Multnomah County Chair Orders Review of Slow Ambulance Response Times

American Medical Response, which provides ambulance service in Multnomah County, has been out of compliance with response time standards since last March. But the county has declined to fine the company, citing a nationwide shortage of paramedics. AMR says it can’t find enough to staff all of its ambulances.

That could soon change. In a statement released to WW this afternoon, Multnomah County Chair Jessica Vega Pederson says she’s “directed the Health Department and County legal to analyze and update their recommendations on the ambulance response time issue, including decisions not to levy fines, a staffing pilot and all other alternatives with the hope of improving performance and ambulance response times with increased urgency.”

AMR recently won a contract to provide ambulance service in Washington County beginning in July. That, some fear, will further exacerbate AMR’s staffing crisis.

“We are also aware that AMR is expanding into Washington County, and it’s concerning that they are taking on new work while not providing adequate coverage for our community,” Pederson added.

AMR is proposing the county change its long-standing policy requiring two paramedics per ambulance. That proposal has the support of County Commissioner Sharon Meieran. “We need more ambulances, and AMR proposed a temporary solution that would turn things around in weeks,” she wrote on Twitter last night. “Multnomah County refused. As an ER doc, I beg the county to act.”

AMR wants to replace one of two paramedics per ambulance with emergency medical technicians, or EMTs, who have less training and are limited in what medical procedures they can perform.

That, says Multnomah County EMS medical director Dr. Jonathan Jui, is a recipe for disaster.

“When you have a critical patient, two paramedics or even more is optimal,” he tells WW. “It’s a patient safety issue.”

He also wondered whether AMR’s effort to change the policy was related to its new contractual obligations.

“There are approximately 250 AMR paramedics. If we go to one-plus-one staffing, a lot of those medics go to Washington County,” he said.