The Yachats Fire District is no longer transporting patients to the hospital in Florence because of the length of time it takes firefighter/paramedics out of the district. Although in effect for most of the year, that change has surprised some residents. (Quinton Smith/Lincoln Chronicle)By GARRET JAROS/Lincoln Chronicle
YACHATS – A month ago Betty Johnston of Yachats was not feeling well. She had been up most of the night in discomfort before making the 1 a.m. decision to call the Yachats’ fire department and ask that they drop by for a blood pressure test.
“I packed a small bag, thinking I might have to stay in the hospital,” she told the board of the Yachats Rural Fire Protection District at its monthly meeting Monday. “When they finished with the blood pressure – and it was high – I decided to go and I said, ‘Are you ready to go to Florence?’ I wanted to go to the hospital. I was sick. I thought I had a stroke.”
And that is when she learned the Yachats-based South Lincoln Ambulance, which is in transition to becoming the fire district’s ambulance, no longer drives patients to Florence.
“And when I heard that I couldn’t go to the place where I chose – I was flabbergasted,” said Johnston, 85, who served on the fire board for 17 years before resigning in 2023.
Johnston Johnston, along with Yachats resident Morgen Brodie, attended Monday’s meeting to ask why the change in policy, with Johnston noting residents had always been given a choice which hospital to be taken to, and when the change occurred.
Brodie told the board she had just been made aware of the change, which she learned was not all that recent, and was concerned because Florence is “where many of us have our health care. So I came to see what the deal is.”
Interim fire chief Jeff Mathia said the change came at the beginning of the year and that the reason came down to the basics of trying to provide sufficient fire and ambulance coverage in an area with an increasing number of calls for service.
When the ambulance takes someone to Samaritan Pacific Communities Hospital in Newport it takes about an hour round trip, Mathia said. Whereas that same trip to PeaceHealth Peace Harbor Medical Center is 1½ to two hours because of the many curves along U.S. Highway 101 between Yachats and Florence.
The ambulance is allowed to run lights and siren when necessary for a quick return from Newport to Yachats if responding to a call. That is not allowed while returning out of its jurisdiction through Lane County. And it is dangerous to do that in the curves while transporting to Florence, Mathis said, compared with the route to Newport “which is a straight shot.”
The ambulance is also required by state statute to take patients to the closest appropriate facility that can handle their needs.
“And that’s kind of the key right there,” Mathia added.
Taking someone to Florence instead of Newport also creates an undue delay for the ambulance’s return to service. Part of the ambulance’s mutual aid agreement is that Yachats is responsible for covering areas in Lincoln County if Pacific West Ambulance is unable to respond.
Mathia said on Sunday, the Yachats ambulance had to back up PacWest three times because they were busy on calls.
While Yachats residents may have their primary care physician in Florence, Mathia said it does not matter when they are taken to Florence or Newport hospitals because they will be seeing an emergency room physician, that both hospitals provide the same level of care, and that patient records are shared and available statewide.
Some people are also under the impression that if they go the hospital via ambulance they will not go into the emergency room but instead be booked into a room, Mathia said, but that is not the case.
An added reason to take patients to Newport is the time factor – where depending on the emergency arriving a few minutes sooner for treatment can make a big difference. And if a Newport emergency room doctor determines a patient needs to go to Salem, Corvallis or Eugene for treatment, the hospital arranges that transport.
Staff and members of the Yachats Rural Fire Protection District board conduct business during their monthly meeting Monday. (Garret Jaros/Lincoln Chronicle)Call volumes
Johnston said she chose not to go to Newport and instead waited until a neighbor could take her to Peace Harbor the next morning. And she said she would not have moved to Yachats 25 years ago had there not been a choice which hospital where she could be taken. She said the elderly of Yachats have always had two choices of which hospital to go to, now they do not and she does not think that is right.
“We have picked a place where we thought we got better care, and we just like the vibe, but now we don’t have that choice,” Johnston said. “I don’t get why we don’t get a choice. I know I’ve heard you. I understand times have changed. But I want to know, is the ambulance doing fewer transports now that it is not going to Florence?”
Mathia told her that Yachats’ firefighter/paramedics are “busier than we ever have been.” In the last 90 days, Mathis said, they’ve had nine back-to-back calls for ambulance service, meaning someone called 911 and then 30 minutes later another call came in. And the volume is only increasing, he added.
“We’re going to probably approach 900 calls this year versus the 100 we did, you know, 15 or 20 years ago.”
South Lincoln Ambulance ended its service contract to cover the Tenmile area in Lane County south of Yachats in June. It now has a mutual aid agreement with Western Lane Fire & EMS Authority in Florence, which has three ambulances.
