Officials: Calif. EMS agency violated response time standards in much of 2017
A dramatic report documents chronic failure to meet time performance standards in four “exclusive operating areas”
By James Burger
The Bakersfield Californian
KERN COUNTY, Calif. — Hall Ambulance’s seemingly unassailable, exclusive grip on ambulance service in western Kern County has been shaken by a dramatic report from the Kern County Public Health Services Department.
Hall Ambulance, it states, is in violation of its contract to supply ambulance service to customers in Bakersfield, Wasco, Tehachapi, Arvin, Lamont and Frazier Park and surrounding areas.
The report, released publicly Thursday, documents chronic failure to meet time performance standards in four “exclusive operating areas” in western Kern.
In three of those areas — including the two areas that include all of metropolitan Bakersfield — Hall has been out of compliance for at least three months and is in breach of its contract.
“Hall Ambulance Service, Inc. is aware of the report and will respond to the County of Kern Board of Supervisors on Tuesday, February 6,” wrote Hall Ambulance spokesman Mark Corum.
Public Health officials declined, Thursday, to comment about the public report prior to Tuesday’s meeting.
And they would not say whether Hall Ambulance could be stripped of control of the operating areas in question because that control is part of a contractual agreement between the company and the county.
The county has been working with Hall to try and achieve compliance since August.
The issue is time.
Hall’s ambulances are reportedly taking too long to get to patients.
Under Kern County’s ambulance rules each geographical area of the county is assigned exclusively to a single ambulance provider.
As long as that provider complies with county standards they have sole right to provide ambulance services to residents in that area.
Nobody else can compete with them.
Under the rules ambulances have a certain amount of time — after they have been dispatched — to arrive on the scene of a call.
Those ambulance responses are tracked by the priority of the call and the zone that the call comes from.
An ambulance has more time to get to a non-life threatening call in a rural area, for example, then it does to get to a life-threatening call in a metro area.
To meet standards, ambulances have to arrive on time in at least 90 percent of the calls in each zone and priority.
But over the past year, according to the county report, Hall Ambulance’s performance in four of those “exclusive operating areas” has slipped below that 90 percent standard.
Hall Ambulance’s failures to meet standards in each of the four operating areas are a little different.
The contract with the county is breached if an ambulance company is out of compliance with response time standards for three consecutive months or four non-consecutive months.
Here are where the lapses took place.
Exclusive Operating Area One:
EOA 1 runs through the rural areas of northern Kern County area and ends in the northwest corner of the county. It includes Wasco and Lost Hills.
Hall failed to meet performance standards for Priority 1 calls, the most serious emergency alerts, in areas designated as "suburban" in June, July, August, October and November.
It also missed priority three and four call standards in the suburban areas from July through December.
Hall failed to meet standards for priority one calls in "urban" areas of EOA 1 in every month between June and December, according to county reports.
Exclusive Operating Area Four:
EOA 4 covers nearly all of metropolitan Bakersfield with the exception of the area roughly north of Brundage Lane and east of Chester Avenue. It also covers rural areas north and west of the city.
According to the county reports Hall Ambulance failed to meet priority one call response standards in in the metro areas of EOA 4 in April, August, September, October and November. Hall missed priority two call standards in the metro area in October.
Exclusive Operating Area Five:
EOA 5 covers northeast Bakersfield and Oildale as well as the rural areas in a strip that runs north to Glennville.
According to the county reports Hall Ambulance violated priority two call standards in in the metro areas of EOA 5 in 11 of the 12 months of 2017. That standard was only met in January of that year.
Exclusive Operating Area Eight:
EOA 8 runs from Lamont south to Frazier Park and Pine Mountain Club and east to Tehachapi and Sand Canyon.
Hall failed to meet response time standards for priority one calls in the urban areas of EOA 8 in August and priority two calls in the urban areas in November.
Hall Ambulance has, according to letters from Harvey Hall to Kern County Public Health, made a dramatic effort to fix the problems the county has identified.
Hall wrote in an Oct. 4 missive that the non-compliance in EOA 1 and 5 happened because “inaccurate” internal reports made it appear Hall was in compliance.
In a Jan. 18 letter Hall reported that his company has hired 42 new employees since August and deployed 25 new ambulances into the system.
Hall has also reworked its ambulance assignment system to shift lower priority work from advance life support ambulances that handle serious cases to basic life support units, he wrote.
But, while some major improvements have been made, the efforts have not completely erased the history of violations.
Hall wrote that, in the metropolitan areas of east, south, west and northwest Bakersfield, his ambulances met response time standards for priority one calls in December and January.
He also cast some blame at local hospitals which, he wrote, have been delaying his ambulances for hours on end while his EMTs and paramedics wait to off-load the patient to the hospital.
“The hospitals, which are not subject to any sanctions for performance, have found it is easy to dump their problem on my employees and me,” he wrote.
The “ridiculous” level of delay, Hall wrote, is taking his units out of circulation and eliminating the benefit he sought in hiring more staff and fielding more ambulances.
But the long list of months in which Hall Ambulance violated standards in 2017 mean the company remains in violation of its contract and will likely do so for some months to come.
Tuesday’s meeting could be a dramatic one before the Kern County Board of Supervisors because Harvey Hall is proud of his company’s long record of service.
Previous conflicts over service issues give some indication of the tension that is likely to ignite next week.
In 2003, before the county of Kern took over all ambulance regulation in Kern County, Hall asked the city of Bakersfield for rate increases of between 25 and 77 percent while he was mayor.
The Bakersfield City Council declined to grant the increases immediately, launched an investigation into whether Hall had a conflict of interest and debated the issue for six months. Eventually the Bakersfield City Council approved a 12.7 percent increase in Hall’s ambulance rates
It was a hard time for Hall, a self-described perfectionist who campaigned, won and held the Mayor’s seat based on his passionate belief he could bring different segments of the community together in harmony.
The conflict in 2003 had him wondering if he would be forced to leave the position he loved.
At one point Hall removed boxes of his belongings from the office.
He eventually moved back in and remained as Bakersfield mayor until he retired in 2016.
Copyright 2018 The Bakersfield Californian
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