By Austin De Dios
oregonlive.com
MULTNOMAH COUNTY, Ore. — Multnomah County officials are weighing a change to its ambulance policy that requires two paramedics in each vehicle — a guideline that ambulance contractor American Medical Response claims is hindering response times.
Already slow emergency service is what prompted the county to fine the company over $500,000 last month. Officials said AMR failed to meet response requirements in August, including one that calls for ambulances to reach “high acuity calls in urban areas” in eight minutes. Of the company’s 11,577 responses in August, 14% were late enough to warrant penalties.
In a Multnomah County board meeting Thursday, Commissioner Sharon Meieran proposed allowing AMR to change its staffing to one paramedic and one EMT per ambulance. The aim would be to address the employee shortages confronting the ambulance provider since the pandemic amid a nationwide labor crunch.
That shortage could get worse, AMR officials warn. As their Washington County employees take steps to unionize, contract provisions could allow Multnomah County’s ambulance crews to transfer elsewhere.
Multnomah County is the only area in the country serviced by AMR that requires two paramedics per vehicle.
County Chair Jessica Vega Pederson agreed Thursday that officials should re-evaluate the two paramedic model but warned that it could be a long process. Vega Pederson told Meieran that she consulted with the county’s lawyers and other officials who said that the review could take as long as nine months.
She also said that AMR could be doing more to solve the problem, highlighting the company’s decision in August to contract with Washington County.
“I do not believe they are doing enough to incentivize people to come to Multnomah County or to incentivize people to come and stay in Multnomah County,” Vega Pederson said.
Robert McDonald, AMR’s operations manager in Multnomah County, supports Meieran’s proposal, he said.
“Our system is going to continue to fracture under the weight of the national paramedic shortage and the two paramedic system requirement,” McDonald said.
As of now, the company has not permitted paramedics hired in Multnomah County to transfer to other job sites such as Washington County.
But Washington County’s AMR staff are in negotiations to unionize, and when they do, paramedics and EMTs will have the opportunity to transfer, McDonald said.
“It’s going to put a huge dent in our ability to staff and deploy paramedics,” he said.
McDonald said in addition to staffing problems, a higher volume of calls due to drug overdoses, increased violence and danger for paramedics and education requirements are adding barriers for paramedics in the county.
”EMS in Portland is tough,” he said. “With all the social concerns going on in the city, EMS is sad here. EMS is hard here.”
In response, AMR has been offering full-ride scholarships for their paramedic program, which costs roughly $18,000. They have also been working with the county on an EMT program to respond to more minor calls, McDonald said.
If Multnomah County were to allow one paramedic per ambulance, AMR could put four to five more ambulances on the road within 24 hours, and the company could fully staff up to 50 ambulances — up from 34 — in three months, McDonald said.
“This is a change that must happen to save the system,” McDonald said.
Last month, Portland Commissioner Rene Gonzalez added his support to Meieran’s push.
“It is time for the county to reassess whether the costs of mandating a 2-paramedic staffing model are now outweighing the benefits,” he wrote on X on Nov. 30, about a week before announcing he would run for Portland mayor.
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