WASILLA -- As slashed hours leave emergency medical responders scrambling for 911 calls in the crowded heart of the Mat-Su Borough, officials are pitching a nearly 14 percent increase in ambulance fees so they can hire new full-time medics to fill the void.
The responder crunch comes after the borough in January limited hours for its corps of 107 paid on-call EMS responders to 29.5 hours a week in response to potential Alaska Public Employees' Retirement System and health care costs.
The hours' cap means there aren't always enough paid, on-call EMTs to staff ambulances, particularly in the Mat-Su's "core area" around Palmer and Wasilla. More than 85 percent of the ambulance calls in the borough originated in that area in the last year -- a little more than 5,000 calls in all.
The 12 or so full-time medics at the borough now are filling the holes in the ambulance staffing schedule as much as they can. Some are working upward of 80 hours a week. One medic responded to 36 calls for help in a 24-hour period.
During a Mat-Su Assembly budget work session Tuesday night, the borough's emergency services director floated a 13.7 percent increase in ambulance fees to generate enough money to hire seven new full-time paramedics working 48-hour weeks in the core area. The Assembly would need to approve any fee change.
Plans for the next year call for hiring another seven medics for rural areas of the borough, which spans an area the size of West Virginia.
Kara Boothby, the medic with 36 calls in 24 hours, said Wednesday only three ambulances had enough responders to run. Normally, the borough runs five.
The 31-year-old Boothby has been picking up a bunch of overtime to fill the gaps left by the hours' cap, responding to everything from car wrecks and house fires to births and CPR-in-progress calls. She's averaged about 70 hours a week lately.
The borough recently added some new on-call EMTs but they aren't quite ready to respond yet, Boothby said. And some of them are replacing previous EMTs who left in frustration with the new hours policy or needed to find other work once their hours dropped.
"We really do need that full-time staffing," she said. "We're still going to have holes on our schedule. The only way to really fix that is to start transitioning to a full-time department."
Fewer than 10 percent of the borough's roughly 430 emergency responders -- that includes firefighters, rescue and medical responders -- are full time now, borough officials have said.
The new positions would cost $951,043, according to a report developed by emergency service director Dennis Brodigan. But they'll replace on-call responder positions that cost $502,728, for a net increase of $448,315. They would also be classified as "Mobile Intensive Care Paramedic" positions, which involves high-level training.
The ambulance fee would net $457,000, for an annual surplus of $8,685, according to Brodigan's report.
Borough ambulance rates now start at $690 plus $17 for every mile driven with a patient. If the Assembly approved the fee increase, the base rate would rise to $800 and mileage to $20; other fees would go up as well.
Mat-Su ambulance fees are currently lower than in Fairbanks and Anchorage for LifeMed Alaska, a private company, according to a comparison chart in Brodigan's report.
"We would still be slightly cheaper than EMS services in Anchorage," Borough Manager John Moosey noted in a phone interview Wednesday, adding that the ambulance fees didn't go up during the last budget cycle.
Mileage rates, however, are already considerably higher here than those charged by Anchorage or Fairbanks.
The borough would need to increase ambulance rates again the next year, by nearly 10 percent, to fund the new rural medic positions, the report shows. If those increases were also approved, an ambulance trip in the Mat-Su would cost more than every service but LifeMed, according to Brodigan's research.
That decision comes as the borough Assembly embarks on this year's budget process already facing numerous hurdles including a major shortfall at the borough's port.
The Assembly next talks budget on Tuesday, at a 10 a.m. work session on the manager's budget overview, with department presentations.
The borough, for the first time, has created a separate budget website on its home page. Go to www.matsugov.us/budget to see more.
Reach Zaz Hollander at firstname.lastname@example.org or 257-4317.
By ZAZ HOLLANDER