Emergency transportation companies are facing a crisis because the cost of transport far exceeds Medi-Cal payment for those services, according to a recently-formed coalition of emergency ambulance providers.

“We can’t turn anybody away,” said John Surface, vice president of operations for Hall Ambulance, based in Bakersfield. “We’re the only ones by law who can’t turn away anyone, can’t turn away Medi-Cal patients. Everyone who dials 911 needs care.”

Surface said the average cost of an emergency transport is about $600 and the average reimbursement from the state is just over $100. In the past, billings from private pay insurance made up the difference, but Surface said insurers have no interest in subsidizing Medi-Cal anymore.

The governor has called for a special session in the Legislature to deal with Medi-Cal issues, including a possible future rise in provider rates. Those rates were a big topic of conversation in the Capitol this session, as a reversal of a 2011 provider rate hike was on the table and got shelved in the final budget agreement.

Surface said negotiations so far have not included emergency transportation services.

“We’ve been left out of the conversation,” Surface said. “Ambulance transports and 911 calls are the most basic level of safety net, but that is never included in the conversation in the Capitol.”

That’s why six ambulance companies this week announced formation of a coalition to advance the cause of Medi-Cal rate reimbursement for emergency services, Surface said. Those companies provide services in 35 of California’s 58 counties.

“We’re not even talking about the transfers, we’re talking only about 911 calls,” Surface said. “The emergency services everyone needs. That’s what needs action. That needs action now.”

A bill in the Legislature this session addressing emergency transportation services reimbursement — AB 1257 by Assembly member Adam Gray (D-Merced) — passed the Assembly health committee but stalled in Assembly appropriations.