Laguna Beach powers through costs of hiring new ambulance team

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A Doctor’s Ambulance responds to a crash near Cress and Coast Highway in 2013. File Photo

By Megan Miller, Special to the Independent

The Laguna Beach City Council unanimously approved city staffers’ recommendations Tuesday to push forward on hiring its own ambulance team despite concerns over staffing models and costs.

Councilmembers have been following the recommendations of Fire Chief Mike Garcia closely in the development of an in-house ambulance program. The city will have three of its own ambulances crewed by July 1 with at least two available around the clock and a third as a backup.

A budget of about $1.8 million will also include salaries and benefits for 12 full-time ambulance operators for fixed three-year terms. One ambulance coordinator position will serve the program’s management and scheduling needs.

Councilmembers approved amendments to the existing budget to allow the hiring process to begin. The council also granted approval to purchase the necessary equipment, such as chest compression systems and gurneys.

Laguna Beach transports about 1,500 patients each year. The city had previously held a 25-year partnership with Doctor’s Ambulance for transport services, but councilmembers decided in December to let the contract expire due to concerns over growing response times.

“This is a major improvement for the safety and welfare of our community, to own and control our ambulance service,” said Tom Gibbs, a resident and member of the Emergency Disaster Preparedness Committee.

However, questions still linger over staffing and revenue specifics.

Back in December, Mayor Pro Tem Bob Whalen had asked whether it would be possible to staff ambulances with firefighter-paramedics instead of ambulance operators, citing concerns about a high turnover rate in the program since the latter position is often a “stepping stone” in many careers.

The change would annually cost an extra $1.3 million, bringing the total to $3.1 million, almost double the approved operating budget.

Emergency Medical Technician (EMT) is the minimum Medical Certification required to become an ambulance operator, which is a common job title in both cities that run ambulance service and private ambulance operators, Garcia said.

Changing such a position could also endanger the July 1 launch date, which is necessary for the city to meet due to the Doctor’s Ambulance contract expiring.

Councilmembers decided to keep the EMT ambulance operator position, with Garcia adding that the issue could be revisited in the program’s first end-of-year review.

Whalen also raised questions about Wittman Enterprises, which will be partnering with the city for billing purposes. The company has been in service for 30 years and represents 12 other public EMS and fire clients in Orange County.

In the case a patient defaults on their ambulance bill, it will be up to the City to handle collections.

“Our plan is not to take anyone into collections and to press hard on them,” Garcia said.

The City Council had approved a base rate of $2,800 for each ambulance ride, to allow the program to function without being partially subsidized by the city’s General Fund. According to Chief Garcia, users of Medicare or Medi-Cal would not be affected, as each program has its own cap on ambulance services.

However, close to 42% of other patients who are commercially insured, uninsured, or under-insured could see a spike in costs, shouldering the bulk of the program’s operating budget.

Councilmember Toni Iseman called the projected revenue too “optimistic” for the reality of what the city might be spending.

Gavin Curran, director of administrative services, assured councilmembers that the expected revenue was adjusted based on past reports and extensive research by city staff. The city is also eligible to receive close to $200,000 in federal funds to also account for deficits.

In addition to approving the seven recommendations from the Fire Department, the City Council requested clarification from Wittman on their collection methodologies, as well as a program readiness report in June.

“We’re gonna evaluate this program during the first year,” Garcia said. “We’re gonna look at our collections. We expect them to be what they’ve been historically, if not better, and we’ll make adjustments and work with finance [department staffers] to make sure that we can meet our revenue and our expenditures.”

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