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PRESS RELEASE - SEPTEMBER 26, 2018 | Published in the Delta County Independent

Each September, North Fork Ambulance has conducted an annual membership drive to ask residents and businesses to become members, but that will not take place this year. If you are a member, you will receive a renewal letter in the mail.

At this time NFA will not be conducting a membership drive to attract new members this fall. This is because two funding questions for North Fork Ambulance will be on the ballot in November and NFA board members are hopeful both measures will pass. 

Voters will be asked to approve two questions; 7E asks for the formation of a Special District and establishes the initial Board of Directors. 7F asks for funding of the District. The formation and funding of a special district will provide the core financial support needed to maintain quality ambulance service in three communities, upgrade and replace aging equipment and ambulances and retain and attract on-call staff members and provide them with quality EMS training.

If the district is formed, North Fork Ambulance will prorate memberships and refunds will be offered when the district starts providing ambulance service. 

In the event that the special district does not pass, memberships and ambulance benefits will remain in place for 365 days from when it was paid. Membership Drive would also take place immediately. 

North Fork Ambulance has never received public funding, but has been funded by membership, grants, donations and fees for service. Calls for service have increased 22 percent over the past 10 years. Insurance industry standard caps by Medicare and private insurance cause write-offs of 50 percent of what is billed. The Colorado Medicaid program pays 12 cents on the dollar resulting in an 88 percent write off. The number of people who have been accepted by Medicaid in Delta County has increased from 1,172 in September 2013, to 10,221 by the end of 2016. The agency is also struggling with the rising cost of EMS equipment, vehicles, training and supplies. Only one out of three residents are currently members and while this reflects great support and community participation, these few cannot continue to carry 100 percent of the system!

North Fork Ambulance board members have been researching options for financial sustainability since 2015. Through financial analysis, it is clear that for this service to continue and have the flexibility to meet the needs of the future, the current financial structure must evolve. It has been determined the best solution is the formation of a special district to sustain quality ambulance service now and into the future. 



Q - Why is the North Fork Ambulance forming a Special District? Is it really important? 

A - Forming a special District is a proactive step to ensure everyone in the valley has a financially stable and sustainable ambulance service that can serve people with professionalism and compassion. Financial responsibility for this service would be shared by the residents and taxpayers who have a perpetual interest in the health and well-being of all people in the North Fork valley. 

Q - What are the benefits of a Special District to me as a resident?

A - There are many benefits to our residents. These include:

- Response times as quick as possible.

- High levels of responder training.

- Quality ambulance service is maintained without interruption

- Equipment and vehicle replacement plans are in place

- Ambulance stations can be improved and infrastructure upgraded

- On-Call staff is retained and new members are attracted.

Q - What will the funding of a Special District Cost me as a Property Owner?

A - The annual cost will be about $41 per $100,000 of residential property value. 

Ex - If your home is worth $200,000, you will pay $82 per year or roughly $6.83 per month.

Q - Wasn't a mill levy increase just passed for EMS last fall?

A - Delta County Ambulance District (DCAD) who serves Delta, Cedaredge and Orchard City held a special election and the residents in their service area passed a mill-levy increase to maintain and improve emergency ambulance service in that area. NONE of that funding applies to EMS in the North Fork Valley though. 

Everywhere east of Payne Siding Rd to the top of McClure Pass, and to Mile Marker 56 on Hwy 92 on Black Mesa is in the North Fork Ambulance service area and is not funded by tax dollars currently. 

Q - Isn't the North Fork Valley covered by Delta County Ambulance District (DCAD)? 

A- NO - DCAD was formed in the 1990s as a Special District to serve Delta, Orchard City and Cedaredge. DCAD has supported the North Fork Ambulance in the past with Advanced Life Support (ALS) intercepts and still does ocasionally. Delta, Cedaredge and Orchard City residents and businesses pay property taxes that support DCAD. 

Q- Doesn't it make sense to consolidate ambulance services in Delta County?

