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Grand Jury: Bring Back Program That Reduced 911 Overuse

The office for the San Diego County Grand Jury located on C Street downtown, ...

Credit: Matt Hoffman/KPBS

Above: The office for the San Diego County Grand Jury located on C Street downtown, Jan. 5, 2018.

In the final report of its term, San Diego County's 2017-18 grand jury Wednesday recommended the city of San Diego find a way to bring back a program aimed at reducing unnecessary 911 calls.

From 2010-16, the city ran the Resource Access Program pilot project, a paramedic-based team that identified and provided services to a relatively small number of people who were determined to frequently call 911 for situations that were not life-threatening or medical emergencies.

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The program ended in December 2016 when the pilot project period ended and its four paramedics, who were employees on loan from American Medical Response, were called back to the ambulance provider, which serves the city of San Diego.

During its existence, the program reduced emergency calls from 911 "mega-users" by more than 70 percent, and data show the program saved $700,000 per year and reduced the amount of time emergency responders spent with frequent 911 callers by more than 40 percent.

When it was disbanded, the San Diego City Council tried but was unable to find funds to continue it, the grand jury report said, and the four paramedics on the program were reassigned to conventional ambulance crews to help address a staffing shortage that American Medical Response said resulted in fines for failing to meet response time standards.

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The company argued that two additional ambulance units were needed to meet standards, and recently requested an increase in rates charged for ambulance transport due to increased costs, the grand jury said. But one of the complaints in the request, the overuse of emergency services by people who don't need it, is exactly what the Resource Access Program was trying to mitigate, grand jurors said.

Since negotiations between the city and American Medical Response included authorizing the city to seek a new emergency services contractor a year ahead of time, in 2019 rather than the original termination date of the contract in 2020, the grand jury said this is "an excellent opportunity" to reinstate the Resource Access Program.

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The program, they said, brought significant financial savings for the city and reduced strain on emergency responders during its existence, and being taken to an emergency room is simply not the proper treatment for many 911 over-users.

"This program should be considered an essential service, and funding and administrative responsibilities should be within the SDFD Fire-Rescue unit, rather than determined by the decisions of an outside contractor," grand jurors said in their report.

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