Stanislaus County contract ensures fast care

OUR VIEW

May 4, 2013 

Today marks the start of a five-year contract that should assure Stanislaus County residents a quick and professional response when they call for an ambulance.

Response time standards already were relatively short — second fastest in the state — but there will be tougher financial penalties if providers don't consistently meet them.

Under the old and new contracts, ambulances are expected to arrive "on scene" in less than 7.5 minutes in urban areas, 11.5 minutes in suburban areas, 19.5 minutes in rural areas and as soon as possible in so-called wilderness areas, where there are fewer than seven persons living in a square mile.

The new agreement also tells ambulance providers to begin negotiations immediately with the fire departments that are providing support services, such as assistance with lifting patients. Under first-responder protocol, firefighters and ambulance paramedics are likely to roll to a 911 call involving a heart attack or other life-threatening medical situation.

But the arrival of firefighters — paid or volunteer — doesn't relieve the ambulance provider of its responsibilities under the contract and doesn't satisfy the response time requirement.

This has become an issue because the great majority of fire calls are for medical aid, not fires, and because fire agencies are almost universally strapped for money. Not surprisingly, fire department leaders have been frustrated that they're providing free assistance to the ambulance companies, which are paid for their services. (Ambulance companies point out they don't get paid when they are transporting patients with no insurance.)

It isn't clear what kind of agreements the fire agencies and ambulance companies will work out, but they have only 90 days to get some meaningful conversations going or they will be subject to a fine of $100 per day.

Stanislaus County is divided into eight ambulance response zones. American Medical Response serves three of them, basically the cities and towns along Highway 99. Hospital or ambulance districts serve four of the other zones.

AMR also operates an emergency ambulance dispatch center, LifeCom. A project is under way to improve dispatch as well, by making sure information about a medical call is shared in real time by computers at the police-fire dispatch centers at LifeCom.

While people may complain about the cost of ambulance service, we're not aware of big concerns about the reliability of service other than in Hughson, where Hughson Ambulance was replaced by Pro Transport 1. There was no discussion of eliminating AMR's exclusive contract.

In Merced County, in contrast, there's an ongoing debate over whether the contract will go to Riggs, the longtime provider, or to AMR. The issue has not been resolved.

We think Stanislaus County has been satisfactorily served by its ambulance providers, but we applaud the fact that county supervisors directed the Mountain Valley Emergency Services Agency, the joint powers agency to which Stanislaus belongs, to negotiate a contract that retains quick responses.

Mountain Valley also monitors the providers to ensure that paramedics meet training and certification standards and that the vehicles are well-maintained and stocked — the kind of things people take for granted, until it's their emergency.OUR VIEW

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