District cites more than three years of unsuccessful countywide planning, financial sustainability, and lack of coordinated solutions; emphasizes ambulance transportation services would continue when resources are available. 

SALT CREEK, OREGON – Southwestern Polk County Rural Fire Protection District (SW Polk Fire District) is considering withdrawing as an assigned ambulance service provider under the Polk County Ambulance Service Area (ASA) Plan due to ongoing concerns regarding the financial sustainability of the County's ambulance service delivery model.  

The potential decision follows more than three years of unsuccessful efforts to establish an updated, coordinated, and financially sustainable countywide ambulance service system. 

Importantly, withdrawing as an assigned ASA provider would not mean SW Polk Fire District intends to eliminate ambulance transportation services. The District will continue operating ambulance resources and providing emergency medical transportation when personnel and equipment are available, consistent with applicable regulations and coordination with the responsible ASA provider. 

The distinction is significant. withdrawing as an assigned ASA provider would end the District's responsibility to maintain designated ambulance coverage for that specific service area, while allowing SW Polk to continue providing ambulance transportation and emergency medical assistance as an available regional resource. 

Under the County's ASA Plan, ambulance providers may discontinue service as an assigned provider by providing the Polk County Board of Commissioners with at least six months' written notice. Although the District has not made a final decision to withdraw its ASA assignment, District leadership is evaluating whether continued participation under the existing structure is financially responsible or sustainable. 

"This is not a direction we want to take, but it is one we must seriously consider," said Fire Chief Fred Hertel. "For more than three years, we have worked with the Polk County Commissioners, provided operational data, identified financial concerns, and proposed solutions. Unfortunately, the fundamental problems remain unresolved, and our taxpayers cannot be expected to indefinitely subsidize an ambulance system that was not designed to be financially sustainable, as required within the County's own ASA Plan." 

Three Years of Planning Without a Sustainable Solution 

Polk County has spent more than three years working toward an updated Ambulance Service Area Plan. During that process, the County spent more than $50,000 on professional consultants to evaluate the existing ambulance delivery system and provide recommendations for improvements. 

Despite that investment, the County has not completed and implemented an updated ASA Plan, and significant recommendations from the consulting process have not been incorporated into the existing service model. 

Throughout the process, SW Polk Fire District repeatedly notified the County Commissioners that the ambulance service area assigned to the District did not generate sufficient call volume or revenue to financially support the resources necessary to maintain ambulance service. 

Those warnings have now become a financial reality. 

"The County invested substantial taxpayer dollars in professional consultation to help develop a better ambulance system," Hertel said. "Unfortunately, the resulting decisions did not adequately address the recommendations or the financial realities facing ambulance providers. We repeatedly warned that the area assigned to SW Polk could not support a sustainable ambulance operation. More than three years later, we are still dealing with the same problem." 

The Numbers Demonstrate the Problem 

SW Polk Fire District's historical ambulance response data illustrates the imbalance within the existing system: 

These figures demonstrate that the majority of SW Polk Fire District's ambulance responses occur outside the Ambulance Service Area assigned to the District by Polk County. 

Maintaining ambulance readiness requires substantial ongoing investment in personnel, equipment, vehicles, facilities, training, medical oversight, and supplies, regardless of the number of emergency calls received. 

"We are being asked to maintain an ambulance service with an assigned service area that generates approximately twelve calls per month," Hertel explained. "Meanwhile, we routinely provide ambulance services to neighboring jurisdictions when their resources are unavailable. That is not an efficient or financially sustainable way to operate a regional emergency medical system." 

SW Polk Has Worked to Preserve Ambulance Service 

Rather than discontinuing ambulance transportation services, SW Polk Fire District has spent several years pursuing alternatives to maintain its participation in the regional EMS system. 

The District has sought additional grant funding, implemented operational efficiencies, reduced expenditures, deferred equipment and facility investments, adjusted ambulance fees, and developed cost-recovery programs to help offset the expense of providing regional ambulance services. 

SW Polk has also repeatedly advocated for a closest-appropriate-unit response model, which would dispatch the closest available and appropriate ambulance to an emergency regardless of jurisdictional boundaries. 

