A new ambulance contract is needed for Washington County and it may change the services provided. At Tuesday’s Washington County Board of Supervisors meeting a new request for proposal for services was presented. The current contract with Washington County Ambulance comes to an end with the fiscal year. Currently, WCA has two ambulances fully staffed at all times and then calls in additional crews when there is an increase in call volume. The new RFP proposes having three fully-staffed ambulances at all times with a fourth on standby.

Paramedic Andre Ruby explained it will be tough to fully staff with a shortage of paramedics across the state, “Increasing your service by six personnel when you’re looking at shortage of 600 paramedics throughout the state of Iowa and only graduating a maximum of 98 paramedics, that is a huge expectation for a smaller service to be able to recruit from that number of paramedics.” Having a third ambulance crew would also increase the costs for the services.

The RFP document was created with supervisors, ECICOG representatives, and staff from Washington County Hospital and Clinics. The current provider was not included so as to avoid bias. Supervisor Jack Seward said if it is too costly the board could negotiate other terms for the contract, “We are not bound to take any of the contract proposals that come in. And whatever one we think is best we can always negotiate for what is best for the county.” The county does subsidize the current ambulance service.

There was a request to make 911 calls a priority over interfacility transports regardless of patient acuity. There was no discussion of triage, or taking into consideration the level of care needed for each patient, whether that person called 911 or walked into a local care facility for help.

The board approved the RFP document with four votes in favor and Richard Young abstaining, since he is also the director of the Washington County Ambulance. In Iowa, ambulance service is not considered an essential service and is not required. In 2018 in Washington County there were 1,844 transport calls and 377 no transport calls.