In November, Dove Creek and western Dolores County will try to resolve a conundrum created by the special election in 2015 that approved formation of the Dove Creek Ambulance District.
The purpose of creating this district was to improve emergency medical and ambulance services in the western part of the county through more-reliable funding and governance. But the vote was separated into two parts: in the first referendum, voters could approve the formation of the district. The second referendum sought a mill levy of 2.75 mills to fund the newly formed district.
Residents of Dove Creek and western Dolores County will be voting on a ballot question to fund their ambulance district through a mill levy. Photo by Carolyn Dunmire.
As expected in this fiscally conservative part of the state, voters supported the formation of the ambulance district but did not approve the funding. Since then, the ambulance district has been operating in limbo with a mix of part-time and volunteer staff that is not sufficient to provide 24/7 ambulance coverage. The problem may have been best
summed up by Deanne Knuckles at the Dolores County Commission meeting on April 4. She said people told her that they voted against the mill levy because they believe that Dove Creek will always have an ambulance. That has proven to be true. However, without personnel to ride in it, it’s the same as not having ambulance service.
With an average of three calls per week, the Dove Creek Ambulance District has been struggling to provide adequate emergency-response staffing as they transition from a volunteers to paid staff. The ambulance district has placed another mill-levy proposal on the November ballot that they hope will resolve the current staffing crisis. The question facing voters is determining how much ambulance service is appropriate for Dove Creek and how to support this service – with tax dollars or volunteer hours.
Changing times
“The days of the all-volunteer ambulance service are over,” declared Dove Creek Volunteer Ambulance Service board president Joyce Barnett during an interview. She says the reality of local residents having to work out of town, the cost and time needed to keep up the training required to be an emergency medical technician (EMT), and demographics are all playing against staffing the Dove Creek ambulance with volunteers.
These same factors are creating staffing crises in many other rural communities. With longer commutes and work weeks, many of the folks who would regularly volunteer for the ambulance, fire department, or library board are away from home during the week when they are needed. And they are unwilling to give up their precious weekends to community service.
The high-tech revolution and the risk of litigation risk have both made it difficult for “regular” folks to volunteer for emergency services. Hundreds of hours of training must be completed to learn how to properly use all the life-saving devices included in a modern ambulance, to say nothing of the protocols and communication knowledge required to participate effectively in an emergency medical response system with other responders and medical professionals.
Finally, the aging of local communities is becoming more evident with each passing day. The population of Dove Creek, like Montezuma County and the state of Colorado, is becoming older, which means residents are more likely to be on the receiving end of emergency services than in the provider position. Barnett herself is a perfect example. As she explained in a letter to the editor in the Dove Creek Press on Sept. 8, Barnett is shifting her role in the community. “I have never regretted my choice to become a paramedic and if this old woman could still do the things my mind says I could, I would still be riding [in the ambulance] but there comes a time when you have to be realistic and take care of the health you have and not be crippled and a burden to family and friends. I am still trying to take care of this community by trying to find a way to keep well-trained people ready when you call that emergency line.”
‘Unacceptably slow’
The Dove Creek Volunteer Ambulance Service (DCVAS) started in 1952. The ambulance was staffed by people who lived and worked locally, in a time when community service was an important part of professional life. Dove Creek residents who had medical training volunteered to help with the ambulance service.
Over time, the Dove Creek community invested in training for citizens who expressed interest in participating in the ambulance service. Today, residents in Dove Creek have three additional options for emergency medical response: from the Pleasant View Fire Protection District (approximately 15 miles from Dove Creek), Southwest Memorial Hospital ambulance (35 miles away), and the San Juan Hospital ambulance in Monticello, Utah (25 miles distant).
The ambulance staffing situation became acute this spring when several key volunteers and employees were not available for ambulance runs. Dolores County Sheriff Jerry Martin explained the problem to the Dolores County commissioners at their April 4 meeting. He said, “when the dispatcher spends 30 minutes looking for personnel to ride Dove Creek’s ambulance and eventually has to call the Cortez ambulance, that is an unacceptably slow response time.”
Furthermore, the lack of ambulance staffing is taxing other county services. Martin described a situation when an emergency call came in the middle of the night and Monticello’s ambulance would only respond within the town limits of Dove Creek. Martin had to find the patient a ride into Dove Creek so that they could get picked up by Monticello’s ambulance.
This crisis highlighted the fundamental problem for the Dove Creek ambulance – lack of trained staff to respond to emergency medical calls. Several solutions have been proposed:
- Fund the newly formed ambulance district to a level that will allow for sufficient paid staff. It is estimated that 24/7 staffing would cost at least $150,000 per year depending on how over-time and on-call hours are paid.
