Update 3/23/2021 – 57 individuals responded to the La Pine Rural Fire Protection Districts (LPRFPD) call for public comments regarding Ordinance #2019-03, which allowed the District to bill medical facilities for transports that the Chief deemed to be non-emergent. Most of the submissions were in opposition to the ordinance and asked the District to stop billing the medical clinics. You may view the public comments on the Districts website here: https://lapinefire.org/wp-content/uploads/documents/ordinances/Public-Comment-re-Ord-019-03-Redacted.pdf
After consideration of the comments that were received, the District Board of Directors has decided to repeal Ordinance #2019-03 and propose Ordinance #2021-01.
Ordinance #2021-01 (click to view) | AN ORDINANCE TO REPEAL ORDINANCE #2019-03 AND ADOPT RULES AND REGULATIONS TO GOVERN COST RECOVERY FOR MEDICAL AND HEALTH CARE FACILITY AMBULANCE TRANSPORTS REQUESTED THROUGH 911
In summary, this new ordinance would allow the District to bill medical clinics for all ambulance transports that are a result of the clinic activating the 9-1-1 system. If this ordinance is passed, any time that a District ambulance takes a patient from a medical clinic to the emergency department, the patient and their insurance will not be billed—the financial responsibility will fall on the medical clinic.
While this may seem favorable for the patient and for the District financially, the result of the medical clinics paying for these ambulance transports would most likely be a reduction of services and reduced access in the La Pine area. In fact, not only would it reduce the number of services that are currently available, but this ordinance would also most likely deter other medical providers from coming to La Pine.
This reduction of services and healthcare access would ultimately lead to a less healthy community and more 9-1-1 calls from people’s homes. Although we acknowledge that the Fire District does need additional funds to expand its services for our growing community, this is not the way to do it.
The first reading of this new ordinance took place at the March 11th District board meeting. The second reading is on the agenda for the Wednesday, April 8th meeting where they will then vote whether to adopt the new ordinance.
WE NEED YOUR HELP. Only you can help us prevent this ordinance from being passed. It is important that our community members and taxpayers participate and voice their opinions in public matters such as this.
Send Your Comments:
If you would like to send your comments regarding ordinance #2021-01 to the Fire District, you may email them to info@lapinefire.com.
Attend the Meeting:
If you would like to attend the virtual meeting on 4/8, visit https://lapinefire.org/board/ for information on how to RSVP.
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Thank you for taking the time to visit this page and educate yourself on a very important and time sensitive issue that is greatly impacting the healthcare community of La Pine.
Decisions that have been made by the La Pine Rural Fire Protection District (LPRFPD) in recent years have the potential to:
- create a lack of confidence that urgent medical needs will be cared for in a timely manner;
- lead to reduction of health services in the local area; and
- provide a sense of “rationed” services rather than increased service availability for a growing population.
These decisions also may cause negative impacts on the local healthcare system such as:
- causing great financial strain that could lead to reduction of staff and services;
- creating doubt in the minds of medical providers when deciding whether or not to activate the 9-1-1 system; and
- creating conflict between LPRFPD and local medical professionals where there should be collaboration and a mutual respect for each others office and competencies.
Please review the informational summary and document links provided below and let us know if you have any further questions and would like to schedule a phone call or meeting to discuss.
Once you have reviewed the information, please take a moment to send an email to info@lapinefire.com letting the La Pine Rural Fire Protection District know your opinion, either opposing or supporting Board Policy #600.02 and Ordinance #2019-03.
The staff at La Pine Community Health Center are grateful for you and your support of our organization.
Summary
La Pine Rural Fire Protection District (LPRFPD) runs two ambulances, 24 hours a day, 7 days a week. Over the past several years, as the community has grown, they have experienced many instances where more than two simultaneous EMS calls occur, leaving one of those EMS callers to have a delayed response for their medical emergency.
La Pine Community Health Center (LCHC) and St. Charles Family Care-La Pine (St. Charles) are primary care facilities that offer primary medical care on an appointment and walk-in basis. Though their Walk-In and Immediate Care clinics treat minor illnesses and minor injuries, they are not urgent or emergency care facilities. When patients present at either facility with a potentially life-threatening illness such as a possible active heart attack, stroke, pulmonary embolism, etc. and are unstable, the 9-1-1 system is activated so that the patient may be safely transported by ambulance to the emergency department where they can receive the level of care that is necessary. For LCHC, this happens approximately 44 times for every 23,000 patient visits (or less than 1% of the time).
The LPRFPD’s expectation has been that there should be zero emergency calls from professional medical facilities and LPRFPD policy states that each call must be triaged for the greater good, which could translate to your emergency not being as important as the next emergency.
In 2018, in an effort to balance (some might say ration) their available resources, LPRFPD created a policy (Board Policy #600.02) to authorize their paramedics to assess the patient and triage for the greater good to make a decision to transport immediately, delay transport for another ambulance to be in the service area or to decline transport of the patient.
Next, LPRFPD passed an ordinance (Ordinance #2019-03 – effective Jan 2020) that attempts to regulate non-emergent transports but is inconsistent with the transport standards that are set by Deschutes County in the Ambulance Service Area Plan*. The ordinance has no standard as to what qualifies as an emergent or non-emergent call. The ordinance does allow for the medical facilities to appeal the invoices but to our knowledge the decision-making process is not guided by a medical director.
Throughout 2020, LCHC and St. Charles have attempted to work with LPRFPD to come to a resolution or find alternative solutions to the issue of limited EMS resources in a rapidly growing community. Though there are some ideas being worked on, it may take months or years more to resolve the issue. In the meantime, LCHC and St. Charles are receiving multiple invoices per month, each in the amount of $2,655 (significantly more than if a La Pine resident called 9-1-1 directly). The financial impact of paying these invoices would be devastating–not only to LCHC and St. Charles’ business and staff, but to the community members who rely on the many services that each provide to keep them healthy and connected to the care and resources that they desperately need.
Included in the links below are documents that provide more detailed information about this issue.
Deschutes County Ambulance Service Area Plan
LPRFPD Medical Services Billing Rate Schedule
LPRFPD Board of Directors Meeting Minutes
For more information, contact LCHC’s Executive Assistant, Courtney, at 541-876-2135.
*For more information regarding the Deschutes County Ambulance Service Area Plan: https://www.deschutes.org/health/page/ambulance-service-area-asa