As a general policy we believe ideas for privatization of governmental services are always worth a good hard look. The city’s sale of Klamath Memorial Park a few years ago effectively privatized that cemetery, got the city out of competition with the private sector and saved tax dollars. However, not all privatization is equally justified.
It has been proposed that privatization of a portion of the local ambulance service be considered. The Community Public Safety Advisory Committee has been presented such an option by the local air ambulance company. It is good that this proposal will spark a committee discussion of the state of ambulance service countywide, but privatization of ambulance service raises some serious questions for the committee and the public to address:
Ambulance service in the Klamath Falls area originally was provided by the private sector. It did not survive and when it went, the fire departments were forced to quickly step in.
At the time the private company finally failed some 30 years ago, service consisted of little more than a driver and a vehicle. Patient during transport the hospital routinely was provided by “loaned” EMT-trained firefighters. Today, EMT-trained firefighters are the first responders, providing advanced life support and transport to the hospital. Will a private company assure such advanced life support staffing levels continue?
Emergency medical service providers countywide work extremely well together and are extremely efficient. Most of rural Klamath County receives its ambulance service coverage through districts staffed by volunteers.
If those district units are already committed or otherwise not available, neighboring districts are called on with Fire District No. 1 acting as the ultimate backstop for the county. If FD1 is no longer available for backup, large areas of rural Klamath County will periodically be without ambulance service. Will a private company assure continued backup support for the rural areas of the county?
If the ambulance service is privatized, FD1 will lose another dozen firefighters and the public will realize no tax savings.
Currently the ambulance almost covers its cost, bringing in $1.5 million in revenue annually to FD1. These dollars are “fees for service” primarily received from insurance carriers, Medicare and Medicaid. They are not local property tax dollars and in most cases are not even locally paid fees.
If the fire district is no longer providing the ambulance service, it will no longer receive the $1.5 million in revenue and that revenue equates to a dozen EMT-trained firefighters.
A private company can probably provide ambulance service more cost effectively. Whether or not those cost savings would result in reduced transport fees and therefore savings, in some form, to local residents is a question for the committee to explore.
The bigger question for the committee to consider is the impact of the potential loss of a dozen paid firefighters. Firefighters are cross-trained as emergency responders for medical, fire, rescue and hazardous material spill incidents.
Even if the ambulance is privatized there will remain an expectation that EMT-trained firefighters will act as first-responders for medical emergencies.
With sufficient staffing, the district has the flexibility to dispatch cross-trained personnel to various types of incidents as needed with call back and mutual aid available as needed. FD1 is already operating about as lean as advisable, having lost nine people over the last five years.
At some point, loss of staffing will seriously impact response times and service levels. This potential adverse service impact on the public will be the most important question for the committee to consider as it looks at privatization.
For the record, we do not think this proposed privatization will pass muster.