Jessica Vega Pederson, candidate for Multnomah County Chair.
Courtesy of Jessica Vega Pederson
Multnomah County Chair Jessica Vega Pederson is responding to mounting public pressure for the county to reconsider its ambulance staffing requirements and address slow response times countywide.
In a press conference Tuesday, Vega Pederson sounded defiant. She threatened fines and repeatedly blamed ambulance service provider American Medical Response for a staffing shortage.
She continued to criticize the company’s proposal to get more ambulances on the street by switching to a staffing model with one paramedic and one EMT. The county currently requires two paramedics on ambulances.
“AMR’s plan to reduce the level of medical expertise on ambulances would give their company bigger profits and it would shift the cost of the system to taxpayers,” she said.
Yet, Vega Pederson also said she is taking the first step necessary to reconsider the county’s two paramedic requirement: Asking the Board of Multnomah County Commissioners to immediately reopen the ambulance service plan, two years ahead of schedule.
“Any changes we make to our system have to be informed by a thorough process, to avoid unintended consequences,” she said.
Vega Pederson said the county has entered formal mediation with AMR and will begin collecting fines against it next month if the company doesn’t work harder to meet ambulance response times.
Pederson said AMR has accrued $2 million in fines so far for its late response to 911 calls since last August.
“The only way that we are going to truly solve this crisis is by trusting medical experts and by holding AMR accountable,” she said.
Vega Pederson said AMR has not taken several steps that could help improve ambulance response times but might cost the company. Those include subcontracting with other ambulance providers to shore up their staffing and deploying more Basic Life Support ambulances, staffed by EMTs only, to simple calls that don’t require any paramedics.
AMR has struggled for the past year to respond to the most serious 911 calls within eight minutes, the national benchmark and a requirement in its contract with the county. The county has reported a significant number of “level zero” periods when all staffed ambulances are deployed and there are none available to respond to new emergencies.
AMR’s leadership has said that in the aftermath of the COVID-19 pandemic, the company is dealing with a shortage of paramedics in Multnomah County and nationwide.
AMR has blamed Multnomah County’s two paramedic staffing rule for exacerbating the crisis, saying it’s more typical nationwide for ambulances to be staffed by a single paramedic paired with an EMT.
In a brief proposal submitted to the county last week, AMR operations manager Rob McDonald said the company could be back in compliance with the eight-minute response times within three months if it is allowed to deploy ambulances staffed with a paramedic-EMT team.
EMTs can provide basic life support, including CPR, to patients. Paramedics have additional training to administer medications and intravenous drugs.
According to its most recent tally, the company is short 60 paramedics in Multnomah County, and as a result, cannot staff and deploy the 50 ambulances it needs daily to meet response times.
Multnomah County’s current model has ambulances with two paramedics responding to virtually all 911 calls, including many low-acuity calls that don’t need any paramedic response.
More serious 911 calls, for critical emergencies like heart attacks and respiratory distress, trigger a response from a Portland Fire and Rescue truck that is staffed by a paramedic, meaning three paramedics and multiple EMTs dispatch to calls in Portland.
A growing list of stakeholders has asked Vega Pederson to accept AMR’s proposal to switch to the one paramedic and one EMT staffing model, including Portland Fire and Rescue, Gresham Fire and Rescue, Corbett Fire, and Portland Emergency Management, as well as the mayors of Gresham and Troutdale.
In a letter to the county’s EMS director, Interim Portland Fire Chief Ryan Gillespie wrote that the status of ambulance service in the city of Portland is putting lives at risk.
“While the stalemate persists, our community continues to suffer the consequences,” Gillepsie wrote. “... I implore you to change your hardline stance on the current two Paramedic model and allow AMR the flexibility to attempt to address the issue.”
The Portland City Council is set to discuss a resolution Wednesday, calling on the county to change its ambulance staffing model.
