Eighty percent of Upper Pine River Fire District calls are for medical response, not fires, but the district is dealing with a critical shortage of ambulances.
The district board held a special meeting on Dec. 29 to discuss options to get an additional ambulance in service as soon as possible. The district needs three ambulances, given the percentage of medical calls, district board president Jeff Dyar said.
As of that day, the district was down to one Upper Pine ambulance and one on loan from Durango Fire. One of Upper Pine's other ambulances stalled out and quit while transporting a patient on Christmas weekend.
Chief Bruce Evans called that a "near miss" for patient outcome. But he stressed to the Times this week that the district now has two very reliable ambulances, with one of them at Vallecito.
Ambulances run on a chassis built by Ford or Dodge. That includes the engine, and the Ford diesel 6.0 diesel engines have had ongoing problems locally and nationally, according to board discussion. The ambulance "box" is installed by a separate vendor authorized by Ford or Dodge.
Upper Pine has one ambulance with a Dodge chassis and wants to switch to all Dodges. So do other responders, Evans said. That's created a demand backlog. The Ford engines are defective, he said, and it's across the country. All the departments in the area are having problems. An Archuleta County ambulance also broke down after Christmas while transporting a patient, he said. "Everyone is switching to Dodge, so they are hard to get."
The board approved spending up to $145,000 for a demo ambulance on a Dodge chassis in the Denver area, contingent on a state EMS grant for $70,000. That unit could be in service in 10 to 14 days.
But Evans later said the state grant wasn't approved, leaving the district to lease an ambulance for the 90 to 120 days it will take to find a Dodge chassis and get one of the district's ambulance boxes switched onto it. The state is paying to lease an ambulance from Durango Fire for four months, he said.
Dyar outlined options to the board. "The addition of the Dodge re-chassis in 2015 gave us a single reliable unit," he wrote. The ambulances on Ford chassis "have cost the district in excess of $100,000 and there has been no resolution offered by Ford. Crews feel that the operation of the Dodge has been exemplary with no mechanical issues."
The second option Dyar listed was the one the district is now pursuing, although Evans clarified that this will be to get a third Dodge chassis and move an ambulance box onto it. Dyar said it will cost the district $30,000 (Evans estimated $35,000) if the district can get another $30,000 from a state EMS grant.
Option three would be to cannibalize the Ford engines to get one running, which would take a few days. But Dyar said, "Due to reliability issues with the existing Ford engines, this may not be a good option." Evans said their mechanic took apart one of the Ford engines. It has about 59,000 miles on it and is totally gummed up with crud.
Upper Pine has $70,000 in the 2016 budget to move one ambulance onto a Dodge chassis this year, and $70,000 for a type 6 brush truck for wildland fires.
Board member Mack Coker asked by phone link about using the other $70,000 for an ambulance if needed.
Evans said that was a good option. "It's 80 percent of our business. It's the mission-critical vehicle right now."
But the district makes money by providing equipment and personnel to fight wildland fires, so now the board has to decide which option is more important.
Coker observed, "In the past, we've excused ourselves from long range transport, which is the money maker, because we don't have enough units."
Evans added, "We've turned down at least five long distance transports and a wildland ambulance which is high reimbursement, because of lack of vehicles." The district makes money on sending vehicles and crews to non-local wildfires.
Jim Applegate from Durango Fire was at the meeting. He said, "We were in the same boat as you with the Ford diesels that were extremely unreliable. Ford wasn't willing to work with us. We had one break down with a patient. ... The Fords were costing me a lot of money. The reliability meant tons to me." Since 2009, Durango Fire has moved to Dodge chassis. They have needed repairs a couple times, he said. "There have been issues. There always are. But they haven't been extreme."
Upper Pine began ambulance transport in 2006. Before that, Upper Pine ambulance crews would arrive and stabilize the patient, then they would wait for an ambulance from Durango to do the actual transport.
