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Report finds Calif. county EMS maintaining response times despite challenges

Monterey County EMS faces funding challenges amid rising operations costs


A Monterey County EMS ambulance.

Monterey County EMS/Facebook

By Dennis L. Taylor
Monterey Daily Herald

SALINAS, Calif. — Monterey County’s emergency medical system has maintained top response times despite increased call volumes and funding challenges, according to a recent report provided to county elected officials.

The 47-page annual report by the county’s Emergency Medical Services agency to the Board of Supervisors highlighted areas of emergency response during the 2023 fiscal year.

While EMS is a single agency – a bureau of the Monterey County Health Department – its goal in ensuring top emergency care includes coordinating and overseeing pre-hospital emergency care with more than 40 individual agencies, including ground and air ambulance, law enforcement, fire departments and the four hospitals in the county.

Like many county departments, EMS is facing revenue challenges, particularly in a pair of funding sources that have not kept up with escalating costs.

“In our most recent report, we highlighted the funding challenges faced by the EMS Agency as revenue from sources such as the CSA-74 special tax and the Maddy Fund have failed to keep pace with the rising costs of providing services,” wrote Teresa Rios, the EMS bureau chief.

The CSA-74 is a parcel tax and the Maddy Fund is revenue collected from traffic fines that compensate healthcare providers for emergency medical services provided to people who are uninsured and cannot afford to pay for emergency care.

One of the highlights during 2023 is the establishment of a program addressing the escalating number of opiate overdoses in the county. The Buprenorphine Program is a collaboration with Santa Cruz and San Benito counties. Buprenorphine is a drug that now can be administered by paramedics that counters serious opiate withdrawal symptoms. The program goes hand in hand with the use of naloxone – brand name Narcan – that reverses the effects of an opiate overdose.

EMS has experienced an uptick in call volumes, going from 31,740 in 2021 to 35,293 last year. Rios, in an email interview with the Herald, said the increased volumes could be the result of several factors. Population growth could have increased the numbers, but so could the return to some degree of normalcy following the COVID-19 pandemic.

“A gradual return of more tourists and special events after the pandemic may also contribute to the increases,” Rios said.

Despite those increased call volumes, ambulance response times have kept above the 90% threshold established by EMS. The consensus of emergency response times among medical institutions and the National Institutes of Health is eight minutes.

The use of automated external defibrillators for cardiac arrest got a boost in 2023 when EMS joined a nonprofit network called the PulsePoint Registry. PulsePoint’s free website and smartphone app provide the public, first responders and 911 dispatchers with the exact location of the closest AED to the scene of a cardiac arrest, improving the likelihood of patient survival.

EMS is the lead agency coordinating medical response in the event of disasters or mass casualty incidents. The system is also responsible for the designation and oversight of specialty care centers for three types of medical emergencies – trauma, stroke and what’s called ST-elevation myocardial infarction, which is a particular type of heart attack where a coronary artery becomes completely blocked, causing death to the part of the heart muscle it feeds.

For example, the Community Hospital of the Monterey Peninsula and Salinas Valley Health Medical Center have accreditations as Primary Stroke Centers, according to their websites. Natividad Medical Center is the only accredited trauma center in the county, designated as a Level II facility. The only difference between a Level I and a Level II trauma centers is Level I facilities have research arms. Otherwise, their capabilities are identical.

EMS also provides initial certification and renewal of certification for emergency medical technicians, and accreditations for paramedics to be employed in Monterey County.

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