By Les Mahler
Inside Bay Area (California)
Copyright 2006 MediaNews Group, Inc. and ANG Newspapers
All Rights Reserved
STOCKTON, Calif. — Three months after winning an exclusive three-year contract to dispatch emergency calls throughout the county, American Medical Response is rapidly meeting the mark for handling emergency calls under the agreement.
Although AMR had problems when it started in May, by June improvements were starting to show, Dan Burch, director of the countys Emergency Medical Service told county supervisors Tuesday.
Those early problems have resulted in $119,240 in fines, which AMR has appealed.
In its response letter to the report, AMRs vice president of operations, Brad White, cited the Stockton Fire Departments lack of cooperation for many of its problems in the beginning.
According to White, the obstacles the department has added include the agencys unwillingness to implement the computer-assisted dispatch link. CAD would link AMRs LIFECOM in Salida to the Stockton Fire Departments dispatch center, he said in the letter. The CAD link would allow both agencies to see the same emergency call at the same time. Without the CAD link, AMR is forced to call Stockton dispatch and alert it about an emergency call.
Another obstacle, according to White, is that Stockton firefighters are riding along with AMR ambulances into the hospital when not requested by AMR. Such a ride-along forces an AMR ambulance crew to return the firefighter to the fire station, thereby taking the ambulance out of position to respond to subsequent calls for service, White wrote.
Burch, in his report to supervisors, cited the lack of cooperation from Stockton, Manteca and Lodi for compounding those earlier problems.
In fact, the three cities have joined together to sue the county to stop the AMR switchover. Stockton officials have said in the past that the county does not have the right to dictate whocan dispatch 9-1-1 emergency calls for them.
And earlier this year, Stockton officials sued the 13 fire districts for breach of contract for changing to AMRs LIFECOM to handle dispatch.
If it loses the dispatch contract, the Stockton Fire Department will lose more than
$2 million through 9-1-1 emergency and dispatch fees to fire companies and ambulance crews.
Still, in May, when AMR was awarded the exclusive contract for San Joaquin County, response time was at 77.26 percent. By the end of June, response time compliance was at 87.75 percent, Burch said.
Thats because AMR made changes almost immediately. From day one, when AMR noticed it would fall short of compliance time, it switched to a full-flex system which meant adding more ambulance crews, Burch said. Those crews were added on the streets, not in stations, he said.
Under the contract with AMR, response time must be at the 90 percent level for response times in the 11 regions within the county.
Burch said he expects AMR to meet the threshold in July, although figures have not been tallied.
The system is improving significantly, Ken Cohen, the countys director of Health Care Services, told board members.
The changes have not gone unnoticed. Of the 15 fire districts in the county, 13 have switched to AMRs LIFECOM center in Salida from the Stockton dispatch center, he said.
For the fire districts and several ambulance companies, the difference has been a savings of $126,000 over what Stockton Fire Department was charging for dispatching calls to the different agencies, Cohen said.
Mike Kirkle, fire chief at the Woodbridge Fire District, thanked supervisors for the changeover to AMR. The benefit, he said, has meant consistency in response time in the county.
The ability to meet response time was at the heart of the changeover. In the past, with ambulance service being a jigsaw puzzle of different ambulance companies competing against each other for patients, response time in most city emergencies was well over the 7-minute mark.
Under the new formula, which had been in the works for almost two years, a quick response time was critical.
Burch and Cohen said the progress couldnt have been done without AMRs complete cooperation in monitoring response time in real time. That, Burch said, has resulted in significant improvement in accountability.
Supervisors praised the transparency of AMRs system, adding that it was something new for the county.