A - There are significant differences in the two areas served. First, there is quite a difference in the size of the areas served, with the North Fork Ambulance responding to a large, rural area of over 1,500 square miles, in three counties.  Another significant difference is population density. Because the North Fork Valley has a relatively low population density for their large service area, we have a relatively low call volume. 

Considering this low call volume, in a large service area, North Fork Ambulance is able to keep their response time to emergencies as quick as possible by maintaining on-call people in each community ready to respond when a call comes in for their area. The on-call system keeps three (3) crews ready to respond without tying up a lot of money in wages. 

As a separate district, North Fork Ambulance's Special District revenues will stay in the North Fork Valley. The steadfast dedication to provide for our own people in the North Fork Valley is strong!

Q: Why will North Fork Ambulance be asking voters for public funding?

A: North Fork Ambulance’s current membership funding structure is not viable long-term. Only 34% of the valley residents are currently members of the voluntary payment program. Although membership revenue has been growing, costs for equipment, supplies, on-call labor, insurance, as well as Medicare and Medicaid reimbursement rates, have been growing faster.

Over the ten years from 2007 to 2017, billing income increased by only half the rate of expense growth. Membership revenue in no longer able to cover this ever-widening financial gap. Public funding would distribute the cost of ambulance service, rather than placing the responsibility on the 34% who volunteer to support the ambulance service for the benefit of all.

How will money be spent?

A: Tax revenue will enable the new district to:

- Close the current financial gap between revenue and expenses.

- Continue to maintain the fastest response time possible by retaining and recruiting on-call crew members.

- Support our Advance Life Support training and response.

- Replace/upgrade EMS equipment and ambulances as needed. (The oldest vehicle currently in the fleet is a 1996 ambulance with almost 150,000 miles.)

- Set aside funds to upgrade Paonia and Crawford facilities over time.


Q: Will there be an interruption in ambulance services if a District is formed?

A: No. The North Fork Ambulance will make the transition with no perceivable difference in service. The ambulances will keep responding to 911 calls as if nothing changed.

Q: Isn’t the ambulance service in the North Fork funded by the County or taxes, just like local law enforcement and the volunteer fire departments?

A: North Fork Ambulance has never received public funding. Instead it has been a grassroots effort, built by the community, funded through Membership fees, grants, donations and fees for ambulance transport for the past 49 years.

Q: Why don't the fire departments provide EMS services in Delta County?

A: All five Fire Districts in Delta County are strictly volunteer and are not adequately funded, staffed or equipped to provide ambulance service.

Q: What happens if the Special District doesn’t pass? What should I expect?

A: This is a great question and while we expect the Special District ballot measure will pass, it's always ideal to have a backup plan. If the voters do not approve the Special District the North Fork Ambulance Board is prepared to kick-off a Membership Drive once again and will take the steps needed to go to the voters in the fall of 2019 and beyond if necessary.


Q: How large is the North Fork service area?

A: The service area includes 1,550 square miles, with 75 miles of paved two-lane highway and over 300 miles of county road ranging from paved to primitive. The service from Hotchkiss extends west on Highway 92 to Payne Siding, encompasses part of Redlands Mesa and continues east on Highway 133 to Paonia. From Paonia, the service area continues north up Stephen’s Gulch to the Mesa County Line and northeast of Paonia on Highway 133 into Gunnison County through Somerset to the top of McClure Pass. The service area also extends southeast from Hotchkiss on Highway 92 through Crawford and into Montrose County and runs to Mile Marker 56 at the Gunnison County Line on Black Mesa.

Q: How many calls for service does North Fork Ambulance receive each year?

A: In 2017, there were 774 calls for service, with 522 of those transporting to Delta County Memorial Hospital and seven to St. Marys Hospital via Careflight. Of the remaining calls, those without transport, the vast majority were for lift assists and some were due to standbys and canceled calls.

Q: In regards to level of service provided, how does North Fork Ambulance compare with similar agencies in Colorado?

A: 80% of rural Colorado EMS agencies (those responding to less than 1,000 calls per year), provide service at a Basic Life Support level, just like North Fork Ambulance. The advantage to our service and to our patients is the recent addition of Advanced Life Support providers responding in the Quick Response Vehicles. These providers are able to assess patients and bring a higher level of care to emergencies immediately.


