San Diego's new ambulance service criticized for lack of ambulances, challenging city officials

Although Falck has only provided service since November, one councilmember suggests talks to shift from a private provider to an "in-house" service


David Garrick
The San Diego Union-Tribune

SAN DIEGO — San Diego officials say the city's new ambulance provider is not deploying enough ambulances, refusing to provide information, overworking its staff and ignoring advice on ways to improve.

However, officials say it's too soon to consider imposing penalties on the provider, Falck USA, or to explore how the city could declare the company in default on its contract with San Diego.

San Diego officials say the city's new ambulance provider is not deploying enough ambulances, refusing to provide information, overworking its staff and ignoring advice on ways to improve.
San Diego officials say the city's new ambulance provider is not deploying enough ambulances, refusing to provide information, overworking its staff and ignoring advice on ways to improve. (Photo/Tribune News Service)

"I would recommend we wait until we have at least a full quarter worth of data that we can evaluate and provide a clear perspective," said Deputy Fire Chief Jodie Pierce, noting that Falck only took over on Nov. 27. "Anything sooner than that I think would not be a fair representation."

But Councilmember Vivian Moreno said city officials should immediately explore shifting away from a private provider to bringing city ambulance service "in-house," similar to how Los Angeles, San Francisco and Chula Vista handle it.

Falck officials said ambulance coverage improved somewhat in February and blamed the company's poor performance in December and January primarily on a COVID-19 surge fueled by the Omicron variant.

The company said "misunderstandings" are to blame for what city officials characterize as Falck refusing to provide information to the city about its operations and ignoring city advice on ways to improve.

"The Fire Department presents a picture somewhat of the sky falling, but I will tell you that I believe we are moving in the right direction," said Jeff Behm, leader of Falck's local operations. "It has only been three months, and in the third month things have really improved tremendously."

Councilmember Raul Campillo said he intends to hold Falck accountable, especially on its promises to boost ambulance hours, which prompted the city to choose the company over longtime provider American Medical Response.

"It's important to convey to any contractor with the city that when they don't meet their obligations to the city they are going to face penalties," he said.

Falck, the city's first new ambulance provider in more than two decades, promised to increase daily ambulance hours from 840 to 1,008 and increase the number of ambulances in operation by roughly a dozen.

But they have only met the goal of 1,008 hours on eight of the 102 days they have operated in San Diego. And Falck has often fallen short of an 864-hour minimum, city officials said.

Ambulance hours is the number of ambulances available that day multiplied by the number of total hours they were available.

Falck provided only 576 ambulance hours on Dec. 26, 696 hours on Jan. 8 and 668 hours on Feb. 13, Pierce said.

The company also has chosen to frequently shut down many ambulances across San Diego, which city officials say saves Falck money on staffing while putting lives at risk.

Four ambulances have been shut down more than 30 percent of the time since Falck took over: M22 in Point Loma, M21 in Skyline-Paradise Hills, M44 in Mira Mesa and M23 in Linda Vista.

"This is deeply disappointing and quite frankly angering," Campillo said. "All the extra promises they made they are falling far, far short of."

The region's most powerful labor official said San Diego must hold Falck accountable.

"We don't think contractors should be allowed to do a bait and switch," said Brigette Browning, leader of the 136-union San Diego-Imperial Counties Labor Council. "If you don't hold them accountable, how are you going to hold other contractors accountable?"

Falck is slated to pay the city $9 million per year for the right to transport patients to hospitals and charge those patients for the service. In its proposal to the city, Falck estimated it would receive nearly $75 million in annual revenue.

In a recent letter to Falck, fire officials say "some members of Falck's leadership team routinely challenge city management and disregard requests for information."

City officials also criticized Falck for high turnover among its leadership positions in San Diego.

But Fire Chief Colin Stowell said the shutting down of ambulances and the overworking of its employees are Falck's most glaring problems.

The shutting down of ambulances forces hospital transports to be handled by ambulances from farther away, typically forcing firefighters to wait longer and be unavailable to take other calls for longer.

Forcing employees to work longer hours because positions can't be filled leads to fatigued employees and morale problems, Stowell said.

"They cannot continue to run those units that way and have a satisfied workforce," he said.

Tony Sorci, head of the labor union representing the city's ambulance workers, the San Diego Association of Prehospital Professionals, said he believes things will improve.

"My workforce has endured incredible adversity — call volumes, staffing levels and difficult working conditions — throughout these last few months," he said. "We are working weekly with Falck management to develop policies, processes and real-time solutions."

Behm, the Falck official, said he is optimistic the relationship between the company and city officials will improve during an "all hands" meeting scheduled for next week.

Falck is a Danish company that handles ambulance service in many cities and counties around the world, including Orange, Los Angeles and Alameda counties in California.

This story originally appeared in San Diego Union-Tribune.

©2022 The San Diego Union-Tribune. Visit sandiegouniontribune.com. Distributed by Tribune Content Agency, LLC.

McClatchy-Tribune News Service

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