PROSSER, Wash. -- Prosser Memorial Hospital in Washington has given the communities served by its ambulances a deadline: Pitch in by March 15 or 911 responses may take twice as long.
Hospital leaders have been asking for help for almost a year and say they can't wait any longer.
"This is not a threat. It is not an ultimatum. We don't want you to take it like that. It's a business decision," said Jim Tavary, hospital chief executive officer. "We simply have got to do something."
The publicly funded hospital owns Emergency Medical Services, the only ambulance program that responds to 911 medical calls in and around Grandview, Prosser and Mabton. The four-ambulance fleet has fallen on hard times, Tavary said.
In 2006, the federal government began restricting Medicare reimbursements to the hospital for its ambulance service, leaving the program a projected $425,000 short each year.
Since then, the hospital has been looking for help.
It first tried voters within its hospital district. That area includes Prosser, Benton City and the surrounding Benton County area. On Nov. 6, 2007, those voters rejected a levy increase that would have raised their property taxes to keep the ambulance service running in the black.
The hospital plans to go back to the voters again this November. This time, officials will ask to form a special taxing district covering Grandview, Prosser and Mabton just for ambulance service. Early estimates put the tax increase at 15 cents per $1,000 of assessed value, Tavary said, or $150 per year for the owner of a $100,000 home.
However, that will take time. The hospital needs help now, Tavary said.
Hospital officials are asking the communities it serves to sign contracts for 2008. City councils and the county commissioners of Yakima and Benton counties have discussed the request but have not made any decisions.
"I think it's fair that Grandview pay something," said Grandview Mayor Norm Childress.
The hospital has asked those communities to contribute $250,000 through the contracts, called interlocal agreements.
For the rest of the shortfall, the hospital plans to absorb some losses and rely on existing contracts for nonemergency transports with Sunnyside Community Hospital and Kadlec Medical Center in Richland.
If the communities don't help by March 15, the hospital will reduce services to about 70 percent starting May 1, Tavary said. That includes closing a station in Grandview and laying off employees, which will lengthen response times. For example, responses would jump from a rough average of 8 minutes to 16 minutes in Grandview and from 7 minutes to 13 minutes in Prosser.
The problems stem from stricter Medicare payment rules for ambulance fleets. Federal guidelines mandate that Medicare pay for ambulance service only in rural areas where another service is not available within 35 miles.
There are other ambulance fleets within that area, but they generally don't leave their designated service areas, creating gaps that Prosser Memorial Hospital has filled. The federal government formerly made an exception for that but stopped in 2006.Hospital leaders across the country, including Tavary, are lobbying for proposed legislation in Congress that would change the 35-mile rule.