Laguna Beach manages the costs of hiring a new ambulance crew

A medical ambulance responds to an accident near Cress and Coast Highway in 2013. File photo

By Megan Miller, Indie Special

The Laguna Beach City Council on Tuesday unanimously approved recommendations from city employees to move forward with hiring its own ambulance crew despite concerns about staffing patterns and costs.

Council members closely followed Fire Chief Mike Garcia’s recommendations in developing an in-house ambulance program. The city will have three of its own manned ambulances by July 1, with at least two available 24 hours a day and a third on standby.

A budget of approximately $1.8 million will also include salaries and benefits for 12 full-time paramedics for fixed three-year terms. An Ambulance Coordinator position will support the management and scheduling needs of the program.

Board members approved amendments to the existing budget to allow the hiring process to begin. The board also granted permission to purchase necessary equipment, such as chest compression systems and stretchers.

Laguna Beach transports approximately 1,500 patients each year. The city had previously entered into a 25-year partnership with Doctor’s Ambulance for transportation services, but council members decided in December to let the contract expire due to concerns about increasing response times.

“It’s a major improvement for the safety and well-being of our community to own and control our ambulance service,” said resident and Emergency Disaster Preparedness Committee member Tom Gibbs.

However, questions remain over staffing and revenue details.

In December, Pro Tem Mayor Bob Whalen asked if it would be possible to staff ambulances with firefighters-paramedics instead of paramedics, citing concerns about high turnover in the program, as the latter position is often a “stepping stone” in many careers.

The change would cost an additional $1.3 million annually, bringing the total to $3.1 million, nearly double the approved operating budget.

Emergency medical technician (EMT) is the minimum medical certification required to become a paramedic, which is a common job title in the two cities that run the ambulance service and private paramedics, Garcia said.

Changing such a stance could also jeopardize the July 1 launch date, which is needed for the city to come together due to the expiration of the medical ambulance contract.

Board members decided to keep the position of EMT ambulance operator, with Garcia adding that the issue could be revisited during the program’s first year-end review.

Whalen also raised questions about Wittman Enterprises, which will partner with the city for billing purposes. The company has been in service for 30 years and represents 12 other public EMS and fire department customers in Orange County.

In the event that a patient fails to pay their ambulance bill, it will be the City’s responsibility to handle collections.

“Our plan is not to take anyone from the collections and pressure them,” Garcia said.

The city council had approved a base fare of $2,800 for each ambulance ride, to allow the program to operate without being partially subsidized from the city’s general fund. According to Chief Garcia, Medicare or Medi-Cal users would not be affected because each program has its own cap on ambulance services.

However, nearly 42% of other patients who are commercially insured, uninsured, or underinsured could see increased costs, taking up the bulk of the program’s operating budget.

Council member Toni Iseman called the projected revenues too “optimistic” for the reality of what the city could spend.

Gavin Curran, director of administrative services, assured council members that expected revenues had been adjusted based on past reports and extensive research by city staff. The city is also eligible to receive nearly $200,000 in federal funds to also account for deficits.

In addition to approving the fire department’s seven recommendations, the city council sought clarification from Wittman on their collection methodologies, as well as a program readiness report in June.

“We’re going to evaluate this program in the first year,” Garcia said. “We are going to look at our collections. We expect them to be what they have been historically, if not better, and we will make adjustments and work with finance [department staffers] to ensure that we can meet our income and expenses.

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