Public ambulance modified its coverage agreement to spend more time near Exeter, provide more rest for crews
EXETER – Exeter District Ambulance crews were able to sleep easier last month, and not just because COVID case rates have fallen as vaccination rates have risen.
In January, Exeter District Ambulance modified its participation in the posting plan used by the Ambulance Provider Association of Tulare County (APATC)—comprised of six ambulance companies which collectively cover Tulare County’s urban and rural areas. The plan is an agreement between American Ambulance in Visalia, Imperial in Porterville, Lifestar in Tulare and Exeter on how they shift units throughout the county to cover areas when another ambulance company is forced to leave its primary coverage area.
District manager Peter Sodhy said Exeter changed the plan to provide relief for its EMTs and paramedics who were being overworked. Prior to the change, Sodhy said Exeter crews were making eight to 12 moves each shift in areas they share coverage with American Ambulance, the rural areas east of Exeter including Woodlake, Lemon Cove, Three Rivers, Badger, while American was only moving three times per shift after opting out of the posting plan in February 2020, right before the pandemic began. That put Exeter crews in a position where, at times, crews never got more than one continuous hour of sleep in a 48-hour period, a dangerous situation which can lead to crew injuries and, potentially, patient deaths all while dealing with extra regulations and protocols due to COVID-19.
“It has significantly improved the morale of the crews,” Sodhy said. “The new posting plan fixed 95% of that problem.”
While the posting plan has improved the health and safety of crews, it hasn’t necessarily helped the public ambulance company’s finances recover. Sodhy said the more metropolitan ambulance providers in Visalia, Tulare and Porterville have seen call volumes return to pre-pandemic levels while more rural areas seem to be lagging by about a month in terms of current versus normal call volumes. Total calls minus cancellations for Exeter District Ambulance were down just 7% in January 2021 compared with January 2020, 16% in February and 18% in March, according to the latest numbers from the Tulare County Consolidated Ambulance Dispatch.
Sodhy said the change in the posting plan also meant Exeter crews spent more time in Exeter, the only community they are legally obligated to provide service. Exeter District Ambulance was formed in March 1977 after 63% of the voters living in the 592 telephone prefix approved a 10-cent tax on each $100 of assessed property value. The district encompasses all of Exeter and Lindcove and extends west to Road 176, east to Road 236, north to Avenue 320 and south to Avenue 256.
“It can be frustrating for people to see ambulances with Exeter on the side responding to other areas and we felt Exeter was being short changed in the last posting plan,” Sodhy said. “As a result of the new plan, we are in Exeter much more than we used to be.”
Medical transports, where ambulance companies generate most of their guaranteed revenue, minus cancellations were down 24% in January but just 7% in February and were up 19% in March. Most of that was due to the local hospital’s rescinding their assess and refer policies.
The Central California Emergency Medical Services Agency (CCEMSA), which oversees ambulance providers in Tulare, Kings, Fresno and Madera counties, issued the unprecedented assess and refer order on Dec. 21 as cases were surging during the holiday season. The order required emergency responders to perform a patient assessment upon arrival. If paramedics determine emergency transport is not necessary, they would then advise the patient against being going to the hospital, which were reaching capacity with COVID patients, and instead seeking care at an urgent care, primary care physician or using tele-health services available through most insurance carriers.
As the only tax-funded ambulance company, Exeter is also recovering in terms of elected oversight. Marilyn Rankin was appointed to represent Area 5 on the district’s board of directors in-lieu of election as the only candidate who filed for the seat. Rankin retired as the assistant superintendent of special services for the Tulare County Office of Education in 2012 after 32 years in that position and nearly 40 years in education.
It has also been difficult for the district’s board of directors to meet for lack of a quorum. Adam Pfenning and Diana Mendez were the only sitting board members for a quarter of last year. Tony Miller resigned from the board following the April 2020 meeting, vacating the at-large seat held over from the previous board, seats for Areas 3 and 5 have been vacant since 2018 and has had at least two vacancies since 2017. Last July, the Board of Supervisors appointed longtime firefighter Juan “Bobby” Martinez to the at-large seat. Prior to Rankin’s appointment, every active board member had to show up for every meeting in order for there to be a meeting, as state law requires a majority of the board, three of five seats in this case, must be present to vote on items. The lack of quorum has meant EDA’s board did not hold a meeting for between April 27 and Aug. 31.