscal year, according to state records, Medicare was billed $94 million for ambulance runs to assist Oklahoma senior citizens on Medicare. But ambulance companies only received $52 million from the federal government for those Medicare patients.

Rogers said most 911 calls in Oklahoma are for ambulance assistance, but few communities support emergency medical services to the same extent they support other public safety agencies such as police and fire departments.

A shortage of paramedics and emergency medical technicians also contributes to the problem, Rogers said. Those ambulance personnel make about $22,000 a year.

Rural Oklahoma is in a particularly precarious position, the task force reported.

“EMTs and paramedics know that Oklahomans are stoic folks, by and large. When they finally call for an ambulance, they are usually at death’s door, and every second counts,” Rogers said.

“The dispatch phone rings, and the clock starts. For the citizens of Wakita in Grant County and Garber in Garfield County, the clock runs a lot longer since the loss of their ambulance services,” Rogers said.

“A person having a heart attack in either city used to be able to count on an ambulance arriving almost immediately — within five minutes in Wakita and six minutes in Garber,” he said.

Now the Medford ambulance takes about 15 minutes to get a crew and drive the 16 miles to Wakita, and Life EMS from Enid takes about 20 minutes to make the 19-mile drive to Garber, Rogers said.

“Lost minutes mean lost lives,” he said.

Garfield County Undersheriff Jerry Niles said response times to accidents in rural portions of the county are lacking one crucial thing — “time.”

“That’s the crucial thing,” Niles said, “and that’s what we’re lacking.”

Niles said a service in Marshall covers the southeast portion of the county, and Life EMS has arrangements in Helena. For service to areas on the eastern side of the county, the ambulance has to come from Enid.

Most emergency medical care comes from rural fire departments for areas that have lost ambulance service, he said.

But Niles pointed out, most are volunteers and getting from their places of business to the department, then to the scene, takes time.

“So it’s still just a time constraint,” Niles said.



Staff writer Cass Rains and The Associated Press contributed to this story.