Emergency Medical Services (EMS)
The Emergency Medical Services Division is responsible for providing emergency medical care to the citizens. The division provides both advanced life support (ALS) and basic medical life support (BLS) services. Emergency Medical Technicians (EMTs) and Paramedics provide immediate medical assessment, evaluation, and treatment. They transport patients to Kittitas Valley Hospital or out-of-area facilities for continued treatment, as needed. The district must provide highly trained, skilled personnel and adequate vehicles and equipment to accomplish the division’s mission. Emergency medical vehicles and equipment must be maintained and upgraded to meet the ever-changing technologies of medical science. Vehicles must not only be equipped for the safety of the district’s patients and personnel, but must also be equipped with a wide array of medical equipment such as defibrillators, cardiac monitors, oxygen, and many other instruments needed for the successful treatment of the critically ill and traumatized patient. EMS transport billing and patient account service are provided in-house by the EMS Billing Coordinator position.
Ambulance Transport Fees
Because the cost of providing EMS services is partially subsidized by property taxes, residents of the district are charged a lesser rate than non-residents. To be considered a resident of the district, the patient’s primary residence must be within Kittitas County Fire District No. 2 boundaries.
In October 2015, KVFR entered into an inter-local agreement with Kittitas County Hospital District No. 2. Both Hospital District No. 1 and District No. 2 share responsibility for inter-facility transports originating from Kittitas Valley Healthcare. Patients from both taxing districts contribute tax revenue to each system; therefore, both districts have agreed to extend resident rates to each other’s residents when the ambulance transport services are provided.
The ambulance transport fees were previously established by Resolution 13-34 which was adopted on December 12, 2013. Those rates have been in effect for all of 2014 and 2015.
In November 2015, staff prepared a study of ambulance fees and the costs allocated to the EMS division. It was determined that the ambulance transport fees would need to be raised by 5.9% in order to cover the budgeted cost of providing EMS services in 2016. Details of this cost study are outlined in the "2016 Ambulance Fee Study and Cost Allocation Analysis" document which may be obtained by contacting the administrative office at 509-933-7232.
KVFR has traditionally had a policy of charging only for patient transports and has not previously realized income for responding to calls that do not result in the transport of a patient. The only noted exception to this was that KVFR, and previously the Ellensburg Fire Department, did charge for patient care services - such as starting IV’s - in skilled nursing facilities. Such charges were imposed due to the fact that the facilities are staffed to provide that level of care, but choose not to do so.
In recent years, service demand has periodically exceeded the capacity to deliver emergent services. Requests from assisted living facility staff for “lift-assists” of non-injured patients represent a significant burden on emergency medical service providers that could be managed in a less impactful manner. Calls for this type of service account for upwards of 250 calls per year for patients who report they are uninjured and simply need assistance returning to a wheelchair, a walker, a bed, or to a standing position. Legal advice obtained by the district indicates that the charge for such non-transport calls must be comparable to the fee charged for transport service calls.
Staff is recommending consideration of a fee to these facilities that would assist in mitigating the impact, either through cost-recovery or discouraging KVFR’s response for services that are clearly not medically necessary. Analysis indicates that the fee for a responding to a BLS – Resident – Non-Emergent call should be $660. Staff recommends that such a fee be imposed on assisted living facilities for responses to requests made by the facility staff to “lift-assist” non-injured patients who do not require transport. Staff is not recommending consideration of extending this fee to private residences where skilled staff may not be present to help the fallen individual.
Event EMS Standby Fees
Different organizations hold events during which they are either required to or prefer to have emergency medical staff on-site during the event. KVFR has fulfilled such requests on movie sets and at sporting events such as football games, rodeos, triathlons, and roller derbies.
Fees are charged depending on the personnel and apparatus requested. A minimum of one hour will be charged. Additional hours are charged with the time calculated to the next highest 15 minute increment.
Every effort is made to fulfill BLS requests with non-career staff, but when those resources are not available, the district must cover the cost of having to send career staff members to the event by charging the hourly cost of salaries and benefits for the entire increment of time the career staff is paid for.
The cost of standby services at Central Washington University (CWU) football games is included in the fire protection contract in place with CWU. However, other events at CWU which require EMS standby services may be charged for after review by KVFR staff and the Board of Fire Commissioners.
Fees for special community events where a large percentage of those gathered are citizens of the District are usually and customarily waived at the discretion of the Board of Fire Commissioners. High school sporting events and the Kittitas County Fair are examples of events held by not-for-profit organizations where there are large gatherings of the community. The district feels it is prudent to have emergency response personnel present in the interest of community safety.
*Loaded Rate refers to the hourly cost of salaries and benefits for each of the personnel present for the entire time they are on the clock to fulfill the event request.
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