By Emily White
The Spokesman-Review
SPOKANE COUNTY, Wash. — Three new, shiny, cherry red ambulances are purchased and awaiting service as Spokane County Fire District 9 finishes preparations to shed its contract with American Medical Response.
Beginning July 1, Fire District 9 will operate its own ambulance service that District 9 Fire Chief Matthew Vinci says will provide services to everyone in the district without charge. The Mead district will be the only fire district in the county to provide its own ambulance services independent from AMR.
“If you’re a resident in District 9, you’ll never see a bill,” Vinci said.
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The push to create its own ambulance service was sparked when AMR, which is responsible for 95% of all medical transport in Spokane County, doubled its rates in August. AMR charges more than $5,200 for basic life support transport for residents in Spokane and Spokane Valley, which have the highest ambulance rates in Washington.
Ambulance services for residents in the district will be paid for by insurance providers, Vinci said, and existing levy funds are also available if needed. District 9 serves the Fairwood, Glenden, Midway, Wandermere, Arrowhead Point and Brentwood communities. If people who don’t live in the district get ambulance services, they’ll pay a separate rate that District 9 will likely set in a month. That rate, Vinci said, will be less than half of what AMR charges for ambulance services in Spokane .
The district will get money for the ambulance services through users’ insurance, including Medicare and Medicaid, and Washington’s Ground Emergency Medical Transportation program, which supplements payments to publicly owned ambulance providers in the state. Vinci anticipates the system will be cost-neutral and estimates it will cost about $2 million each year, but the district will bring in $2 million through insurance and state payments.
Two applications were submitted to the Washington Department of Health , each fighting for the advanced life support trauma-verified transport service in District 9 in Spokane County — District 9’s and ComTrans , which is a subsidiary of AMR from Oregon that does nonemergency transports. Only one verified trauma transporter license was available.
“It was AMR’s attempt at trying to get the license,” Vinci said. “It was pretty surprising to have an out-of-state, nonemergency transport application pop up, but the process worked and we were assigned the license.”
AMR declined to comment on why the corporation sent in a competing application to provide ambulance services in District 9.
After the Department of Health reviewed the applications, it confirmed District 9 as an ALS trauma-verified support service for the county, according to a denial letter sent to ComTrans and obtained by The Spokesman-Review . District 9 got all 200 points possible in the evaluation of its application. ComTrans got 137.5 out of 200 points. Applications need at least 150 points to qualify for verified transport service. The ComTrans application did not have any current EMS providers listed and lacked a staffing model that would be able to provide constant coverage in the district.
Vinci has not contacted AMR about the ComTrans application.
“We let the process play out and we had faith that an out-of-state company that doesn’t do 911 transport would not be providing emergency transport to our citizens,” Vinci said.
The entire process of starting the district’s own ambulance district began eight months ago, Vinci said.
The district has three new ambulances ready to go and is working on getting another ready to add to the fleet, Vinci said. Each ambulance cost around $385,000, Vinci said. The fourth ambulance is a used one but will help the district if calls for service increase.
There were 3,000 ambulance transports in District 9, which is about 125 square miles, last year. 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.
The shift is one the district is ready for, said District 9 Medical Director Joel Edminster.
“It will be easier to have a single organization responsible for the entirety of pre-hospital care and transport,” Edminster said. “Consolidating the care to a single agency makes things a lot more efficient.”
The fire district will hire 15 new employees to support its independent ambulance service. The district currently has 65 uniformed staff.
Other districts in the county could follow in District 9’s footsteps.
Although District 4 , which serves the northern most part of Spokane County , currently contracts ambulances through AMR, it got a transport license in 2023, Fire Chief Mike Nokes said. District 4’s contract with AMR will be up by the end of the year, and the district is in negotiations to figure out if it will continue contracting ambulance services or start its own service.
According to Nokes, the district obtained a transport license to help AMR provide fast service to some areas of the district. The fire department does around 100 transports every year.
“Our decision will be based on what’s best for District 4,” Nokes said.
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