San Diego's ambulance provider still underperforming, changes looming over emergency medical services
The city of San Diego’s ambulance provider, Falck, is still not meeting expectations and city officials are prepared to take more control over the local 911 system, which could see a contract with another ambulance company to makeup for shortfalls.
“We can't continue to operate this way,” said Marni von Wilpert, chair of the San Diego City Council’s Public Safety Committee. “It’s been over a year now — we’ve never gotten the full unit hours or staffing levels we need. We have patients being carried to hospitals on fire trucks and that is not acceptable.”
Falck fully took over San Diego’s 911 contract last November.
An update provided to the Public Safety Committee Wednesday showed Falck continues to fall short of staffing goals, which the fire department said impacts response times and burdens existing staff.
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“We continue to see struggles in them meeting their contractual obligations,” said San Diego Fire-Rescue Chief Colin Stowell. "Both in the number of unit hours, their compliance in the emergency response zone and up until recently — filling some key management positions that we need for the success of this contract."
Wednesday’s update to the council focused on the months of October, November and December. Data from the fire department revealed Falck still has not once met their promised 900 monthly median paramedic hours. They reported 794 hours in October, 771 in November and 792 in December.
Fire-Rescue officials also said there continues to be times when no paramedic ambulances are available for 911 calls. That was the case for 21 hours in October, 34 hours in November and 15 hours in December. In those instances, a basic life support ambulance or even San Diego Fire-Rescue trucks may have to transport patients.
“It is not ideal — but from a public perspective we continue to provide a very high level of service because our apparatus’ have the paramedics and we have the ALS (advanced life support) equipment on them,” said San Diego Fire-Rescue Deputy Chief Jodie Pierce. “So we are responding to all of the 911 needs.”
Falck introduced a $50,000 sign-on bonus late last year and representatives said it has helped recruit 22 new paramedics, with another nine slated to start next month. Seven existing paramedics left the company during the same time period.
“Falck's new $50,000 hiring bonus is working despite the ongoing national shortage of paramedics and we are successfully hiring new paramedics to work in the city of San Diego,” said Falck San Diego Spokesperson Jeff Lucia in an emailed statement.
Lucia also said Falck is negotiating with employees on a new collective bargaining agreement, something that, “Supports increased recruitment and higher retention rates.”
Despite efforts, the San Diego-Fire Rescue Department is working with Falck on a contract amendment that would likely see another ambulance provider operating in the city. Chief Stowell said subcontracting will be a “pillar” of the amendment.
“Allow another provider to offer the supplemental hours that we need out in the system,” he said. “It gives the current workforce a break and allows us to stabilize the system.”
Falck officials said they are collaborating with the department on this long-term solution, which is expected to be presented to the Public Safety Committee next month.
“It’s been over a year since Falck took over this contract and we find ourselves in an unacceptable position where ... we don’t see improvement quarter by quarter — we’re seeing stagnation,” said San Diego City Councilmember Raul Campillo. “We need to do something different.”
Falck San Diego’s managing director Jeff Behm said their system still needs at least 32 additional paramedics.
“It is more than that in terms of the number when you look at issuing and approving (paid time off), managing the system for callouts and any type of leave of absence or injury on the job,” he said.
Falck is also being hit with just over $900,000 in fines for delayed response times during the months of July, August and September. The company signed a five year contract with the city in 2021.