American Medical Response took over ambulance services for Washington County on Aug. 1, and the agency is facing some of the same issues that led the county to switch providers for the first time in two decades.
According to Willamette Week, Forest Grove Fire Chief Jim Geering sent an email saying he was fed up with AMR’s slow response times, which in turn took his staff away from other responsibilities to transport patients to hospitals.
“We are taking firefighters away from the fire engine they are assigned to,” he wrote. “We can no longer support this level of risk to our public’s safety.”
In Washington County, AMR is still working to get fully staffed since taking over ambulance services. AMR rehired many employees from the county’s previous provider, Hillsboro-based Metro West Ambulance, which helped with the transition.
Adrienne Donner, the county’s public health emergency preparedness and emergency medical services supervisor, said AMR is short of staffing by about six paramedics and three EMTs.
AMR provides ambulance service in neighboring Multnomah County, where the county just issued a $513,650 fine to AMR on Nov. 14 for failing to arrive at 911 calls in the required time. The fine was based on August’s response times, according to a release sent out by Multnomah County, “including failing to arrive within eight minutes for high acuity calls in urban areas. AMR responded to 11,577 calls that month; 14 percent of the responses were late enough to trigger penalties.”
Metro West was having similar issues in Washington County before the switch took place.
The most recent 18-month review of Metro West’s response times in Washington County came during a board of commissioners’ work session in April 2022. The assessment was conducted by the Washington County Emergency Medical Services Program, and determined that Metro West failed to meet seven of the established 25 criteria points.
Depending on where in the county calls come from, the agreement stated that Metro West had to respond to the call in either eight, 11, or 30 minutes. The agreement called for those times to be met 90 percent of the time. In six out of the 18 months in the assessment, the call response times fell below 90 percent. The lowest was 83 percent in October and December of 2021.
Metro West’s most recent data was provided to the county board of commissioners in May of this year, when that number fell to 68 percent.
Donner said county officials weren’t too concerned about the issues AMR was facing since so many agencies have struggled these last few years due to employees leaving the industry and paramedic schools closed for a bit during the pandemic.
Another reason Donner wasn’t too worried about the response times is that the reason Washington County started looking at other agencies for ambulance services is that new strategic plan.
The most notable change is a tiered response system. At the June 27 Washington County Board of Commissioners meeting, Tim Case, the county’s emergency medical services senior program coordinator, broke down the two tiers of calls.
There will be Advanced Life Support calls and Basic Life Support calls. Advanced call ambulances will be staffed with one paramedic and one emergency medical technician, while basic call ambulances will be staffed with two emergency medical technicians.
“Having this layer of delivery allows the resources to be reserved for the most appropriate care to the most appropriate patients,” Case said. “The higher acuity patients receiving advance-level services, as in strokes and heart attacks, and that brings the BLS to the lower-acuity calls, again, reserving those critical patients for the ALS level.”
Another change is that the calls will be dispatched through the Washington County Consolidated Communications Agency, where the determination will be made whether the response should be for advanced or basic support.
The new dispatch system officially went online as of Nov. 1, Donner said. It will take some time for the new system to be in place to see how it impacts response times in Washington County.
So far, Donner said the transition from Metro West to AMR has gone well thanks to all the agencies working together.
“Having that collaborative partnership with Washington County, with AMR, with all the fire agencies, we had very transparent communication,” said Jan Lee, an EMT and public information officer with Metro West. “Everybody understood what needed to happen. It was very respective. We want whoever has the contract to do well. They’re going to be taking care of our community.”
Metro West, which has provided services in the area since 1953, isn’t going away. Metro West will focus on non-emergency transport, which are things like inter-facility transportation for when a patient is discharged from a hospital and needs to get to a long-term care facility.
“The bottom line is this needed to happen; the changes needed to be made,” Lee said. “It’s for the best for the citizens of Washington County. We weren’t chosen. When things go out to bid, that can happen. We’re going to change direction, and we’re going to provide services our region needs very much.
