Ambulance services pursue consolidation
December 16, 2021
Castle Rock Ambulance Service and Sweetwater Medics are continuing discussions about consolidating ambulance services and looking into the possibility of Castle Rock eventually taking over service for both Green River and Rock Springs.
The discussions started during last week’s Sweetwater County Commissioners meeting, when the group approved their contract with Sweetwater Medics and approved an additional $235,000, which Sweetwater Medics Director Ron Gatti said was necessary to continue service.
Castle Rock Director Bailie Dockter and CFO Todd Toolson spoke at the meeting, expressing unhappiness with the situation. The commissioners asked if Castle Rock was interested in taking over ambulance service in Rock Springs. By the end of the meeting, Gatti and Dokter had committed to discussing options for the future of ambulance service in the county.
Discussions have continued since then. Last Tuesday evening after the commission meeting, the Castle Rock Board of Directors had their meeting and discussed Castle Rock’s interest in taking over ambulance services. Last Wednesday the ambulance committee consisting of Commissioner Jeff Smith, Green River City Councilwoman Sherry Bushman and Rock Springs City Councilman Tim Robinson met to discuss the recent developments. Updates were given and discussion continued during Monday’s Intergovernmental Joint Leadership Meeting.
During the intergovernmental meeting, Dockter confirmed she and Gatti have been working together over the past week and are looking into what it would take for Castle Rock to take over service in Rock Springs as well. Smith said he, Dockter and Toolson also met with a consultant from Safe Tech who gave advice on how to move forward and who will continue to work with Castle Rock through the transition.
The next step is for the Castle Rock Board of Trustees to put together a proposal for the county commission explaining what they need, according to Smith. Dockter said Castle Rock hopes to have that proposal to the commissioners by the end of the month.
While progress is being made quickly, Dockter admitted the timeframe for making the transition could be longer than she initially estimated.
“I think we were pretty aggressive on Tuesday with our timeline as far as how long it might take to complete the acquisition,” Dockter said, noting she had told the commissioners 60 days during the meeting. “It’s probably looking more realistically like six months, and again, that’s because we want to make sure that we do everything right from the start.”
During the intergovernmental meeting, questions came up about what consolidating services would mean for Green River and Rock Springs. From 1
“I think it’s a great plan to have a single service county-wide, but, you know, there’s a lot of little details yet to be ironed out,” Robinson said.
Questions about the level of care residents would receive in the future were answered with reassurances from Dockter, who explained Castle Rock is an Advanced Life Support provider with trained paramedics. Wendling also expressed his feeling that the commissioners wouldn’t support the consolidation if services couldn’t continue at the same level of quality as before.
“We all have been saying for a while that we wanted to find a solution, and I think we are working toward that,” Commissioner Roy Lloyd said at the end of the meeting.
Finding solutions to sustaining Sweetwater County’s ambulance service long-term has been an ongoing discussion over the past several years. Smith, who is a member of ambulance committees both in Sweetwater County and for the state of Wyoming, has been heavily involved in those discussions.
“There’s really two parts of this equation,” Smith explained.
He said the two considerations came from two Safe Tech surveys commissioned in 2015 and 2019 that gave feedback on how to improve ambulance services in Sweetwater County.
“Those two both said consolidation — there’s not nearly enough work here or revenue here to support two services, so consolidate them. And then the second thing was finding a steady stream of funding. So those have been my two goals,” Smith said. “So this accomplishes one, which is the consolidation, which should reduce costs overall. So that’s step one.”
While consolidation of services has been considered in the past, several factors kept it from moving forward. Smith explained the last time Castle Rock approached the commissioners with a proposal for taking over ambulance services in Rock Springs, it couldn’t move forward because Sweetwater Medics was in the middle of negotiations for the University of Utah AirMed to purchase their company, and the commission couldn’t tell Medics, a private company, what to do.
Waiting on AirMed for an answer took several months, and ultimately they ended up not taking over Sweetwater Medics. During the period of waiting, Smith said the lack of communication caused Castle Rock to lose trust in the commissioners.
After that, Castle Rock said they weren’t interested in taking over ambulance service in Rock Springs, until last week.
Now that the commissioners and Castle Rock are rebuilding trust, they can go forward with discussions of what to expect, according to Smith. One topic currently being discussed is the length of a contract between Castle Rock and the county commissioners. Smith described the need to find a “sweet spot” in the contract length, wanting it to be long enough to provide stability and insight while not being so long it can’t be flexible with changing circumstances.
Other discussions are business negotiations between Castle Rock and Sweetwater Medics, Smith said, such as staffing, payroll and equipment considerations. Smith said Dockter has been clear she wants to assure Sweetwater Medics staff members they are “welcome and needed” during the transition and would have jobs with Castle Rock.
The second part of the ambulance equation is funding, which continues to need solutions. Smith explained he asked Castle Rock to include information in their proposal to the commissioners about how much the ambulance service would cost without any money from the hospital district mill levy. Smith knows some Green River residents are wondering why their tax dollars would go toward subsidizing Rock Springs services. But Smith explained the mill levy is for the hospital district, and ambulance services are not required to be a part of the district, so the mill levy doesn’t necessarily have to fund it. Smith asked Castle Rock to include in their proposal to the commission the amount ambulance services cost on their own, so the amount can be taken into consideration without necessarily bringing in the mill levy.
While there is still work to be done, Smith is optimistic about the progress being made. He believes the consolidation will help provide at least a 3-5 year solution while other long-term solutions are considered.
When it comes to how this solution will affect the citizens of Green River, City Government Affairs and Grants Manager Ryan Rust is also optimistic about the consolidation being beneficial.
“We were happy to see that Castle Rock, Sweetwater Medics, and the County Commission got together and were able to move forward with a plan,” Rust wrote in an email to the Green River Star. “We are confident that with the support and cooperation of all entities involved, Castle Rock can provide quality efficient ambulance service to the residents currently served by Sweetwater Medics, without impacting the quality services provided in Green River.”
When it comes to funding, Rust recognized the mill levy being a factor, and the need for long-term solutions.
“With monthly revenues continuing to come in significantly below the average over the last 15 years, along with the increasing costs we are facing at multiple levels in our operations and services, taking on any additional funding responsibilities will come with difficult decisions,” Rust wrote.
However, he also recognized the consolidation of services is a step in the right direction, saying “We recognize that studies have shown one ambulance service provider for both communities creates greater efficiencies and comes at a lower cost for the residents of the county as a whole, and we are committed to continued discussions on how a variety of services provided in the County can be done more efficiently.”