Breckenridge ambulance dispute enters stalemate as fire district digs in
June 8, 2017
Three ambulance units in Breckenridge may be grounded indefinitely as a dispute between an EMS provider and the county government has reached a stalemate.
Last month, the county threatened to revoke the Red, White and Blue Fire Protection District's authority to run ambulances unless the fire service agreed to contribute more to countywide services, namely out-of-county patient transports.
This week, RWB rebuffed that demand, outlining in a letter to the Board of County Commissioners its long-simmering grievances over revenue sharing and service agreements, which the fire district argues are a subsidy for the financially troubled Summit County Ambulance Service.
If the county follows through on its ultimatum, RWB paramedics could provide on-scene emergency care, but patients would have to wait for a county-approved ambulance to arrive before being transported — even if an RWB ambulance arrived first.
For years, the county has sought to bring more collective decision-making to the small patchwork of ambulance providers in Summit. But the current dispute suggests that RWB has chafed at these efforts, preferring instead to exercise its autonomy and prioritize its own district's taxpayers.
"At every corner we've turned, it's been about revenue, and it's always been about how much do we get pulled into the system," fire chief Jim Keating said. "If we're going to go any deeper into this, it's going to have to look completely different."
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In an email, assistant county manager Sarah Vaine said that county staff was still reviewing the details of the letter, but she pushed back against the fire district's narrative.
"At this time, County staff can say that we believe Red, White and Blue's letter mischaracterizes the historical facts and legal issues pertaining to our joint efforts to provide ambulance services," she wrote.
She could not immediately comment on whether or not RWB's transport privileges would be revoked.
Ambulance providers generally dislike out-of-county transports because they leave crews shorthanded for hours. They are, however, the only revenue-generating activity of ambulances because reimbursement rates are higher on the Front Range.
Unlike Copper Mountain Fire, Lake Dillon Fire-Rescue and the county ambulance service, RWB doesn't participate in the countywide rotation for Denver transports, arguing that they are a personnel drain that limits the fire service's ability to respond to local calls.
The county disputes that claim, citing a study by outside consultants indicating that Summit's collective ambulance services already have excess capacity. RWB counters that the study was biased toward the county, which commissioned it in the first place.
According to the letter, RWB has paid between 45 and 92 percent of its patient transport revenues to the county over the years. Forcing the fire district to do more out-of-county transports, or OCTs, is merely a way to bring in more revenue, the letter argues.
"Now that (the county) siphons off the majority of revenue generated by Red, White and Blue transports, its strategy to obtain more subsidy is to require Red, White and Blue to take more OCTs that do not even originate within the District's boundaries," it reads.
The county has argued that it merely wants RWB to contribute its fair share of services. Additionally, it argues that the district's planned deployment of an all-hazards unit — which includes EMS — at a new substation in the Peak 5 area is unnecessary and inefficient.
Red, White and Blue, however, is committed to moving forward with the substation, arguing that it isn't beholden to any other agency on how it spends its own tax revenues.
The county alone has the authority to grant ambulance licenses, but that leverage was not enough to sway RWB; in it's letter, the district makes clear that it will not give ground on out-of-county transports or the Peak 5 substation.
Instead, the district has offered an olive branch of sorts: if the county revokes its ambulance authority, RWB says it would be willing to retire one of its medic units and lease space to SCAS, which would take over as the primary responder within the district.
In exchange, RWB would expect an ambulance license for its Peak 5 crew, which would serve as backup for the SCAS unit.
"That would be better than taking a total axe to our units and not allowing us to do any patient transport," Keating said.
In her email, Vaine said that county staff hadn't fully reviewed the proposal or discussed it with other partner agencies. The matter has been placed on the Board of County Commissioners work session agenda for Tuesday, June 13.
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