By Emily White
The Spokesman-Review
SPOKANE COUNTY, Wash. — As the cost for an ambulance ride soars, Spokane County Fire District 9 plans to shed its contract with American Medical Response and start its own ambulance service that won’t result in an expensive transport bill for residents.
If the move is approved by the Washington Department of Health , the fire district serving 50,000 people living in Mead and other areas directly north of Spokane and Spokane Valley will be be the only fire district in Spokane County to operate its own full-time ambulance transport operation, Chief Matthew Vinci said.
The push for its own ambulance service came about after current provider AMR doubled its rates beginning last month. The cost rose to almost $4,700 for basic life support and transport, Vinci said. That doesn’t include charges for supplies, IV therapies, medication or mileage rates that are applied to ambulance bills.
District 9 plans to have a fully independent ambulance service by July 1 if it can get approval, including a special license from the state Department of Health.
The service will be funded by existing levies and payments by insurance companies, Vinci said. The fire district will hire 15 new employees to support its independent ambulance service. The district currently has 65 uniformed staff.
AMR Operations Manager Jack Busch said the increased ambulance fees reflect the nationwide trend of rising costs in emergency medical services and health care — including costs to have personnel, equipment, supplies and maintenance for 60 ambulances in Spokane County. AMR is responsible for 95% of all medical transport in the county.
Busch disputed that residents within District 9 experience big savings. Taxes will likely increase, he said, if Vinci’s plan is approved.
But Vinci says the district doesn’t need a new levy to be able to fund an ambulance service. He said the money collected from insurance providers will cover the cost.
“There’s no bill, no cost, no balance billing, no co-pay associated with an ambulance ride in our district,” Vinci said of the plan.
There were 3,000 ambulance transports in District 9 last year. That compares with 2,500 ambulance transports every month in the city of Spokane, said Spokane Fire Chief Julie O’Berg said.
Spokane’s rates for ambulance rides are similar to District 9’s, she said. In June, Spokane’s published rate was $4,790.
AMR’s rates for ambulance rides have increased because it costs a significant amount of money to have care and lifesaving services available in minutes, O’Berg said, adding that the recent adjustment in AMR rates mirrors national inflation trends.
“The bigger problem is the health insurance and the health care system as a whole. We’ve lost context on what it costs to care for the sick and injured,” she said.
O’Berg expressed support for District 9’s endeavor and said every fire district has the authority to provide its residents with emergency medical services.
She noted, however, that fire districts operate on a tax-based system, in which all residents within a district contribute to emergency medical services regardless of their individual usage.
The city of Spokane operates on a service-based system, where people who use emergency medical services are billed for the care they receive. AMR advocates for such service-based models, Busch said.
According to Busch, most patients transported by AMR won’t be affected by its price increase.
About 81% of the Spokane market are people dependent on Medicare and Medicaid, which means they pay little to nothing since federal and state programs set reimbursement levels well below AMR’s published rate, O’Berg said. Even uninsured or privately insured patients can be shielded from unexpected charges, either through AMR’s compassionate care program or Washington’s balance billing protections, O’Berg said. Providers typically cover less than 15% of most transport fees, O’Berg said.
It’s unclear how many residents in District 9 are covered by Medicare or Medicaid, but Vinci says it’s less than in Spokane.
District 9 covers about 125 square miles. Its population has increased by 16,000 in the past 25 years, resulting in greater service demands and longer transportation times for ambulances, Vinci said.
“We saw a 96% increase in ambulance transport fees to our residents overnight,” Vinci said. “This is all driven by the people we serve ... the services we provide to our community need to be at the highest level and need to be accessible and affordable.”
Another driving factor for the change was the staff District 9 currently has, that Vinci said can provide more continuous care to patients. And, they usually arrive first.
From 2022 to 2024, Spokane County Fire District 9 was the first to arrive at ambulance transport incidents 78% of the time, while AMR was first on the scene 22% of the time, according to the district.
“We have really highly skilled veteran firefighter EMTs and firefighter paramedics that have been serving the community,” Vinci said. “Our medics and our EMTs were going out to calls and then transferring care over to AMR.”
© 2025 The Spokesman-Review (Spokane, Wash.).
Visit www.spokesman.com.
Distributed by Tribune Content Agency, LLC.
