Board approves Ambulance Service Plan

December 8, 2016

The  Board of Commissioners voted 4-to-1 today to approve a new Ambulance Service Plan, paving the way for a competitive process  in 2017 to contract for emergency medical care county-wide.    

The Board also by a vote of 4 to 1 rejected an amendment by Commissioner Jules Bailey to allow another government agency -- such as the city of Portland - to become the provider and subcontract the ambulance services.              

All counties are required to have an ambulance service plan. The plan lays out the structure of the emergency medical system such as communications, roles of fire agencies, ambulance deployment and staffing, response times, and medical direction.

Since 1994, the plan has required one ambulance provider serving the whole county under one medical director, and accountable to the Health Department and Board of Commissioners.

The contract for the current provider, American Medical Response, ends in August 2018.

Health officials said the 1994 plan created a system that works extremely well and the update seeks only to increase quality, equity and stability.

Ken Burns, acting on behalf of Portland Fire &  Rescue and the city of Portland, asked the Board for a friendly amendment that would allow another agency, such as the city of Portland, to get the contract and subcontract as a means to tap federal money for transporting people on Medicaid.

Dr. Paul Lewis, the Multnomah County Health Officer who oversees the Emergency Medical system, said while subcontracting is allowed to address unique challenges such as a hard-to-reach area, allowing a second bureaucracy between the county and the provider and limit the Board’s ability to hold the ambulance provider accountable and ensure all parts of the country -- especially rural and east county -- receive the same services.

“We feel we’re accountable to you and by handing it to another set of elected officials would affect our accountability to you and our accountability.

He added, “It also opens up possibility of having multiple 911 providers and that was the 1994 plan was specifically was created to solve, a single accountable provider that serves the entire county, not just part.’’

Chair Deborah Kafoury said “there isn't a person here who does want our emergency management system to have additional dollars,’’ but that the potential to tap federal money is still unclear and unformed and won’t be decided soon or at the local level.

“Also if we’re going to hand over and bifurcate the system, I want to see our other government here. No offense to Portland Fire, but I don't’ see anyone from the city of Portland here advocating say they want this responsibility.’’

Commissioner Judy Shiprack agreed, “I don't want to venture into that world where the services are fragmented and there is no clear responsibility.’’

The plan does address city of Gresham concerns about first responders being on scene for prolonged periods by adding a response time for non-critical medical issues and creating a way to adapt to the eventual upgrade of the 911 triage call system.

But the board declined to require the plan to have worker wage and benefit protection language saying that language would be included in the RFP as it was in earlier contracts.

Commisioner Jules Bailey said he wanted worker protection language in the ordinance.

“There are a lot of hardworking women and men that show up every day that make that system function. The lives of our constituents depend on a well-trained, well-qualified, well-compensated and well-supported workforce.’’

“I want to say ditto, ditto ditto,’’ said Commissioner Loretta Smith. “We have a lot of hardworking folks who are doing a wonderful job and we want to continue that.

Commissioner Diane McKeel thanked the Health Department team for working across the entire county:
“I want to thank you working with East County cities, all four of them, very diligently.’’