The Proposal

Supporting San Bernardino County’s Most Underserved Communities  

Barstow Desert Ambulance, Baker Ambulance, and Morongo Basin Ambulance serve some of the most remote and rugged regions of San Bernardino County — from Barstow to Twentynine Palms and everywhere in between. These providers are the sole 911 responders for thousands of residents living in “super rural” areas, yet they face an outdated and unsustainable reimbursement structure that places them at risk.

Key challenges include:

• Emergency transports spanning 40 to over 100 miles
• High fixed costs with limited call volume
• 24/7 staffing requirements despite low demand
• No access to urban EMS incentive programs
• Limited administrative resources to manage billing, reporting, and regulatory compliance

Today, these rural EMS providers receive as little as $339 per emergency run — while public agencies such as fire departments are paid $1,065 or more for performing the same service. That disparity is not just unfair — it’s unsustainable.

We respectfully request that IEHP adopt a Medicare Super Rural Rate Bonus Framework, which increases reimbursements of up to $2 million annually for rural ambulance providers under Medicare. This would be modeled on the federal Medicare Super Rural Bonus.

This implementation would represent a modest and fair step toward closing the longstanding reimbursement gap.

The estimated $2 million in additional funding would be distributed across all affected rural providers, including:

• Barstow Desert Ambulance
• Baker Ambulance
• Morongo Basin Ambulance

If reimbursement improves, rural EMS providers will reinvest the additional support into front-line care:

• Maintaining 24/7 staffing in super rural areas
• Recruiting and training EMTs and paramedics in rural trauma response
• Upgrading lifesaving equipment and modern communications
• Adding cold storage for blood and critical medications
• Replacing and maintaining long-haul transport vehicles
• Strengthening billing, reporting, and compliance systems

Rural ambulance providers are the only line of emergency defense for thousands of residents spread across some of California’s most challenging terrain. They do the same lifesaving work — often under more difficult conditions — for far less compensation.

This modest funding fix will help ensure that these critical services do not collapse under financial strain. Without action, rural EMS is at serious risk of cutbacks, delays, and service loss.

We need your voice and support to ensure emergency medical services remain in place for San Bernardino County’s most vulnerable communities.

📢 Contact your local officials

🤝 Support our coalition

🚑 Protect rural 911 services