“If there’s a serious call, let’s say in Sea Perch, that’s kind of a common place we go in the Tenmile area … then Western Lane can ask us to respond,” Mathia said. “And we’ll go and respond because we will get there quicker because we are closer. And then Western Lane will help cover our area while we take care of their patient. Or we’ll intercept with Western Lane and give the patient over them to continue on to Florence.”
The fact is, South Lincoln Ambulance cannot support itself with its own staff, which is why the fire department is folding the ambulance into its service, he added.
“Being an ambulance manager for 25 years, the numbers don’t add up to support a single ambulance here,” Mathia said. “But we can make it work. We have to watch what we’re spending, how we’re spending it, where we go … .”
And that also means walking a fine line to make sure residents and taxpayers are happy. If Yachats discontinued the ambulance service, PacWest’s owner has said the company would not station an ambulance at the fire station because there’s not enough business to justify a separate PacWest medical staff. The Yachats ambulance is staffed by the fire district’s firefighter/paramedics.
“There’s no way any of my partners to the north can afford to staff an ambulance,” he added. “But because of Yachats and your generosity and your belief in us, we’re still able to keep that ambulance here in the fire station in the city.”
But that means staying fiscally responsible and making sure the ambulance is not tied up in Florence for two hours while someone might be having a stroke in Yachats. If PacWest is busy, its closest ambulance might have to come from Depoe Bay instead of Waldport or Newport.
“So again, we’re tipping the scales both directions and we’re trying to provide the best service that we can with what we have, knowing what we do know today,” Mathia said.
Fire board president Doug Myers piggybacked on what Mathia said.
“As the chief mentioned, we’ve run a rash of back-to-back calls in the last three months, including back-to-back-to-back calls,” he said. “And with the new format we’ve been able to handle those calls. We still do depend on our automatic aid and our mutual aid.”
How to get a ride
Non-emergency medical transportation is available for doctor appointments or hospital tests through PacWest Ambulance and Cascade West Ride Line. Both services offer weekday and weekend rides and both are for medical appointments only. It is illegal in Oregon for a medical service company to provide take someone to the emergency room.
PacWest: Rides can be scheduled from 7:30 a.m. to 4 p.m. Monday through Friday by calling 541-265-3175.
Cascade West Ride Line: The Medicaid broker arranges transport for people who are on Medicaid, the Oregon Health Plan and Inner Community Health and is available for scheduling from 8 a.m to 5 p.m. Monday through Friday. They can be reached toll free at 866-724-2975 or 503-861-5530.
- Garret Jaros covers the communities of Yachats, Waldport, south Lincoln County and natural resources issues for Lincoln Chronicle and can be reached at [email protected]
Chief Mathia is correct – OHA 410-136-3160 states that “(4) Emergency ambulance transportation is required when a client’s medical condition is an emergency pursuant to OAR 410-120-0000, Acronyms and Definitions. The ambulance must transport the client to the nearest appropriate facility able to meet the client’s medical needs. Brokerages do not arrange emergency transportation.”
In an emergency, people are not offered options for which facility they are transported to for emergency treatment. EMS services are covered in the broader context by the Incident Command System, which provides a standard framework for how emergency services are deployed and utilized.
That’s some cherry-picking right there. I did a stint in EMS in the 1990s and unless it was a condition of patient instability you are allowed to transport to the hospital of their choice, even if it was on divert (so long as the patient was informed what that meant). So if someone broke their foot near Kaiser Hillsboro and wanted to go to Legacy Emanuel they could do it, bypassing Kaiser Hillsboro, Providence St Vincent’s, OHSU, and Legacy Good Samaritan. Because their condition was stable.
If call volume is going up, maybe they need to add a unit.
Here’s that definition from OHA 410-120-0000. It says a prudent layperson with average knowledge. A prudent layperson would know Johnson’s condition was urgent but not emergent based on Johnson’s history; the definition doesn’t require you to be ignorant of their history. She wasn’t unconscious, slurring words, mentally altered. She may have been able to wait a little while to get to the doctor but medical monitoring while getting there would be appropriate. This sounds to me like someone really reaching to justify a new policy.
(111) “Emergency Medical Condition” means a medical condition, whether physical, dental, or behavioral, manifesting itself by acute symptoms of sufficient severity such that a prudent layperson who possesses an average knowledge of health and medicine could reasonably expect the absence of immediate medical attention to result in placing the health of the individual (or with respect to the pregnant person, the health of the person or their pregnancy) in serious jeopardy, serious impairment to bodily functions or serious dysfunction of any bodily organ or part. An emergency medical condition is not based on the final diagnosis but is based on presenting symptoms as perceived by a prudent layperson and includes cases in which the absence of immediate medical attention would not in fact have had the adverse results described in the previous sentence.
