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Ambulance response times in urban parts of Multnomah County have improved since reaching a nadir in October 2023, but, as of June, about a third of all ambulances still failed to arrive within eight minutes for life-threatening emergencies, according to county data.
By contract with Multhomah County, ambulance company American Medical Response is required to dispatch ambulances to life-threatening emergencies in urban areas within eight minutes 90% of the time or face fines. AMR hasn’t met the 90% benchmark since April 2022, county data shows. In June, AMR met the eight-minute requirement about 70% of the time, up from a low of around 50% in October 2023.
The data shows that AMR is still out of compliance with its contract after four months of mediation between the company and staff from County Chair Jessica Vega Pederson’s office. County commissioners are scheduled to vote tomorrow on whether to approve a new ambulance staffing plan, which would clear to the way for the county and AMR to settle their dispute over response times.
The latest on-time statistics, shared with county commissioners this month and obtained by WW through a public records request, shows that AMR has a long way to go toward providing better ambulance service in the county, Commissioner Julia Brim-Edwards said. The county chair’s efforts to improve AMR’s performance with fines appears to have been ineffective, she said.
“The mechanism for compliance was going to be the fine,” Brim-Edwards said in an interview. “It appears that was an ineffective mechanism.”
The county has levied $7.1 million in fines on AMR since April 2022, when the ambulance tardiness began, county records show. None of those fines has been paid, and AMR has the opportunity to avoid them if it meets response times and exceeds some staffing requirements starting Nov. 1, according to the settlement agreement between AMR and the county reached on July 31.
As part of the settlement, which would govern ambulance operations for a year, the county agreed to allow “advanced life support ambulances,” the ones that respond to life-threatening situations, to be staffed by one paramedic and one less-trained emergency medical technician, a solution proposed by Commissioner Sharon Meieran 18 months ago to cope with a shortage of paramedics.
Few large cities require two paramedics in ambulances. In neighboring Clackamas and Washington counties, ambulances have one paramedic and one EMT. If approved tomorrow, the new staffing plan would require AMR to keep two paramedics on a minimum of 20 advanced life support ambulances. The company runs between 34 and 44 ALS ambulances in the county at any one time.
The pact also requires AMR to deploy enough “basic life support ambulances,” staffed by two EMTs to respond to 85% of lower-acuity calls. BLS ambulances provide basic care like CPR and defibrillation. ALS crews provide intravenous care, airway management, and advanced cardiac care.
Instead of fining AMR, the county should have allowed the staffing change months ago, Meieran said.
“What is the one thing they could have done to get more ambulances on the road?” Meieran asked. “They could have let AMR change staffing. Instead of taking action, they prevented action.”
Brim-Edwards agreed. By delaying a solution, the county denied resources to paramedics and EMTs, who bear the brunt of county residents’ frustration with the ambulance system. “It’s really important that paremedics and EMTs that arrive on the scene aren’t blamed for this,” Brim-Edwards said.
Meieran and Brim-Edwards said they have been clamoring for new ambulance response data for weeks, to no avail. Vega Pederson’s office told Meieran that it couldn’t release the data until the settlement agreement with AMR was signed, Meieran said. She emailed AMR this week, she said, and the ambulance company said the county could, indeed, release the information.
County spokeswoman Sarah Dean said Meieran’s accounting is incorrect.
“AMR has always had the ability to release their own data,” Dean said in an email. “The county has repeatedly requested consent from AMR to release information publicly without response. The [county] health department renewed this request this week, and received written permission from AMR yesterday.”
The county has always wanted the public to have ambulance data, Dean said. “That’s why we pushed for that in mediation and secured a provision that clearly permits us to share de-identified and aggregated monthly reports to the public about AMR’s compliance with response times and other contract metrics,” she said.
Both Brim-Edwards and Meieran said they would vote for the new ambulance staffing plan, which, in turn, would allow the settlement with AMR to take effect.