The ambulance service started by the Pecos Benedictine Monastery in the 1960s could be shut down by June if it doesn't get a major cash transfusion. That would leave the village of Pecos and some parts of San Miguel County needing to find emergency medical service somewhere else.
The Pecos Valley Ambulance has been operated alternately by the village of Pecos and the Pecos Valley Medical Center since its inception as a volunteer service staffed by monks.
But funding for the service has always been piecemeal.
"The village ran it in the past and we went broke on it," said Mayor Tony Roybal.
The medical center has operated the service since 1999, making ends meet through government subsidies, grants and legislative appropriations.
But the nonprofit has taken losses of as much as $75,000 on its operation in some years. Medical center director Sigrid Olson says that can't continue.
The center has enough money to fund operation through June 31, but if more secure funding isn't found before then, the service may shut down.
"In the nine years since the medical center took over from the village, the center has supported the ambulance to the tune of about $330,000," Olson said. "This is a nonprofit -- we cannot afford to subsidize the ambulance service to the detriment of the medical and dental services it is our mission to provide. We're willing to do it to the tune of $10,000 or $20,000, but $75,000? No."
Olson said the service cost $410,000 to operate last year. San Miguel County contributed $185,000 in exchange for services in the unincorporated areas outside the village of Pecos. The village pitched in about $12,000 in cash and in-kind contributions. Patient payments totaled $114,000. But that left the medical center short by $125,000. A $60,000 legislative appropriation offset some of that loss, but the center paid the rest.
In January, ambulance staff members took voluntary 30 percent pay cuts -- paramedics now make $11 hour, emergency medical technitions now make $7 per hour.
"It makes my heart break that these people don't get paid better than they do," Olson said.
Those in the business say rural ambulance service -- especially in the vast, poor county of San Miguel -- has never been a money-making proposition.
In 2003, Rocky Mountain EMS, the company contracted to provide ambulance service in the areas of San Miguel County that the Pecos ambulance doesn't cover, said it needed a boost from $50,000 per year to $150,000 per year and would need $300,000 annually by 2006.
At the time, the Pecos Valley Ambulance service was getting $80,000 per year from the county. Pecos' subsidy from the county has grown to $185,000.
But San Miguel County has recently found a new provider, Albuquerque-based Superior Ambulance, who is providing service to the part of the county not covered by Pecos Valley Ambulance for only $72,000 per year.
County Manager Les Montoya said he'll continue to support the Pecos Valley Ambulance because of its long history and support in the community. But should it close, he said, the county could likely get Superior to take over the Pecos territory for less than Pecos Valley Ambulance is being paid.
Montoya said Superior seems to take a more business-oriented approach to running its service and doesn't rely on government subsidies to keep it alive.
Superior owner Chris Archuleta attributes his company's ability to stay afloat to strict budgeting and aggressive collections practices. Superior has a collection rate of approximately 57 percent, while Pecos Valley has a collection rate of about 40 percent, according to data provided by each provider.
The county has the authority to ask voters to OK a one-quarter-cent tax to fund emergency medical services, but hasn't put the question on the ballot.
"It's one thing we've looked at, but you know how people are about imposing taxes," Montoya said. "I would look at what options we have with (Superior) first."
Ambulance director Dennis Cronin said funding for rural ambulance service is a problem countrywide. Cronin said he'd hate to see the service taken over by an outside provider and plans to meet with the state Emergency Medical Services Bureau to talk about how the agency might help keep the Pecos service alive.
But bureau chief Kyle Thornton said the agency -- which oversees emergency medical certification and doles out about $3 million in grants each year -- can't wholly fund any service.
So who is legally responsible for funding ambulance service? Neither the Department of Health, the New Mexico Association of Counties or the Attorney General's Office could say. Santa Fe County Fire Marshal Stan Holden said a law that requires counties to provide "public safety," but that has been interpreted as police and fire protection, not ambulance service.
Contact Phaedra Haywood at 986-3068 or firstname.lastname@example.org