By Vallery Brown
The Oklahoman
LEFLORE COUNTY, Okla. — Rural ambulance service in Oklahoma is in crisis, according to officials, and it could take a more organized community response to stop the bleeding.
“The model we set up is collapsing,” said Shawn Rogers, the state Department of Health’s emergency services director.
Three ambulance services have closed this year and about 50 have closed since 2000, Rogers said. All relinquished their licenses because of financial hardship.
Shrinking tax bases, low Medicare and insurance reimbursements, and a state law requiring the closest ambulance to respond to an emergency are some of the culprits crippling the business in lower population areas, officials say.
Counties and municipalities in Oklahoma are not bound by state law to provide emergency medical response to their citizens. Oklahoma law requires that the nearest ambulance respond to a call if a neighboring area does not have one to dispatch.
Bob Hawley, EMS director for LeFlore County, said his ambulance service often responds to calls outside his county in communities that have no emergency medical service. Recouping the money lost is difficult if not impossible, he said.
“Nothing is going to change in rural Oklahoma as long as communities can hide behind this rule,” Hawley said.
Hawley also noted that Medicare reimburses about 27 percent below what it costs him to make a run. He must make $624 per ambulance call to break even.
Money is coming too late for some
Oklahoma EMS Coalition Chairman Ron Feller said many take ambulance service for granted and some don’t know whether their area has service.
“Do you really want to carry around a map so you know where you have ambulance service?” he asked.
Last year the state Legislature approved a bill to create a revolving yearly fund with up to $2.5 million per year for emergency medical services development. The money could help some rural ambulance providers restructure their services and train professionals. However, it won’t necessarily help the ones on the brink of collapse, Rogers said.
By the numbers
Ambulance service
$500,000: Average annual cost for personnel, fuel and operations of one ambulance.
$90,000: Cost of an ambulance.
$55,000: Cost of medical equipment on an ambulance.
160: Ground ambulance services in Oklahoma.
Source: Shawn Rogers, EMS division director; Bob Hawley, EMS director Le Flore County