Setting a record for its busiest month on record in the history of the department, Grand County Emergency Medical Services reported 146 emergency runs in September.
“I’m surprised that we hit a new record,” said Andy Smith, Grand County Emergency Medical Services (GCEMS) director. “September is always a busy month for us. Last September was our busiest record ever with 141 runs, but to beat it this year with 146 is just September in Moab. It’s getting busier. We’re doing a lot of car accidents, a lot of backcountry, but everything is up — it’s not just one category.”
GCEMS has one station and an average of two ambulance crews on duty to cover multiple call per day across the county’s 3,694-square-mile area.
September’s 146 emergency runs included 50 medical calls in Moab, 37 backcountry trauma calls, 29 inter-facility transfers, 16 motor vehicle accidents and 14 miscellaneous calls.
The GCEMS staff recently posted a picture on social media on Sept. 19 of the empty ambulance bay and wrote, “Never a good sign when the ambulance bay is empty at 8:30 p.m.”
For that one day in particular, EMS crews responded to a fall in the City of Moab, an inter-facility transfer of a patient to St. Mary’s Medical Center in Grand Junction, Colorado, an inter-facility transfer of a patient to the Intermountain Medical Center, and two ambulance calls for a motor vehicle accident on Interstate 70 with two patients in critical condition and a third with serious injuries.
GCEMS Shift Supervisor McKay Vowles said the crash on Interstate-70 was in Emery County’s response area but was paged to Grand County.
“There were three critical patients and Emery County did not have an ambulance to respond,” Vowels said. “So we took everything we could — we took two ambulances and our supervisor out of Moab to respond close to Green River.”
At that time, if something traumatic had happened in Moab, the next closest ambulance would have had to come from 45-minutes away in San Juan County, he said.
“I can’t think of a recent time where we’ve had a traumatic call in Moab where we haven’t been able to respond right away,” Vowles said. “In the future, that’s our biggest fear, is that crews are out on calls and then something happens in Moab and the nearest ambulance is 45 minutes away.”
Also on that same day, GCEMS responded to three incidents at Arches National Park, including a seizure and cardiac arrest in the Devil’s Garden area and a fall on the Delicate Arch Trail.
GCEMS serves Grand County’s population of about 10,000 residents, including the communities of Moab, Castle Valley, Cisco and Spanish Valley, and also Arches National Park. GCEMS also responds to incidents at Canyonlands National Park and Dead Horse Point State Park in San Juan County since GCEMS can respond most quickly to that area.
“The park service will activate an ambulance if it’s something they can’t handle — head injuries, difficulty breathing, heat stroke,” Vowles said. “Some of their rangers are emergency medical technicians, so if it’s a fall with minor scrapes and bruises or something like a broken wrist, they can handle it.”
Vowles said the GCEMS runs to Arches National Park is increasing as the number of visitors increases. An estimated 3 million people visit the park each year.
“They’re getting busier, like Moab,” Vowles said. “A lot of people come from out of state or country at a lower elevation level and are not physically prepared to go on some of those trails.”
The same goes for the trails in the Canyonlands National Park area, Vowles said.
“Probably the most common rescue we go to out there is for Upheaval Dome,” Vowles said. The Upheaval Dome trail area is located within the park’s Island in the Sky District. “It has a lot of foot traffic and is a difficult trail. I think people are unprepared when they go on it.”
But of the 37 backcountry trauma calls GCEMS responded to in September, Vowles said a majority were for mountain biking incidents. Responding to those can range from a minimum time of two hours up to 12 hours, depending on accessibility to the location.
“If they’re on a singletrack mountain biking trail and (crews) can’t land a helicopter, they can be wheeled on a litter,” Vowles said. Vowles described a litter as “a basket on one wheel, with handlebars on either end, that search and rescue uses to carry patients out of the backcountry.”
Sometimes, UTVs or helicopters are used to rescue people in the backcountry. If the patient then needs to be transferred from Moab Regional Hospital to another medical facility for more intensive treatment, a GCEMS crew can spend six or 12 hours making the transfer.
“A lot of those transfers happen at night, and our crews will be up all night on transfers and are supposed to respond the next morning to go, say, hike Porcupine Rim to rescue a mountain biker, so our crews are getting exhausted,” Vowles said.
COUNTY ADDRESSES EMS FUNDING NEEDS
Currently, GCEMS has an average of five to seven staff members working each day, on-call for 48 or 56 hour shifts. In the future, Vowles said the staff members need to work shorter on-call shifts to prevent burnout and said the agency’s biggest need is funding for hiring more staff.
“We try to schedule three ambulances a day, but we don’t have the staffing or the budget for three ambulance crews a day,” Vowles said.
Despite the record-breaking number services being provided by GCEMS, “increased call volume does not always mean increased revenue,” Vowles said.
“Our ambulance collection rate for ambulance billing is around 50 percent,” Vowles said. “People just don’t pay the bills, it goes to collections. There’s a lot of people who don’t have health insurance. It’s very hard to collect from visitors from other states or from different countries.”
On Tuesday, Oct. 2, the Grand County Council voted to approve of $317,000 in funding for GCEMS.
Smith said the funding was requested to off-set the shortfall in medical bill payments and reimbursements for tourism-related runs.
“In 2017, we lost $317,000 from bills to tourists who didn’t pay their medical bills,” Smith said.
Going forward, Smith said GCEMS is asking the county to set aside 10 percent of the Transient Room Tax (TRT) mitigation revenue.
“Ten percent of the estimated mitigation money is about $320,000,” Smith said. “What we lost in revenue from calls that are a direct result of the tourism economy is about $317,000, so that’s why we are asking for 10 percent.”
Vowles said funding for more full time staff members isn’t the only thing the department needs. Aging equipment needs to be replaced and the facilities are “extremely old and worn out,” he said.
“Ambulances are stored in an old metal building that leaks when it rains, the administration offices are in a different location and the staff sleeps in an old, worn-down house in Moab. All three need updating,” Vowles said.
But even without additional funding to hire more employees to staff another ambulance crew, “we still have this increasing 911 response that we have to staff,” Vowles said.
To address the department’s needs, Smith said the Grand County EMS Special Service District was created recently. The county council’s resolution to establish the Grand County EMS Special Service District is dated as having been approved on May 1.
“It’s a specialized board to focus on the needs of the department,” Smith said. “The board is in place now and they take the reigns on January 1.”
Members of the EMS Special Service District are chair person Elizabeth Tubbs, vice chair Jason Taylor, treasurer Rarni Schultz, Moab City Council representative Rani Derasary, Castle Valley representative Ed Weeks, Grand County Council representative Evan Clapper, Bryony Hill, and GCEMS staff members Smith and administrative clerk Michelle Mefret.
“All ambulance services are struggling right now,” Smith said. “We’re very grateful for that funding from the county and we’re very fortunate to be in Moab, but as far as reimbursement goes, we are very low in medical reimbursement and we need the funding support.”
Grand County EMS responds to 146 runs in September
“In the future, that’s our biggest fear, is that crews are out on calls and then something happens in Moab and the nearest ambulance is 45 minutes away.”