Mid-Columbia Fire & Rescue to discontinue patient transfers; Adventist Health Columbia Gorge says 'situation difficult’

Adventist Health Columbia Gorge has asked the fire board to reconsider.

MCFR officials said they told the hospital of their decision on April 25, but emphasized they only intend to stop service once the hospital finds a replacement service to minimize “any disruption to the patients and the healthcare system,” it said.

Adventist Health Columbia Gorge Community Board Member Michele Spatz was one of several AHCG representatives to speak at a June 17 fire board meeting asking for reconsideration.

“As a hospital community board member, I understand the critical decisions and budget constraints,” Spatz said. “Yet we always weigh our decisions on what is best for our patients and communities we serve. I would respectfully ask the MCFR administration and board to do the same.”

She shared a story about driving her mother-in-law to a Portland hospital from The Dalles after a traumatic fall because there wasn’t an ambulance available.

“I’ll never forget my husband, who drove so carefully and cautiously as he possibly could down I-84 with our most precious, precious cargo — his mom — lying unconscious in the back seat,” she said.

Once they arrived at the hospital, the attending emergency room physician said her mother-in-law was lucky to be alive.

“Having lived this experience, I cannot understand why MCFR would choose to put us local citizens in that situation by dropping ambulance transport services for patients who desperately need a higher level of care without a workable replacement or service plan in place.”

Dr. Luke Webb, Adventist Health Columbia Gorge emergency physician, addressed MCFR’s concern that transferring patients takes resources away from the community. “This is looking at the patients who require transfer, have already actively demonstrated a need for EMS services by way of their illness, and to abstain from participating is a disservice to the community,” he said. “This allows for the condition of people who are sick to potentially worsen.”

He added that there have been times MCFR has questioned the need for transfers and suggested contacting Life Flight instead.

Webb said Life Flight is meant only for the transfer of patients with critical issues. “It is not reasonable to ask Life Flight to bear the burden of providing transportation for the majority of our patients who require care at another facility,” he said. “Life Flight has its own specialist purpose.”

Dr. Jeff Mathison, trauma medical director at AHCG and previously with Mid-Columbia Medical Center, said, “When I learned of the proposal for MCFR to limit the scope of their transportation services to our community I was concerned that this decision would make it even more difficult to care for our patients in the post-pandemic era.”

He then shared a story of a toddler who needed to be transferred to Portland for further care, and how the child’s parents felt comforted and supported by the MCFR team who transferred them. “[The mother] stated that if she and her husband would have been required to race down the Gorge with their child to the hospital, they would have been happy to do that … but that would have been the most anxious trip of her life. And instead, they had familiar professionals from their own community who were willing to join them in the sole purpose to ensure their child receive the best care possible.”

He added, “I respectfully call on all of you to ensure that a reasonable alternative is identified and put into place prior to withdrawal of the current services. A lapse in medical transportation services benefits no one and will define whether our local leadership truly understands our community’s needs.”

Patients are transferred to other hospitals “usually for a higher level of care, specific procedures, low staffing at the hospital or imaging equipment issues at the local hospital,” said a MCFR press release.

MCFR Assistant Fire Chief David Jensen said via email to Columbia Gorge News that the hospital had several options: Operate its own ambulance; contract with a regional service or consortium to assist area hospitals with similar transfer needs; contract with another governmental transfer ambulance provider; or contract with a private ambulance provider.

“We are aware all these options would have very different time needs, and we are willing to work with AHCG to make this a smooth transition,” he said.

Adventist Health Columbia Gorge issued a statement to Columbia Gorge News June 19 that spoke to the challenges of finding an alternative solution: “While we explore alternative solutions for these interfacility transfers, including partnerships with EMS providers from larger metropolitan areas, it is important to note the logistical and economic challenges involved. With an average of 35 transfers per month, establishing a new ambulance service in The Dalles may not be feasible from a cost perspective.”

The statement said that in 2023, AHCG had more than 13,000 emergency room visits, more than 1,700 admissions, and handled 468 transfers, some conducted by Life Flight. Only 12 of those transfers were due to staffing or equipment issues, “highlighting the critical need for timely and efficient transport to ensure positive medical outcomes.”

“Our focus remains on the care of our community and the collaborative relationship with all of our healthcare partners to ensure that our patients get the care they need where they need it,” said Jayme Thompson-Mason, patient care executive at Adventist Health Columbia Gorge, via the statement.

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This is a continuing story. Updates will be posted online at columbiagorgenews.com and in print as information becomes available.