By Greg Kane
The Record (Stockton, California)
Copyright 2006 The Record
Distributed by McClatchy-Tribune Business News
The private firm hired earlier this year to dispatch and provide 911 ambulance service in most of San Joaquin County arrived on time with greater frequency in the past few months, county officials said.
But American Medical Response ambulances continue to miss deadlines in rural areas surrounding Stockton and Lodi, according to a county tally of emergency response times for July and August. In the areas east and west of Lodi, ambulances were late nearly four out of 10 times.
“I don’t think there’s any excuse,” said county Supervisor Jack Sieglock, whose district includes the four rural areas with the lowest response times in the county. “By and large, I think they’re doing a good job. But in those areas, they can — and need to — be better.”
AMR ambulances are required to arrive on the scene of a medical call within 71/2 minutes in urban areas and 171/2 minutes in rural areas under the terms of a five-year deal with the county. In May and June, the first two months of the revamped system, ambulances met those deadlines only roughly eight of every 10 times — results that triggered nearly $120,000 in fines.
In both July and August, ambulances reached a county-imposed threshold by arriving on time 90 percent of the time, said Dan Burch, the county’s Emergency Medical Services administrator. But AMR was below the 90 percent mark in six of 11 individual zones in August, including the Delta and most of the rural areas in northern and eastern San Joaquin County.
Jason Sorrick, a spokesman for AMR, said the firm is positioning ambulances deeper inside rural areas to ensure it responds on time more often. AMR’s performance has improved every month since the May 1 launch, Sorrick said, and it will continue to do so as it learns more about the county’s needs.
“The further we get into providing the service, the better the system will become,” Sorrick said.
The firm faces nearly $75,000 in fines because of the lateness in rural areas in July and August. Penalties include $5,000 a month for each zone below the 90 percent mark, plus $10 for every minute of lateness.
The county Board of Supervisors granted the exclusive contract to AMR in January after a bidding process in which the primary competitor was the Stockton Fire Department. The city continues to fight contract terms that awarded AMR countywide 911 medical dispatching duties, operating a separate dispatch center for residents in Stockton, Lodi and Manteca.
Burch maintains that extra staff added by AMR in May, along with better positioning of ambulances and increased familiarity with the system among paramedics and dispatchers, has improved the performance of the new system.
Burch even points out that one of the system’s biggest critics, Stockton Fire Chief Ron Hittle, complained in a Sept. 20 letter that ambulances were arriving before fire department’s first responders on some emergencies. Hittle and other fire officials have said in the past that lateness has been a major problem with AMR paramedics since May.
“It was an interesting complaint to receive,” Burch said.
Hittle said the letter identifies a problem with AMR’s Lifecom dispatching center in Salida, rather than the speed of ambulance service. The fire chief fears first responders are being beaten to some emergencies because they aren’t being notified as quickly as the paramedics — something that shouldn’t happen any more, since the two dispatch centers were connected by a new computer system last month.
“They’ve never given us any definitive answer of why that’s happening,” Hittle said. “There are things that just don’t add up.”
The county sued Stockton, Lodi and Manteca earlier this year for refusing to send 911 medical calls to AMR’s Lifecom center. The California Highway Patrol and Tracy Police Department also continued sending medical calls to Stockton’s dispatch center after the May 1 launch of the new system, but have since switched to AMR.
A judge in Stanislaus County is expected to hear the case in mid-November, said Deputy County Counsel Mark Myles.
The CHP’s decision to send all calls to the Lifecom center has caused problems for Stockton Fire that go beyond medical response, Hittle said. The CHP handles all 911 calls dialed on cell phones and sends both medical and fire emergencies to AMR’s dispatchers. AMR then relays fire calls to the Stockton Fire Department.
As a result, Stockton firefighters are learning about fires minutes later than they would have when their own dispatchers received the calls, Hittle said. One fire call dialed from a cell phone wasn’t transferred to fire officials until more than eight minutes after it was first reported, he said.
“It’s just taking too long to receive the call and get it processed,” Hittle said.
The July and August figures are expected to be presented to the county Board of Supervisors later this month. Numbers for September and October are not yet available.
There were no time standards tracked by the county before the new contract went into effect in May. Officials cannot compare how quickly ambulances responded to emergencies before then to AMR’s current numbers.
Burch believes AMR’s response times are going to improve as paramedics and dispatchers become more comfortable with the system. He also points out that the firm’s performance has improved even as its dispatchers have handled an increased workload, with the CHP, the Tracy Police Department and all but one of the county’s 13 rural fire districts now using Lifecom.
But Hittle doesn’t see evidence of improvement out in the streets, where he claims communication problems and lateness continue to be an issue.
“The county may be correct in saying it’s improved their speed,” he said, adding that fire officials don’t have the ability to track their exact response times. “But we’re still having problems.”