A local ambulance service provider says passage of two related measures on the March 3 ballot will improve and expand local ambulance services, while a failure of the measures would be detrimental to local medical response and responders.

Measures D and E, respectively, ask for the formation of Trinity Life Support Community Services District, and a parcel tax to provide Advanced Life Support ambulance services, outreach, training and education in the areas already served by Trinity County Life Support. While it may seem simple on the voting ballot, the story behind the measure is much more complex. Firstly, both need to pass in order to be enacted.

Kathleen Ratliff, manager and paramedic at Trinity County Life Support, detailed the reasoning for the measures in a January release. She said TCLS’s two ambulances respond to an average 1,500 calls per year, over a 1.3 million-acre service area. She said the dedicated, but overworked and underpaid staff have kept the ambulance service alive for years with decreasing resources.

A big ask

If approved, Measure E will assess a special tax of $83 per year for each improved parcel, regardless of use; and $48 per year for each unimproved parcel lying within the district. While it would divide down to be about $7 per month, it will be collected in the same manner as other property taxes, according to county ballot information.

However, that tax will only be authorized if Measure D passes, and the Trinity Life Support Community Services District is formed.

In its initial application to the county’s Local Agency Formation Commission, TCLS noted that “to continue providing ambulance services to the community, the formation of a special district is a critical need for our service area. Many outside influences, minimum wage increase, lack of true cost reimbursements from federal and state health systems, and inability to compete with adjacent ambulance service wages in Shasta County, have led TCLS to make this proposal.”


Ratliff said TCLS’s primary challenge is its large service area and low call volume.

“The cost of readiness exceeds what can be generated in transport revenue,” she said. “Next, Medicare and Medi-Cal reimbursement for service is less that the cost of service provision. These government programs comprise 70 percent of our payers.”

According to Ratliff, the challenges are not new or unique to Trinity County, and the problems are getting worse.

“We are all struggling to preserve services and find the solution to protect patients,” she said. “Health care reform continues, Medicare reform is underway, but the issue of less than true cost reimbursement from Medicare and Medi-Cal is long embedded.”

Ratliff said TCLS has been adopting deficit budgets since 2014 to protect services and management hours were cut in half years ago to protect patient care.

“Crews work a 24-hour shift and are paid for 16 hours unless nighttime calls interrupt the sleep period,” she said. “Crews work three consecutive 24-hour shifts, stressful and fatiguing. The shift structure makes it very difficult to maintain advanced life support staffing.”

She said California’s aggressive schedule of mandatory minimum wage updates, combined with the lack of true cost reimbursement from Medicare and Medical have left TCLS facing devastating deficits.


Partnerships with other agencies to obtain program funding were investigated but determined to expose them to TCLS’ financial liability, she said.

Ratliff said the option of creating a county-run ambulance was discussed and found to be unsustainable. She said the solution came with participation from the county, LAFCO, and EMS service consultants.

“The Trinity County Life Support Board of Directors believes this is the best option to stabilize long-term ambulance operations,” Ratliff said. “If Medicare and Medi-Cal reimbursement for ambulance services improves, if reimbursement programs stabilize and support the staffing levels needed to serve you effectively, would the district reduce the assessment, as the Mountain Communities Healthcare District has been able to do? We can promise diligence and openness.”

Should the measures be approved, an at-large Board of Directors will be elected, consisting of five candidates who have already filed paperwork. They are Scott Alvord, Serena Brown, Todd Corbett, Victor “Gus” Kormeier and Carol Ann Minor.

Ratliff said Tuesday that should the measures fail, it will be uncertain whether TCLS will be able to continue serving the county at its current level.

“We’ve been operating at a deficit for four to five years,” she said. “If we have to reduce service, it will be a heavy load for our volunteer fire departments to carry.”

Ratliff explained that when an Advanced Life Support ambulance call is made in Hayfork, an ALS ambulance has to respond from Weaverville.

“It affects everyone if we are out of position,” she said. “We want to do our best to cover both areas. Our goal is to add medical staff and change the shift structure.” Ratliff said a new shift structure would reduce fatigue for employees from the current shift schedule. Adding a 24-hour pay schedule would also solve the ongoing problems of recruitment and retention and allow TCLS to build up its staffing levels, she said.

Go online to trinitycounty.org/Elections for information about voting in your area on March 3. You can also check your voter status by calling 623-1220.

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