The Laguna Beach Fire Department will launch its own ambulance team, ending a 25-year partnership with Doctor’s Ambulance Service on July 1.
The Laguna Beach City Council unanimously approved the recommendation by Laguna Beach Fire Chief Mike Garcia to let its service agreement with Doctor’s expire next year, citing long-standing concerns about growing response times.
In its place, the city will buy three ambulances and hire 12 ambulance operators for up to three years, six part-time operators, and an administrative ambulance coordinator.
“Overall, I’m glad that council look at the analysis and supported our recommendation. I think it’s going to be a great thing for the community,” Garcia said late Tuesday.
Some Laguna Beach residents could see the base rate for an ambulance ride spike from $965 to $2,800 to significantly reduce or eliminate a subsidy from the General Fund. The rate increase will not affect costs for Medicare of Medical users, Garcia said. Laguna Beach Seniors board member Chris Quilter asked councilmembers to reconsider asking uninsured or under-insured individuals to shoulder a 190% fee increase.
“America’s way of paying for healthcare is already heartless. Twenty-five percent of the citizens of the richest country in the world have medical debt. This is not a problem we can solve locally but as one of the most fortunate communities in America we should be ashamed to add to it,” Quilter said.
Garcia emphasized caring for patients will always take priority over someone’s ability to pay.
“Anyone who needs an ambulance gets an ambulance. That’s not a concern and never will be a concern,” Garcia said.
The in-house ambulance service will annually cost at least $1.8 million, according to a city staff report. Federal funding to transport indigent patients would help cover the program’s costs.
Mayor Pro Tem Bob Whalen asked city staffers to return with a cost-benefit analysis for staffing ambulances with firefighter paramedics rather than ambulance operators, who tend to use the position as a stepping stone in their careers.
City Manager Shohreh Dupuis said a preliminary estimate for crewing city ambulances with paramedic firefighters would be about double the cost of ambulance operators.
“I’m absolutely convinced the level of service is going to go through the roof with this new program,” Whalen said. “As I get older and older and I think I’m going to have to pick up the phone one night, I want [the Fire Department] there, so I think this is going to be a huge improvement for or city.”
Under the city’s current contract, a second ambulance must respond from outside the city. Since July, the Fire Department reported 40 cases where patients waited more than 25 minutes for an ambulance.
“If you have a critical patient that’s a death sentence. Paramedics can do miracles but these people need an ER,” said Bill Niccum, a Laguna Beach resident and retired Los Angeles County assistant fire chief who oversaw emergency medical services.
Laguna Beach can hold in-house ambulance operators to a higher standard as they share personal space with crews within the city’s fire stations, said Niccum, who is also a member of the Emergency and Disaster Preparedness Committee. Increasing the base rate to $2,800 will also allow a relatively low-volume city like Laguna to maintain the high-quality service residents expect, he said.
“From a boots-on-the-ground perspective, I’m here to share that time is brain, time is heart, and time is muscle. As paramedics, we don’t have the luxury to wait on scene for an ambulance to arrive when someone is having a medical emergency but, unfortunately, this is becoming all too common,” said Pat Cary, president of Laguna Beach Firefighters Local 3684
The Laguna Beach Police and Fire Management Association also supports the switch to an in-house ambulance program, Battalion Chief Crissy Teichmann said.
Doctor’s informed Laguna Beach earlier this year that it planned to exit Orange County. City officials issued two requests for proposals from private ambulance companies.
A proposal from Falck Mobile Health Corp., which operates an ambulance servicing Emerald Bay, was withdrawn after saying it would need a $744,000 city subsidy in addition to patient billing to dispatch two ambulances.
Doctor’s submitted a proposal that it could staff two ambulances by billing patients for a $2,000 base cost and a $707,000 city subsidy.
Laguna Beach annually transports 1,500 patients by ambulance. By comparison, Newport Beach annually sees 6,000 transports and San Clemente sees 2,500 transports. The cost per user is kept low by spreading the cost over thousands of patients.
Laguna Beach resident Michele Monda said she’s concerned about raising fees for residents when many are already facing higher home insurance costs due to the threat of wildfires.
“I think the response time trumps everything,” Monda said. “When people hear it could be 25 minutes, that’s a non-starter.”