- Continue to work with a mix of paid staff and volunteers. The DCVAS administrator is currently being paid to be on-call 48 hours per week. In addition, Dolores County offered the services of their director of emergency services to be available on-call on a volunteer basis when he is working, usually 8 a.m. to 5 p.m. Monday through Friday. This leaves a gap of evenings and weekends to be filled by volunteers.
- Train new volunteers. The latest EMT class started promisingly with 19 students, but will only graduate six. The cost of the class was subsidized by the county, Pueblo Community College, and the Dove Creek Fire Protection District. Despite the reduced cost, it is likely that the barrier to completion was students’ time commitment with 178 hours of class time and additional time required for practice and testing.
- Transfer ambulance-service provider from Dove Creek to the San Juan or Southwest Memorial Hospital ambulance and potentially increase response times. This option would potentially increase response times and move governance of the ambulance service from a local non-profit board to an outside provider.
Gauging support
To gauge interest and support for the ambulance district, the DCVAS board conducted a survey over the Fourth of July and published the results in the Dove Creek Press on Sept. 8. Of the 106 responses, 105 responded positively to the need for a local ambulance in Dolores County/Dove Creek and 95 of the respondents said they believe that ambulance personnel should be paid. More than 3 out of 4 of the respondents believed there was not adequate funding for “our community ambulance” and provided funding ideas such as taxes, a mill levy, grants, fundraisers, nursing home profits, taxes from marijuana sales, auctions, bake sales, yard sales, and funding from the county, town, banks, or military.
Financial support for the ambulance district is currently provided by Dolores County, the Dove Creek Fire Protection District, the Town of Dove Creek, the Dove Creek Community Health Clinic, grants, service reimbursements, and a $100 ambulance card – paid voluntarily by households within the district. Only a portion of this funding can be used to pay staff. For example, in August 2015, Air Products, the operator of the new helium plant southeast of Dove Creek, donated $90,000 to the DCVAS to pay for half of a new ambulance. The DCVAS board is holding this money in a savings account until they can find matching grant funding for the ambulance purchase. None of this generous donation can be used for staffing the ambulance today.
The ambulance-funding situation is especially interesting for residents in Cahone s who live inside the Pleasant View Fire Protection District boundary. Property owners currently pay a mill levy to this district for fire and emergency medical response services. This amounts to about $80 each year.
Jeff Yoder, chief of the Pleasant View Fire Department, said they have an ambulance that would respond to a 911 call at my house and a volunteer staff that includes a paramedic and several EMTs. According to Yoder, in situations that are not life-threatening, they prefer not to transport patients to the hospital, but would contact Southwest Memorial Hospital or Dove Creek ambulance to provide these transport services. When they do provide transport services, he noted, they cannot transport patients to Utah, although they sometimes they meet the ambulance halfway to shorten transport time.
He enthusiastically supported the Dove Creek ambulance, saying, “We work well with those folks.” He added that they do not hesitate to respond to calls in the surrounding area including Dove Creek and are dedicated to providing the best emergency response possible.
Other services
The funding proposal that will be put before voters in November is a mill levy of 2.5 on property within the Dove Creek Ambulance District. According to the Dolores County Assessor’s Office, the mill levy would cost residents about $20 per year for every $100,000 in property value. The Assessor’s Office estimates that it would raise about $319,289 annually. According to the text of the referendum, the purpose of the new tax is to pay “the district’s administration, operation, and maintenance expenses and other expenses without limitation.”
In a letter to the Dove Creek Press published Aug. 25, Jenni Albin, district treasurer/secretary, said approval of the mill levy would create jobs and keep the “ambulance service in the hands of Dolores County Citizens.”
In other discussions, Barnett mentioned that regular ambulance staffing would allow the district to offer other community services such as free CPR training, wellness events like blood-pressure clinics, in-home elder fall prevention program, and high school EMT courses.
Ultimately, district residents will be voting on how they want to support ambulance service in Dove Creek. The current staffing crisis is unlikely to resolve without additional funding and volunteers. The challenge facing Dove Creek is how to support essential community services at a scale appropriate for smalltown populations.
In the case of the ambulance, residents don’t seem willing to pay for three full-time paramedics to staff the service for three runs a week. However, most community residents want ambulance service. Therefore, they may need to be willing to provide some of their time and expertise in addition to “paying at the office” to make these services feasible.
