San Diego civil rights leaders say new ambulance contract 'a key step forward'

Local activists said the upcoming contract decision is an opportunity to improve racial equality after past complaints about response times in more diverse areas


David Garrick
The San Diego Union-Tribune

SAN DIEGO — Local civil rights leaders say San Diego's plan to potentially switch ambulance providers this year is a key opportunity to show the city's commitment to racial equity and boosting neighborhoods that have been traditionally underserved.

San Diego recently changed some police practices and created an Office on Race and Equity in response to recent protests demanding racial equity. But civil rights leaders say demanding better ambulance service would be a more concrete step.

"We are looking for some bold leadership from the mayor and City Council, and this would be a key step forward," said Francine Maxwell, president of the local chapter of the NAACP. "This is an actionable item that should be a top priority."

The city's efforts to find a new ambulance provider come after years of complaints about service levels and response times under longtime provider Rural/Metro, particularly in more ethnically diverse areas south of state Route 94.

Complaints continued when American Medical Response bought Rural/Metro in 2015 and took over ambulance service in San Diego. AMR has met all city-mandated response time goals since 2017.

City officials still decided to open the contract up to other providers and issued a request for proposals for ambulance service in April, several weeks before the death of a Black man in police custody in Minnesota sparked nationwide protests.

The city received comprehensive proposals from AMR and Falck, a Danish-based ambulance provider, by the June 5 deadline. A city spokeswoman declined to say this week whether any additional companies submitted proposals.

City officials recently began evaluating the proposals. They say their plan is to forge a five-year contract with one of the providers later this year or early next year.

Nancy Maldonado, chief executive of the county's Chicano Federation, said the recent heightened focus on race and equity gives city leaders an opportunity to take a bolder, more rigorous approach to their decision on ambulance service.

"It's an opportunity now to re-evaluate and re-imagine things," Maldonado said. "It's an opportunity to not go with the status quo."

Three years ago, AMR and city officials softened a key standard for emergency response designed to ensure equitable ambulance service across neighborhoods.

A new ambulance contract — either with AMR or a competitor — could be an opportunity to revive that standard, which divided the city into eight service zones and demanded the ambulance provider meet response time goals in each zone.

The standard was softened to four zones in 2017, despite complaints from leaders in neighborhoods south of state Route 94.

Because the zones are now twice as big, there is greater potential for AMR to provide subpar service to some neighborhoods and still meet the response-time goals for a zone by posting stellar times elsewhere in that zone, critics said.

While Maldonado stopped short of demanding a return to eight zones, she said a new approach seems necessary.

"The city needs to make it clear the ambulance provider will be held accountable if they don't operate with an equity lens," she said. "They need to treat all zip codes and neighborhoods the same, and there needs to be accountability for failures."

The city's 93-page request for proposals doesn't mention race, but it does say that San Diego prioritizes having a "socially equitable" emergency services system.

While the city mentions the existing four-zone response time model, the RFP says the new contractor will be asked to help boost equity of service.

"While performance is based upon compliance in the four zones, the city also monitors response equity through geospatial mapping of incidents within census tracts," the RFP says. "The city seeks to collaborate with the contractor to identify and resolve areas within zones that are disproportionately underserved."

In an emailed statement, AMR said the proposal the company submitted to the city will boost the equity of ambulance service across San Diego.

"AMR is deeply committed to providing high quality, equitable service to the people of San Diego," the statement says. "While we can't comment on the specifics of our proposal while it's being evaluated by the city, we can certainly say that it takes this commitment to an even higher level in every neighborhood throughout the city."

Falck also issued an emailed statement expressing a similar commitment.

"Falck is 100 percent committed to ensuring equitable service delivery for the city of San Diego," the statement says. "We value understanding the needs of the cities we operate in and tailoring our service to ensure that those cities have excellent service delivery and equitable coverage."

Falck also said the company has begun cultivating relationships with community organizations in anticipation of potentially taking over service in San Diego.

"Having a true competitive process will help enhance the level of accountability in the city's emergency services," the company said. "We are not San Diego's service provider yet. But we have already invested our time and energy into this community, fostering partnerships with diverse organizations throughout the city."

Councilwoman Monica Montgomery, who leads the council's public safety committee and who spearheaded the new Office on Race and Equity, declined to comment on whether the ambulance contract is a key opportunity for racial equity.

Councilwoman Vivian Moreno, who represents communities along the border where response time concerns have been the most acute, also declined to comment.

Rudy Lopez, a member of the San Ysidro school board, said it's important to note that residents in the city's southern neighborhoods don't want special treatment.

"We don't want anything special, just to be treated fairly," he said. "We just want equity in terms of response times."

Response times have sometimes been longer in South Bay neighborhoods like Otay Mesa and San Ysidro because they are geographically separated from the rest of San Diego by National City and Chula Vista.

That makes it more difficult to share resources with other San Diego fire stations when there is a high volume of calls. The area also is farther from a trauma center than anywhere else in San Diego, with Scripps Mercy and UCSD in Hillcrest being the closest.

Ambulance service in San Diego, which covers a 342-square-mile area, faces other challenges including traffic congestion, dozens of neighborhoods where streets don't follow grid patterns and the need to navigate neighborhoods divided by the city's many canyons.

In 2019, AMR handled 145,000 emergency calls and 101,000 patient transports — an average of 277 per day.

City officials announced in December that they had chosen Falck to replace AMR after evaluating responses to a previous "request for proposals" issued in 2019. But AMR filed a protest last winter that prompted the city to start the process over.

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©2020 The San Diego Union-Tribune

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