Third ambulance shift remains hot topic for county

WASHINGTON — Washington County supervisors and ambulance department leaders spent over an hour hashing out possible solutions to a growing demand for the service in a work session on Tuesday.

Interim Ambulance Director Katrina Altenhofen said she still recommended the county pursue a third shift for the service. Details are pending about where it would be based, what hours it would cover, and whether it would be a 12- or 16-hour crew.

“When I brought forth the annual report, I stated how there was an uptick in the call volume, and then again at the quarterly report,” Altenhofen said. “We’re at that point of needing to make sure we’re able to cover the citizens and their emergency needs.”

Department staff said they expected the trend to continue as the median age of Washington County residents climbs. Over 60% of the department’s calls are already billed to Medicare, according to Ambulance Billing Coder Jamie Brame.

“Our demographic is older people, that’s to be expected,” she said. “When you look at health trends, those are the people that get sicker. As you get older, you have more ailments. So as that population grows, so does the need for health care.”

A tally of every call to the department so far this year showed the highest volumes between 6 a.m. and 10 p.m.

While many county officials agreed on the need to boost ambulance availability, the main obstacle to do so will be budgeting.

Still, Supervisor Jack Seward Jr. said the expense seemed worthwhile.

“We are spending more money, but we are not doing it frivolously,” he said. “This is important. People expect to have a good ambulance service available 24/7 … there’s going to be some extra spending that we’re going to have to absorb in order to keep providing, at a reasonable rate, what we need to provide.”

Altenhofen said the third crew would reduce the need for emergency overtime pay. While that’s likely true, the math suggests a still-higher net cost to the county.

The salary of a four-person, 16-hour third crew — staffed with the standard two paramedics and two EMTs — would cost just shy of $238,600 per year, assuming the department’s median pay scale. That doesn’t account for the cost of fuel, benefits for new hires, or other expenses, and a more precise budget request for the crew is expected at a future meeting.

For comparison, last fiscal year’s overtime expense for the department was $137,409. It’s expected to come in higher this year, however, with $57,601 already racked up by the end of November.

The exact timeline for a third crew’s potential adoption is unclear. Some at the meeting suggested they hope to see it implemented by this spring, but that depends on the length of debates at future meetings.

As for the times of day not covered by the suggested third crew, other solutions are in the works.

Supervisor Richard Young, former boss of the then-private Washington County Ambulance Service, proposed another change to handle those hours: overnight on-call staff, likely living near Kalona.

While the county has an ambulance shed in the city, it’s not built for staff to sleep in overnight. Instead, Young proposed paying ambulance crewpeople who live in the area minimum wage to keep their pagers on overnight, and respond in the event of an emergency, paid at their normal hourly rate once they enter an ambulance.

“From probably 11 o’clock until 6 in the morning, it doesn’t justify three ambulances,” Young said. “But there’s always those occasions that something happens, where you need that third one, sometimes … they would go home, make $7.25 an hour to sleep.”

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