CARE Ambulance details staffing crisis

FAIRFIELD — The Jefferson County Ambulance Service Agency called an emergency meeting Thursday to discuss a contract breach with CARE Ambulance, which can no longer supply two full-time ambulances as required by the contract.

Four representatives of CARE Ambulance were on hand at Fairfield City Hall to explain its staffing crisis, which is related to its financial crisis, and why it has asked the service agency for an additional $90,000 per month. CARE’s director of operations, Chris Bodenstadt, said that a lack of paramedics is forcing the company to scale back its ambulance service in the county from two full-time ambulances to one full-time ambulance, and a second that is on call between 8 a.m. and 8 p.m.

Bodenstadt said he reviewed when call volume is highest and found that 70 percent of calls for service come between 8 a.m. and 8 p.m., so that’s why the company picked those times for the second ambulance.

Bodenstadt said CARE needs six paramedics to safely staff two Advanced Life Support (ALS) ambulances in Jefferson County. Due to the lack of available paramedics, the company is asking some employees to work an enormous number of hours, some as many as 120 hours in a week, Bodenstadt said. To fill all the shifts, Bodenstadt and the company’s CEO Bob Libby have come to Jefferson County to staff the ambulances.

Unfortunately for Jefferson County residents, Bodenstadt said the labor shortage is only going to get worse, because the team of three traveling paramedics that have helped with staffing are leaving on Jan. 5. After that, there will only be two full-time paramedics on staff. Bodenstadt said he’s searching for answers to the staffing shortage but is not finding any. He said that, in the last seven months, only one application has come in, and that person did not return a phone call.

CARE representatives said hiring traveling paramedics is not financially sustainable because they are so expensive. Shelby Garcia-Patton, CARE’s human resources manager, said traveling paramedics cost the company four times as much as a regular employee.

In addition to the staffing difficulties, CARE’s Denice Libby spoke about the company’s financial problems. She said CARE has been losing money in Jefferson County, and is having to use profits from its Iowa City-based contracts to cover the losses.

“We are over $1 million in the hole here,” Libby told the service agency members. “We are paying you guys to serve your community.”

Libby told the service agency members that “your original numbers” were not accurate regarding what percentage of patients had private insurance versus Medicaid, the latter of which pays a lower rate of reimbursement.

Jefferson County Health Center CEO responded by saying that the service agency never gave CARE any numbers about the number of patients with insurance. Fairfield City Attorney John Morrissey piggybacked on Hunger’s comments, adding that all bidders had access to the former ambulance company’s financial records, Midwest Ambulance.

“We didn’t tell you what to expect,” Morrissey said.

Jefferson County Attorney Chauncey Moulding asked Libby if the company knew it was losing so much money a year ago, and she said yes. Her husband Bob Libby, the company’s CEO, said he hoped things would turn around, but they haven’t.

Earlier this fall, CARE ambulance asked for an increase in funds from the service agency amounting to $10,000 per month, which would be a burden shared equally among the agency’s three members, the health center, City of Fairfield and Jefferson County. However, Denice said that $10,000 would only make the company break even, and that the increase it really needed was $90,000. For instance, an extra $10,000 per month would not allow CARE to purchase new uniforms or give its employees a Christmas bonus, she said.

Morrissey told the CARE representatives that the two sides were going to have to meet in the middle.

“Your ask is too big,” Morrissey said of the proposed $90,000.

The discussion turned to whether the county could get by with an ambulance that was “BLS,” short for “Basic Life Support.” In order for an ambulance to be ALS, it must have a paramedic, who is qualified to give medicine. A BLS ambulance is one without a paramedic, only EMTs, who can provide first-aid but not medicine.

Hunger asked JCHC emergency department manager Staci Worley how many of the hospital’s patient transports to another hospital require a paramedic, and she said most of them do. Hunger said an ambulance staffed with only EMTs would not help much with transfers.

The two sides agreed to brainstorm ways to reduce costs for CARE. Morrissey suggested the company could turn its building in Fairfield over to a nonprofit organization so it wouldn’t have to pay real estate taxes.

At the end of the open session, service agency member Dee Sandquist motioned to go into closed session so the board members could further discuss a matter that may involve pending litigation.

CARE Ambulance began providing ambulance service to Jefferson County on Oct. 1, 2020. Its contract with the service agency lasts three years.

Call Andy Hallman at 641-575-0135 or email him at andy.hallman@southeastiowaunion.com