Laguna Beach may part ways with its contract ambulance service after 25 years and dispatch its own fleet of ambulances, following concerns from senior fire officials about long response times.
The Laguna Beach City Council will decide Tuesday whether to follow a recommendation by Laguna Beach Fire Chief Mike Garcia to let its service agreement with Doctor’s Ambulance Service expire in July 2022. In its place, the city would buy three ambulances and hire 12 ambulance operators for up to three years, six part-time operators, and an administrative ambulance coordinator.
Regardless of what service city leaders move forward with, 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.
“If approved, the rate increase would not affect costs for individuals who use Medicare of Medical,” Garcia wrote in a staff report. “Rather the rate increase would apply to commercial insurance, private pay, and non-insured individuals.”
The in-house ambulance service would annually cost about $1.8 million, according to a city staff report. Federal funding to transport indigent patients would help cover the program’s costs.
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.
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 Emerald Bay ambulance, but withdrew 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.
“The City’s transport volume and base rate are low compared to other agencies in the County,” Garcia said in a report.
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.”