The District believes such a model would improve patient care, reduce response times, make better use of existing public resources, and create a more equitable distribution of ambulance incidents. 

Historically, when staffed around the clock, SW Polk's Bridgeport Fire Station was strategically positioned to provide ambulance coverage to communities currently assigned to another ambulance provider. District estimates indicate that appropriate utilization of that resource could generate an additional thirty-five ambulance incidents per month. 

"Our citizens should not have to wait for an ambulance to travel from a greater distance when a closer resource is available," Hertel said. "We have consistently advocated for a system that puts patient care first while making responsible use of taxpayer-funded emergency resources." 

Protecting District Taxpayers While Continuing Ambulance Transportation 

The District's consideration of withdrawing from the ASA Plan is intended to protect the long-term financial stability of SW Polk Fire District while preserving its ability to provide ambulance transportation and other essential emergency services. 

SW Polk Fire District is responsible for fire suppression, rescue, emergency medical first response, wildfire response, and other emergency services throughout its jurisdiction. 

The District cannot continue indefinitely to subsidize a regional ambulance delivery model at the expense of those responsibilities. 

Withdrawing as an assigned ASA provider would change the District's designated coverage responsibilities, not eliminate its ambulance capabilities. 

SW Polk intends to retain the ability to respond to emergency medical incidents and transport patients when appropriate personnel, ambulances, and other necessary resources are available. 

This approach would allow the District to continue supporting its citizens and neighboring agencies without carrying the same financial and operational obligations associated with maintaining an assigned Ambulance Service Area. 

"Our first responsibility is to the citizens and taxpayers of SW Polk Fire District," Hertel stated. "We have made significant sacrifices to maintain ambulance service, but there comes a point when continuing to fund an unsustainable system threatens the other essential services our community depends upon. We cannot allow that to happen." 

Hertel emphasized that the District is not seeking to eliminate ambulance services. 

"We are not talking about getting rid of our ambulances or stopping patient transportation," Hertel said. "We are talking about whether it is financially responsible to remain the designated ambulance provider for an area that does not generate sufficient activity to support the cost of maintaining that obligation. We intend to continue providing ambulance transportation when our resources are available, and we are authorized to respond. What we cannot continue doing is absorbing the financial burden of an unsustainable ASA assignment." 

What This Means for Residents 

SW Polk Fire District has not made a final decision to withdraw its Ambulance Service Area assignment, and this announcement does not change current emergency services. 

The District continues to provide ambulance services within its assigned ASA and emergency medical first response throughout its fire protection jurisdiction, consistent with available resources. 

Should the District ultimately decide to withdraw its ASA assignment, the County's ASA Plan requires a minimum of six months' written notice to the Board of Commissioners. 

That notification period would provide Polk County time to designate another ambulance provider responsible for the affected service area and coordinate an orderly transition. 

Following such a transition, SW Polk Fire District intends to continue providing: 

The primary change would be which ambulance provider is formally responsible for ensuring designated ambulance coverage within the affected ASA—not the District's intention to continue providing ambulance transportation when available. 

Residents would continue to receive ambulance services through the County's assigned provider, with SW Polk remaining an additional emergency medical and transportation resource when available and appropriately dispatched or requested. 

Residents should continue calling 911 for all emergencies. 

District Seeks Action Before Withdrawal Becomes Necessary 

SW Polk Fire District remains willing to work with Polk County and neighboring ambulance providers to establish a sustainable alternative. 

Potential solutions include modifying ambulance service area boundaries, implementing a closest-appropriate-unit response model, developing equitable cost-sharing arrangements, or establishing another financially sustainable regional service structure. 

However, the District believes further discussions must produce meaningful action. 

"We have spent more than three years discussing these issues. We have provided the data, identified the problems, and offered solutions," Hertel said. "What we need now is action. We want to remain part of a coordinated ambulance system, but it must be one that is operationally effective, financially sustainable, and fair to the taxpayers supporting it." 

Hertel emphasized that the District's concerns are not a reflection of the dedication or professionalism of neighboring emergency service providers.