Two of the three ambulances owned by Sonoita Elgin Fire District stand by for EMS calls to the Fire Station. Last year the EMS teams made 131 runs to Patagonia, 35% of all the runs made by the district. Photo by Marion Vendituoli

When Mollie Wright, of Patagonia, stopped in at the Sonoita Elgin Fire district (SEFD) station recently to have her granddaughter’s oxygen level checked, she never expected that her granddaughter, who does not have medical insurance, would receive a $1,200 bill for the ten-minute visit. 

When Wright wrote a letter asking for the charge to be reconsidered, she was told that nothing could be done, as these fees are regulated by the state. They did, however, offer to set up a payment plan. Had Wright instead taken her granddaughter to Cynthia Smith, the local nurse practitioner, one half mile down the road from the fire station in Sonoita, she would have been charged $75 for the visit. 

Wright’s granddaughter was charged for the visit because she does not reside within the Sonoita Elgin Fire District. According to SEFD Chief Operations Officer Marc Meredith, “District residents pay a fire district tax that helps to offset the cost of EMS services. We bill district resident’s insurance for EMS services. Non-district individuals (no matter where they live) will have their insurance billed as well, and it has been our practice in the past to then seek payment from non-district patients for the balance of their bill if insurance does not cover 100%.” 

Meredith stated that SEFD is reviewing its practices. Normally, when a patient is transported in the ambulance, insurance covers the costs, but that is not always the case when the patient does not require transport.

“Ambulance services traditionally have not been set up to account for non-transport patient encounters,” he said. 

The department is “applying to become a ‘Treat and Refer’ approved agency. This designation will allow us to evaluate a patient and if it is the patient’s best interest to stay home and/or seek non-emergent treatment, to provide services at a reduced cost.” They are also looking at “establishing a formal department policy” to address situations where people are struggling to pay bills owed to the Fire District. 

Changes may also be coming to the SEFD ambulance service contract with the town of Patagonia. There were 131 Patagonia ambulance calls in 2020, 35% of the total ambulance calls for SEFD. The average annual income from all ambulance calls over the past three years for SEFD was $257,365. An estimated 35% of that figure would be $90,077 annual income derived from calls to Patagonia. 

Although SEFD has three ambulances at the station, it had been SEFD policy that it would not send out an ambulance to Patagonia if one ambulance were already out on a call elsewhere. That practice has been modified recently.

“We have instructed our crews if the ambulance is out, as long as we can get additional resources to the station, they should answer the call to Patagonia,” Meredith said.

Patagonia Fire Chief Ike Isakson has been looking at alternatives to contracting with Sonoita.

“We love Sonoita,” he said. “We love the people who work there. It’s just something we have to look at.”

He observed that ambulance response has improved in the past few months but is concerned at the high fees associated with non-transport calls.

“I’d rather keep Sonoita. It just seems to me that is a totally unfair charge,” he said. 

He is exploring the possibility of contracting with the Rio Rico Fire District. Rio Rico is annexing the Nogales Suburban District, which has an active station just south of River Rd. on SR 82, which would place an ambulance close to Patagonia. 

Rio Rico does not normally charge for non-transport calls, according to Isakson, and the most they ever charge is $75. The AZ Dept. of Health Services stated that “according to Arizona Revised Statute 36-2239, an ambulance service must charge the rates set by ADHS but may also choose to provide gratuitous services.”

Meredith stressed that SEFD is working to find solutions to these issues.

“Whatever decisions this district has made before are not necessarily the decisions that will be made in the future,” he said. “We always want people to seek emergency help and do not want someone to avoid calling 911 out of financial concern.”