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Ore. FD changes ambulance staffing due to financial struggles

The Lebanon Fire District announced changes to single and dual-role staffing as well as reducing non-emergency transports

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A Lebanon Fire District ambulance.

Lebanon Fire District/Facebook

By Alex Powers
Albany Democrat-Herald

LEBANON, Ore. — Lebanon’s de facto fire department has ended most of its scheduled nonemergency medical services, cutting back ambulance rides between hospitals while tax district officials struggle to find more paramedics and funding.

The Lebanon Fire District announced last week that it had ceased fully staffing the ambulances and crews who transport patients in calls other than those placed through 911, cutting back hours that had been filled with mandatory overtime.

“If you had six more people who could help on that overtime? Maybe. But we don’t have that,” district Operations Chief John Tacy said on Monday, Aug. 26.

Lebanon Fire won’t disrupt ambulance services responding to emergency calls, district officials said in a news release emailed Thursday, Aug. 22.

How the reduction works

The district has staffed one ambulance from noon to 10 p.m. four days a week since Aug. 15, according to the release — a four-fold reduction in crews dedicated solely to medical calls since the 2020 coronavirus pandemic.

Crews on the ambulance primarily move patients from Samaritan Lebanon Community Hospital to other medical centers.

The hospital “is aware” of district cuts, according to spokesperson Leslie Fager in a statement emailed Friday, Aug. 23.

“We understand the challenges the Fire (District) is currently facing and are actively working together to explore alternative solutions and options for nonemergency transportation,” Fager said in the statement.

Tacy said the district usually transports 75 to 105 patients each year to hospitals outside the area in non-emergency calls. Those patients will have to wait or find other arrangements on days when Lebanon Fire isn’t covering the local hospital.

“We’re going to continue doing that. We’re just doing some restructuring,” he said.

The district has been unable to fill listings for paramedics since early 2023, with some jobs open for more than a year. And more people are leaving the emergency medical field in Oregon than are entering, Tacy said.

“And that hasn’t changed over the last couple of years,” he said.

Lebanon Fire previously staffed two people to each of two ambulances every day to respond to those calls, with emergency medical workers, including paramedics, fulfilling the equivalent of eight 40-hour shifts each week. That was on top of firefighters scheduled to respond to emergency calls on either ambulances or firetrucks.

At its previous height of employment the district could field up to four ambulances, depending on whether the crews assigned to emergency calls were responding to fires or medical emergencies.

The district still operates two emergency-focused ambulances twice each day staffed with dual-role firefighter-medics.

The district stopped making overnight nonemergency hospital transfers in October, according to the release, ending medical-only shifts between 10 p.m. and 7 a.m.

Why the changes

Emergency medical workers will staff the remaining nonpriority ambulance in two-day blocks, leaving Lebanon, a city of a few more than 20,000 people, without transfers on local ambulances every couple of days.

The district blames declining enrollment in paramedic programs among other hardships for the shortfall of medical workers. Tacy said private ambulance companies now offer similar compensation as small governments like Lebanon Fire.

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And large governments, like fire departments in the Portland metropolitan area, can offer more pay and more comprehensive health or retirement plans.

“Larger departments steal from smaller departments,” Tacy said.

Lebanon firefighters still transfer patients from the local hospital on an emergency basis, but the district retains just one ambulance for 911 calls when crews drive the other out of the area to bigger or more specialized hospitals including Oregon Health & Science University in Portland.

The Fire District cuts come after voters in May rejected a bid for nearly $11 million in additional tax funding over five years, leaving the district without a new stream of income.

The district anticipated a revenue gap of nearly $1.5 million by 2026, with the costs of paying firefighters and for supplies outpacing the $6.5 million or so collected each year in property taxes — the district’s primary revenue source.

In the news release, district officials said Lebanon Fire sees payment enough to cover about one-third medical services billed. Claims to the federal insurance program Medicare make up about 47% of medical revenue in the district, according to the release.

“This funding model is unsustainable — a challenge faced by ambulance service providers not only in Oregon but across the nation,” district officials said in the release.

A local right-wing political organizer challenged the district’s attempt to pass a local option levy by spreading disinformation in the runup to Oregon’s May primary election. Messaging confused the proposed tax funding for district operations with $16.1 million of bonds levied in 2019 for construction of the district’s new central fire station.

Taxes raised by bonds can only be used for construction, while levies fund ongoing expenses, such as salaries.

Constituents voted no, 69% to 31% in favor, to shoot down Measure 22-202.

Tacy said he’s not sure whether the district could hire someone even with the funding that was meant to add six firefighters and spread out medical duties.

“We have positions we’re budgeted for, and we just can’t hire them because they’re not there,” Tacy said.

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