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Ore. county failed to fine AMR over earlier response times

Report finds AMR failed to consistently meet Multnomah County’s response time requirement since 2019 but was not penalized


Multnomah County said it will start fining American Medical Response ambulances starting September.

Mike Zacchino/The Oregonian

Austin De Dios

MULTNOMAH COUNTY, Ore. — Multnomah County’s ambulance provider has struggled to meet 911 response time standards for years, and county officials failed to act early on, according to a report from the county’s ombudsperson.

The 11-page report published Friday shows that American Medical Response , since at least 2019, has not consistently met the county’s requirement that ambulances arrive at urban calls within eight minutes 90% of the time. County officials did not penalize the provider until recently.

The county first threatened to ding AMR for contract violations in August and issued a fine of more than $500,000 three months later. Chair Jessica Vega Pederson announced those fines had risen to a total of $2 million in February, but the county hasn’t collected on the bill because the two parties entered mediation in March.

The county’s ombudsperson, Cheryl Taylor, said that fining AMR sooner would have made the fines more manageable.

Ambulance response times continued to worsen in 2022, the report shows, including a six-month period when arrival times were well below the 90% threshold. The trend did not improve when Vega Pederson took office as chair in 2023.

“I think people are looking at this as an emerging crisis,” said county Auditor Jennifer McGuirk. “This has been an ongoing issue since early 2022, with patches of time before then with non-compliance.”

Preliminary data shows the situation has not improved in recent months, the report said.

The document pointed to an instance last May when a man in a wheelchair died after he was struck by a hit-and-run driver and waited 32 minutes for an ambulance in Northeast Portland. County officials did not immediately respond to the man’s death, the report said, and that prompted the ombudsperson’s investigation into ambulance response times.

Several similar “level 0″ incidents have put lives in danger, forcing first responders to find unconventional ways to get people to emergency rooms. On New Year’s Eve, Portland firefighters took a man experiencing chest pains to the hospital by TriMet bus.

More recently, the Portland Fire Bureau responded to reports of a stabbing in the Rockwood neighborhood, fire officials said. They arrived to find a person with multiple stab wounds, but no ambulance was available to take them to the hospital. The closest medical transport was in Clackamas County, forcing first responders to load the patient into a Gresham police car to get them to an emergency room.

The report also found that the county was supposed to establish an Emergency Medical Services Advisory Council to help make recommendations to the Multnomah County Board of Commissioners, but this step was never taken.

In a letter responding to the report, Vega Pederson said the decision to delay fines against AMR was intentional and “based on our commitment to collaborative problem-solving.” She said the company’s push to lower its staffing standards and failed attempts at “less-punitive” solutions pushed her to issue the fines.

Vega Pederson said it would be possible to develop a “confidential internal dashboard” for commissioners to check on the status of response times, but argued that the advisory council wouldn’t be necessary because the updated version of the Ambulance Service Plan — the document that guides ambulance services in the county — does not require it.

Commissioner Sharon Meieran also has called on the county to lower its ambulance staffing requirements, allowing an EMT to ride with paramedics instead of having two paramedics on board. Fellow commissioner Julia Brim-Edwards and Portland and Gresham officials joined her, but the proposal was struck down by Vega Pederson .

The county commission voted in April to re-open the county’s Ambulance Service Plan.

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