In Stanislaus County, patients are waiting 45 minutes for an ambulance. Why so long?
Stanislaus County leaders are directing attention to a faltering ambulance system in which responses longer than 35 minutes, or even 45 minutes, are happening too often, top officials said.
“Fortunately, we have not had a major catastrophe, but it is waiting to happen if we don’t address it,” said Richard Murdock, assistant director of the county office of emergency services.
American Medical Response has a 62-year history of ambulance service in the county, but staffing shortages partly stemming from low pay in the industry were made worse during the COVID-19 pandemic.
Paramedics and emergency medical technicians, working on the front lines of the pandemic, missed time on the job due to illness and quarantine, and the training programs that graduate recruits for ambulance providers were closed or severely cut back due to coronavirus regulations.
AMR’s general manager in Modesto says it left the company with few ways to fill the gaps in staffing.
County supervisors learned in an update from staff Tuesday that AMR is deploying fewer than half the ambulances in a 20-unit plan for covering the area including Modesto, Turlock, Ceres, part of Riverbank and other communities.
As a result, smaller health care districts in outlying areas, such as Oak Valley in Oakdale and Del Puerto in Patterson, are being dispatched into AMR’s territory under mutual aid agreements at a rate of 230 calls per month.
From January to May, other ambulance providers spent 540 hours responding to calls for AMR, according to Tuesday’s report to supervisors.
Murdock said health care districts are running close to eight mutual-aid calls per day. An Oak Valley ambulance that takes a patient to a Modesto hospital might get drawn into responding to multiple calls in Modesto because of an EMS system that dispatches the closest unit to an emergency, he said.
The Oak Valley and Patterson ambulance services are expected to serve their own districts, which are funded by local taxpayers.
County supervisors said they’re aware of unacceptable delays in ambulance response, such as the Salida fire crew that waited 45 minutes for an ambulance from Patterson to arrive and take a patient to the hospital.
“There have been several incidents,” Supervisor Buck Condit said. “It does not happen all the time but one time is too many.”
Paul Willette, director of Patterson District Ambulance Service, said mutual aid responses to Modesto and Turlock have increased over the last few years. Patterson is located 16 miles west of Turlock and is 17 miles from Modesto.
Willette said sometimes the emergency response system has peak demand and ambulance crews are waiting longer at hospitals to hand over a patient. He said the increase in calls to Modesto and Turlock are good reason for a review.
“When we are responding Code 3 (with lights and sirens) to a call in Modesto, there is something wrong,” Willette said. “I can’t just keep adding ambulances to offset that. It’s not fiscally sustainable for us to do.”
The health care district has two advanced life support ambulances running 24 hours a day and a 12-hour ambulance scheduled Monday through Saturday — for responding to emergencies in and around Patterson and to vehicle accidents on Interstate 5.
County will separate from EMS agency
Stanislaus County is leaving the Mountain Valley Emergency Medical Services Agency, a joint powers authority that regulates ambulance service in five counties, and is developing a new model for administering EMS services locally.
AMR through a competitive bid process in 2019 was awarded a new contract for serving the Modesto and Turlock area. The contract obligates AMR to deploy resources for achieving standard response times of 7 to 12 minutes in life-threatening emergencies.
According to the update Tuesday, the company has not yet breached the contract. Three consecutive months of being out of compliance would trigger a letter from Mountain Valley giving them 30 days to remedy the problem.
Mountain Valley’s interim director said the agency is reviewing the long response times and other issues with legal counsel.
The general manager for AMR in Modesto discussed the staffing shortages at the May 25 county board meeting, saying staffing shortages and strain from the pandemic are impacting other AMR operations in the Bay Area and elsewhere in California.
Mountain Valley and county staff offered some recommendations Tuesday for dealing with the current issues. They included:
▪ Use of AMR supervisors to backfill unstaffed ambulance units.
▪ Reaching out to other AMR operations in the region for staffing support.
▪ Implementing a tiered response system that would send paramedics to high acuity calls and EMTs to less serious incidents.
▪ Modifying the system status plan and collaborating with other partners in the local system.
AMR General Manager Cindy Woolston said employees have left the company to pursue careers with fire agencies or go into the nursing field.
The company expects to increase hiring of paramedics over the next six months as academies turn out more graduates. It is also offering hiring bonuses and incentives for part-time employees to move into full-time positions, Woolston said.
The new personnel should put more ambulance units on the road, reducing the need for mutual aid, but the hiring process is going to take time, she said.
AMR talking with local fire agencies
AMR has held recent talks with Modesto Fire Department and plans to meet with Stanislaus Consolidated Fire Protection District. One idea is staffing an ambulance unit or two with fire agency paramedics when a “status zero” is called, meaning no ambulances are available.
Condit, a former captain for Stanislaus Consolidated, said he was not aware of that being tried before.
“We will see where that goes,” Condit said.
Mountain Valley could also possibly allow units from outside the county to respond more regularly, such as an ambulance from Ripon handling a call in the north part of Stanislaus County.
County supervisors expect to receive another progress report in August on the EMS system and a restructuring of Mountain Valley. Stanislaus could administer local emergency services in-house, while Calaveras, Mariposa, Amador and Alpine counties explore other options for the JPA.
This story was originally published June 30, 2021 at 6:58 AM.
