Rural ambulances near a crossroad in state
Rural ambulances near a crossroad in state

By Jeff Raymond

Published: September 14, 2007

Oklahoma has lost three rural ambulance services since January, officials said, and consolidation likely will be needed to keep more from collapsing.

Shawn Rogers, director of emergency medical services for the state Health Department, predicted towns would have to combine ambulance services into regional hubs to reverse the trend that has seen 48 close in the last seven years. Nearby ambulance services have absorbed some areas, but 14 have been left without ambulance coverage.

"I think it's only a matter of time before we see people open to that,” he said of consolidation. "The EMS system in rural Oklahoma is going to continue to collapse unless there's action taken.”

Billings, Clayton and Vici-Camargo ambulance services are the latest agencies to close shop. Others are teetering on the brink, Rogers said. He predicted 15 or 20 "large rural systems” could function well.

Oklahoma has about 160 basic ambulance services.

Greg Reid, who chaired Gov. Brad Henry's ambulance task force, said he hoped the benefits of consolidation would be apparent to agencies. He acknowledged there would be local resistance to greater cooperation.

However, by saving money on back-office costs, combining funds for better prices on ambulances and other big-ticket purchases, or sharing a paid medical director, they could better afford to pay their responders and provide better service, he said.

"We know that the history of emergency medical services has generally seen that local communities take a certain amount of pride, and they want to have a certain amount of say in their ambulance service and what level,” he said. "As they start working together, they will start to see benefits of working for each other.”

Without doing something, the situation will continue to worsen, said Reid, director of Shawnee's React EMS.

"Emergency medical service in the state is not consistent from one location to the next. We have some differences that could become most apparent when people are out of their home area, where they would normally have the knowledge and expectation of how their local system would respond to an emergency,” he said.

Among the task force's recommendations were to allocate $5 million a year to rural ambulance services for the next four years, lift the decades-old constitutional cap on property taxes communities can levy on themselves for ambulance service, and increase distance-learning opportunities for emergency medical technicians.

Legislative bills based on the task force's recommendations remain active, but did not receive floor votes during the last session.

Some communities' tax bases are so small that no increase would adequately fund ambulance services, which are paid per ride, not for the capacity to be ready to respond.

Reid said Oklahomans need to view ambulance service alongside police and fire protection as a necessity.

Bob Hawley, executive director of Le Flore County EMS, has struggled with the April closure of Clayton's ambulance service.

Clayton's ambulance closed after one of its emergency medical technician was killed in an ambulance rollover Jan. 27. Its other emergency medical technician decided to quit.

Hawley's agency, which already covered 1,500 square miles, has had to absorb the additional 200 square miles of territory around Clayton, which isn't even in Le Flore County.

Le Flore County EMS serves Clayton through a substation in Talihina — a 30- to 45-minute drive each way.

"The effect has been an additional, uncompensated burden,” said Hawley, who also serves on the board of the Oklahoma Ambulance Association.

Neither Pushmataha County, where Clayton is, nor the state has contributed money for the extra runs his medics must make, he said.

"They're pushing these orphaned areas off onto financially secure services, and they're not getting anything in return,” he said. "Regionalization” could work if backed with sufficient funds for extra personnel, he said.

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