Unpaid Bills Exacerbate Rescue Unit Budget Straits

An elite helicopter rescue unit--already cut to the bone in last year’s Los Angeles County budget--may be grounded permanently for lack of money, leaving thousands of rural residents without emergency medical help.

But this year’s budget crunch may be only part of the reason for the unit’s predicament.

The Sheriff’s Department’s Air 5 helicopter was spared last year after the Board of Supervisors voted to charge a user fee of nearly $1,400 for each rescue, hoping that the money would help offset the unit’s $900,000 annual cost.

But since the fee went into effect last winter, the county has collected only $9,700, prompting criticism of the department’s lax efforts and questioning of its commitment to what supporters say is the finest rescue unit in the country.

The unit, which operates from its station in Barley Flats above Pacoima, performs mountain rescues and airlifts patients in remote parts of Los Angeles County, including vast stretches of the Antelope Valley that are more than 30 minutes by car from the nearest medical facilities. It is among the most popular--and most visible--of the department’s services.

Of the 137 bills sent out since December, the department’s fiscal services division has received payment in full for seven. Five of those reportedly were referred to an outside agency for collection by frustrated sheriff’s deputies tired of the unpaid bills piling up.

Close to 95% of the bills--amounting to nearly $177,000, or more than one-fifth of the unit’s annual budget--have yet to be paid. By comparison, the Los Angeles City Fire Department collects roughly 70% of the bills it sends out for ambulance and helicopter transport.

“I don’t know why they are dragging their feet,” said Deputy David Rathbun, assigned to the unit for the past 22 years. “They aren’t even trying. These things just sit.”

Critics like Rathbun complain that Sheriff’s Department officials are using threats to ground Air 5 as a political ploy to fend off further cuts in the agency’s budget. They contend that if the department is interested in keeping its services intact, it should more aggressively pursue the additional revenue sources such as fees for rescues.

Sheriff’s officials, on the other hand, said they are doing everything they can to collect the fees. But, they acknowledge, they are public servants, not bill collectors, and are not about to bang on victims’ doors demanding money.

“The sheriff would never stand for that,” said Fred Ramirez, director of the department’s administrative services. He acknowledged that the department’s collection record is far lower than expected, but said a number of factors have slowed the process.

First, the department’s fiscal services division is unaccustomed to--and slightly uncomfortable with--billing private citizens for emergency services, he said. Most of the charges levied by the department are to cities and other agencies that contract with the county.

“Billing private people is quite a bit different,” said Chief Larry Anderson, director of Sheriff’s Department field operations for eastern Los Angeles County and the official who oversees Air 5 operations. “We’re pretty new at this.”

Second, the department is reluctant to use strong-arm tactics to collect. After a third billing notice is sent, Ramirez said, the matter is usually dropped. The department is considering turning over billing services to a private contractor, which likely would be more aggressive than the county.

“I doubt we are going to go after them like a collection agency would,” Anderson said. “We’re not doing business that way. But our intention is not for them to get a free ride.”

Finally, Ramirez and Anderson said, sheriff’s officials never expected the fees to completely cover Air 5’s operations budget. Some early estimates indicated that the department would collect on only 30% of the bills it sent out because many patients would be uninsured and poor.

Nonetheless, Supervisors Chairman Ed Edelman said: “We need to get all the revenue we can get.”

Already, the unit operates only four days a week and has a staff of just six deputies, down from 17 last year. Most of the other deputies, all trained as paramedics and scuba divers, were transferred to other duties.

Threats to ground Air 5 permanently anger longtime deputies on the unit.

“It’s a political chess game and it’s being played at our expense and the expense of the citizens of Los Angeles County,” said Deputy Jerry Despues, assigned to the unit for most of the past 12 years. “I think they are going to phase Air 5 out. The department on a constant basis has been undermining the emergency services detail, and this is the perfect opportunity to just let it go.”

The 1993-94 Los Angeles County budget released last week proposes to cut more than $1.5 billion from an array of public services. No area is immune from the cuts, and a steady parade of department heads have pleaded with the Board of Supervisors in recent weeks for fewer cuts, painting horrendous pictures of what the reductions would do.

Much of it has been pro-forma budget wrangling--a poker game with million-dollar stakes--but everyone concedes that this budget year is the tightest anyone can remember. Almost inevitable are layoffs of county employees and noticeable cuts in services such as libraries.

Sheriff’s officials have threatened to close jails and local stations, but deny they are dragging their feet in collecting fees for Air 5 so they can plead poverty.

“There is no truth to anything in regards to the department not wanting to collect fees,” Anderson said. “We would like to get as much offset as we can.”

Rural residents like Cande Gustavson of Lake Los Angeles have rallied in recent weeks to save the unit. Two years ago, Gustavson’s son, Jake, went into seizures, the first indication of what was eventually diagnosed as brain cancer.

After a 12-minute flight from Gustavson’s home to Antelope Valley Medical Center in Lancaster, Jake stopped breathing as the helicopter touched down. But because he was already at the hospital, doctors were able to revive the child, then 6. Without Air 5, Gustavson said, her son would likely be dead today.

Deputy Ron Unger, transferred out of Air 5 when the unit was scaled down last year, said stories like Gustavson’s are common in a unit that performs hundreds of missions each year. The unit also performs swift water and SCUBA rescues, and coordinates search-and-rescue operations for people missing in Southern California mountains.

“If it were my wife and kids at the bottom of a canyon, I would want Air 5 to come in,” Unger said.