Q: What is an on-call labor model and why is it important?

A: An on-call labor model is an efficient and cost effective method when staffing three stations, 24/7/365, in a rural area such as the North Fork valley with a relatively low call volume. On-call crew members voluntarily sign up for shifts and carry a pager to be called into service. The On- call crew member may use their on-call time for their own purposes and also receive a small stipend in appreciation of their time spent “being ready to be called into service”. An on-call labor model saves money, as compared to a full-time employee model where the cost to the employer includes 25%-40% above their wages/salary for the cost of payroll taxes, paid time off, health insurance and retirement benefits, as well as increased overhead costs, ie. crew quarters for overnight accommodations in each station, etc.

Q: Can the North Fork Ambulance continue to operate with volunteers?

A: Yes. There are people willing to be trained as emergency medical care providers because they want to be confident in the face of a medical emergency, whether it is a family member or a complete stranger. Initial education and the continuing education is an attraction for many crew members. The On-Call pay of up to $6 per hour is an incentive as well. Some people are just interested in giving back to their community. As long as there are these people, North Fork Ambulance will continue to thrive and be able to cover all of the on-call hours in three stations.

Q: Are volunteer EMS providers equal in training to those in an EMS profession?

A: Yes, all our EMS certified care providers receive the same education and are held to the same standards for re-certification in the State of Colorado as those providing care for a paid agency. There are many opportunities for continuing education through North Fork Ambulance as well as access to local hospitals and other EMS agencies to gain additional hands-on experience.

Q: Why are there seven people on-call every day in the North Fork valley?

A: Our ambulances are stationed in Paonia, Hotckiss and Crawford in order to serve the communities quickly and efficiently. There are two crew members on call in each community, requiring six people total. The 7th crew member is an Advance Life Support provider and responds to all calls in the North Fork valley in a Quick Response Vehicle to render advance care if the patient’s condition requires it.

Q: How is North Fork Ambulance able to maintain the best response times possible?

A: We have on-call crew members who are carry pagers and are ready to respond from three stations that are centrally located in each of the communities.

501(c)(3) NON-PROFIT

Q: I am a Member of North Fork Ambulance. What will happen to my Membership?

A: As of the transition date, your Membership fee will be pro-rated and returned. Benefits of Membership will cease as of the transition date.

Q: Will North Fork Ambulance Association cease to exist if a Special District is formed?

A: No. This organization is a non-profit, public charity and will continue to operate for the benefit of ambulance service in the North Fork valley, for example, to facilitate EMS training, support equipment purchases and help maintain facilities.  Many of the same board members will serve as Board Members for both the Special District and the 501(c)(3) non-profit. 

Q: Is the North Fork Ambulance Association out of money?

A: No. Financial reserves are still in place and being carefully managed. The community and North Fork Ambulance Members built these savings over the last 49 years. Thanks to the conservative stewardship of past boards, these funds are available to bridge the gap we are currently experiencing. The reserve funds are still there, being used as necessary and it is clear these funds will not last forever. For this reason the Board is making proactive moves toward sustainable funding to ensure the ambulance is here for the community now and into the future.

Q: Why did the North Fork Ambulance purchase a building in Hotchkiss?

A: The board voted unanimously to purchase the property at 110 E. Hotchkiss Avenue for the following reasons:

• To offer a training and education facility for the ambulance crews and also for public health and wellness classes to benefit the entire community.

• Much needed office space, and room to grow.

• Overnight dorm rooms will increase the pool of on-call crew members.

• With the combination of this building and the long-term lease for ambulance bays at the Hotchkiss Fire Station there is no immediate need to build an ambulance station in Hotchkiss. This building and the ambulance bays at HFD will serve the community for many years to come. This purchase was a unique opportunity and a financially responsible decision looking into the future. 


110 E Hotchkiss Avenue
PO Box 127                   
Hotchkiss, CO 81419


Email: office@northforkambulance.com 
Phone: +1 (970) 872-4303