It’s not cherry-picking at all. The rule is one of the first in the Administrative directives governing emergency treatment and transport of ill or injured persons. If you worked a “stint” in EMS, then you would know that on scene, it’s usually the prerogative of the incident commander or the medical party in charge (usually the highest qualified provider on scene) as to where patients are transported. I worked in fire for 20 years and was a qualified EMT for 16 years and I never witnessed a patient being transported to the facility of their choice (or even a patient wanting to choose a particular facility).
Johnston had so much of an emergency that she could wait until the next morning to be driven by a neighbor, while at the same time being willing to tie up the ambulance for an extra hour so see could go to the ER where her primary care physician is? Ambulances are for emergencies and go to the nearest emergency room. They are not Ubers.
What I’d like to are see real, accurate records for the emergency ambulance calls.
“We’re going to probably approach 900 calls this year versus the 100 we did, you know, 15 or 20 years ago.” – Interim fire chief Jeff Mathia
If the City of Yachats has just over 1,000 residents, and a few hundred more within the fire district that pay the taxes that support the Yachats Rural Fire Protection District (YRFPD), then who are the majority of these calls for? My educated guess is transients/tourists.
As a tax paying resident who has basically NO fire protection, I’m not interested in subsidizing the tourism industry…which is what my $500-$600/year in fire protection taxes are currently supporting.
Here are my two recommendations:
1) The YRFPD update their 9-1-1 categories to differentiate between actual residents and tourists/transients. The current system is vague and is based on location, not on the residency of the caller. A system such as what tow trucks and ODOT require would be a better defined way of tallying these calls.
2) Have separate fees for residents vs. tourists/transients. YRFPD has justified their existence and garnished supportive votes for their additional tax requests by stating they offer lower prices than the other ambulance services. Keep the lower prices for those one’s paying the YRFPD taxes, and have a more realistic fee for the transients, especially since, as reported above by the fire chief, we are offering a needed service that saves time and lives, rather than waiting for an ambulance from Waldport or Florence. Stop increasing our taxes to support an over-built fire station aimed at mostly supporting tourism, not the real residents. Use the additional funds from increasing the transient ambulance fee to purchase and hire ambulance drivers (not firefighters) to drive an additional ambulance.
This seems reasonable and more fair to me.
We’ve lived north of the city of Yachats for 24 years. During this time we’ve encountered a fair number of Yachats residents who believe/think that the YRFPD is part of the City of Yachats, and that those in the City of Yachats are the major taxpayers and users of the YRFPD fire and ambulance service. Not so. The number of registered voters (and YRFPD users) who are within the YRFPD area but outside the City of Yachats is around 1,400. This number significantly rises when one considers many of these voters have dependents. Then, add in all the ‘non-voting’ but tax paying properties outside the City of Yachats, but within the YRFPD, such as ‘not for rent second homes’, motels, campgrounds, licensed rental homes (and the many unlicensed rental homes), and other business properties. Unless exempt, these properties pay their share of YRFPD taxes and benefit from YRFPD services.
During the summer (and major holidays) the estimated population number in the area just between the cities of Waldport and Yachats, can swell to around 6,000. This bump is primarily vacationers living in and (hopefully) spending at the businesses within the YRFPD district. This keeps the local economy humming. They also are eligible to use and benefit from the services provided by the YRPFD.
It is time to consider changing the name from Yachats Rural Fire Protection District to something more descriptive of the served area, maybe South Lincoln County Rural Fire Protection District? In any case, the name should better reflect the area it serves and its taxpayers without confusion.
Living in Lincoln City, I didn’t realise I could tell the local ambulance company to take me to West Valley Hospital in Dallas rather than Samaritan North Lincoln in Lincoln City.
I mean, it’s a significantly longer drive, but in an emergency I would much rather be part way to a significantly larger hospital.
Or, I could get treatment locally much quicker if needed… Perhaps that would be for the best after all.
You misread. That would cause an undue delay in returning to their service area. West Valley and North Lincoln offer same emergency services. Under the OAR the ambulance can legally deny your request to be taken to West Vally and take you to North Lincoln as it is the closest facility.
If you have United Healthcare insurance, one of the largest insurers, you better ask the ambulance driver to stop by an ATM on the way to the ER. Samaritan doesn’t accept it.
I’m glad all the i’s are dotted and the t’s crossed and nobody is coloring outside the lines. Too bad some take longer to get care and others end up in the wrong place.