Tensions flare over Calif. ambulance response to calls
The firefighters union claimed ambulances from AMR are frequently unavailable to cover their response area
By Paola Baker
VICTORVILLE, Calif. — Amid calls to action from a local firefighters' union to fix severe issues with ambulance transport systems in the High Desert, officials close to the issue point at several other factors at play while acknowledging the need for an overhaul.
The San Bernardino County Professional Firefighters Union, or Local 935, recently decided to go public in detailing problems with ambulance response times in the region. In a series of social media posts, the union claimed ambulances from American Medical Response, or AMR, are frequently unavailable to cover their response area - a scenario described as "Level Zero."
"The issue of Level Zero is a growing problem and AMR is consistently not staffing enough ambulances for the areas they are responsible for," the union said in a Facebook post. "This has been a problem of concern for several months in the High Desert."
Union president Jim Grigoli stressed that AMR paramedics and emergency crews are not part of the problem.
"We have a good working relationship with EMTs and the medics. The issue is with the corporate office," Grigoli said. "There's this belief that the system is working, but it's not."
Inland County Emergency Medical Agency EMS Administrator Tom Lynch, as well as AMR Director of Communications and Government Relations Jason Sorrick, said hospital bed delay is one of the underlying causes of the "Level Zero" problem. A bed delay is a scenario where a hospital requests that ambulance crews wait with a patient before taking custody and providing care.
"This is an issue we've been working on for years," Lynch said. "As complex as it is, there is no easy fix."
AMR units going on "Level Zero" status means no ambulance units are immediately available to respond to incidents in the High Desert. Units from other areas or County Fire units are then required to respond, tying up resources and causing treatment delays, Grigoli said.
"It affects our resources because we have to stay on scene longer to wait for their ambulance," Grigoli said, "so then we can't respond to other emergencies."
The union posted a recording of dispatch audio from an incident that occurred on New Year's Eve, where two pedestrians were struck by a vehicle on Mojave Drive.
In the recording, first responders can be heard requesting ambulances to respond to the incident and are told that since no units are available in the High Desert, units from San Bernardino would respond.
While the incident was eventually handled by AMR units in the area, the union claimed this response can be common, with ambulance units having to come from as far as Redlands to respond to High Desert incidents.
"When ambulances are dispatched to 911 calls in the High Desert from as far away as 40 miles in San Bernardino, we believe there is a problem that needs to be addressed," the union stated in the Facebook post.
Grigoli said AMR ambulances go on "Level Zero" status in the High Desert at least once a day. He acknowledged that there are several other factors contributing to the lack of resources, but continued to stress the need for change - and pointed at the Inland County Emergency Medical Agency, or ICEMA, to lead the way.
"We never know how many AMR units are available on a given day," Grigoli said. "It's a system problem and it's simply not being addressed. ICEMA needs to step in and realize the system is broken."
ICEMA's Lynch acknowledged the need for better monitoring of units available.
"We're trying to fix the process of monitoring that in real time," Lynch said. "There is no specific measurement of the number of ambulances deployed. We're currently working on fixing that."
Sorrick said bed delays directly contributed to what happened with AMR units' availability on New Year's Eve. However, he also questioned the union's motives in going public with the issue.
"If the fire union truly cared about patient care, they would be working with us to find solutions," Sorrick said. "Instead they put up roadblocks and have chosen just to complicate the issue and frighten the public for what appears, in our opinion, to be financial gain."
According to Sorrick, AMR ambulance units are continuing to meet their response times as outlined by their contract with the county.
"Our contracted response time is 9 minutes and 59 seconds for most of the county," Sorrick said. "We are measured on a 90th percentile requirement, which means that on 90 percent of our calls we must arrive at or below our contracted response time. We are fined if we are not compliant."
Sorrick mentioned recent discussions about annexation of fire services by the Victorville City Council, suggesting that the union's recent push in airing ambulance issues has been influenced by these discussions.
"For the fire union, bed delays on Fire Department ambulances means more union members need to be hired to cover the system, and growing the Fire Department's ambulance service footprint ultimately increases their ranks and in turn their revenue via union dues," Sorrick said.
However, Grigoli said the union's decision was simply a result of extended response times that were not being addressed.
"There should never be a day when you don't know how many units are on the ground," Grigoli said. "We just kept hearing nothing is wrong, so we decided we would show there's something wrong. There are just not enough resources. People need to know that we can do better."
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