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Changes may be coming to San Diego’s emergency medical services

The city of San Diego’s ambulance provider, Falck, is set to see fines again, after failing to meet response times and staffing goals. KPBS Reporter Matt Hoffman has more on changes that could be coming in the new year.

The city of San Diego’s ambulance provider, Falck, is set to see fines again, after failing to meet response times and staffing goals. This week an update on the company’s performance for July, August and September was heard at the San Diego City Council’s Public Safety and Livable Neighborhoods Committee meeting.

San Diego Fire-Rescue (SDFD) Chief Colin Stowell said Wednesday he is still not seeing the high level of service promised by Falck.

“This is not getting better anytime soon,” Stowell said. “We’re seeing the trends right now with the staffing, and I do not feel like anything is going to be corrected in the near future if we just wait this out and wait for it to improve.”

Last November, Falck fully took over San Diego’s 9-1-1 contract. Falck promised more paramedics and EMTs than the previous provider (American Medical Response), but data from the city shows they have not once met monthly staffing goals. Falck is contracted for a monthly median of 900 hours. In July they hit 810 hours, 768 in August and 756 in September.

Falck San Diego’s Managing Director Jeff Behm said low staffing levels have continued to hurt response times.

“July, in terms of compliance, was very good and August became a little worse, but we saw September being one of our worst months of the year next to January,” Behm said, “a lot of that is certainly due to staffing, illness and injury.”

Falck has already been fined $1.5 million, and fire department officials said more fines are on the way. Final response time data for the last few months is not yet finalized and an SDFD spokesperson said fines are still being tallied.

Falck officials said there is a national shortage of paramedics and EMTs. They also admit recruiting has been a challenge, even after offering sign-on bonuses.

“This ebb and flow is very obvious — the problem we have here is they are not competitive,” said Anthony Sorci. Sorci has been a paramedic for 25 years and president of the San Diego Association of Prehospital Professionals, which represents Falck employees.

Sorci said staffing shortages are forcing overtime and first responders are burning out.

“Our members share experiences of helplessness and mental anguish that has resulted in increased numbers of physical injuries, illness, PTSD (post-traumatic stress disorder) and serious clinical depression,” Sorci said.

Sorci also said lack of staff has ambulances traveling all over the city, pushing up response times and even forcing the fire department to take their own measures.

“These delays have resulted in critical patients being transported to area hospitals by San Diego fire engines because the fire crews could no longer wait for an ambulance at the scene...” Sorci said.

A SDFD spokesperson confirmed fire engines have taken patients to hospitals. City data shows availability for paramedic ambulances has risen from just over an hour in April to 42 hours in September.

Councilmember Raul Campillo was not pleased with the lack of improvement.

“I’m disappointed that we seem to be in a position that we can’t provide our residents what we promised them,” Campillo said. “It’s the same song again.”

Councilmember Marni von Wilpert said she does not need to hear any more.

“It seems that we have a pretty serious problem,” she said. “This contract is failing.”

Fire Chief Stowell is preparing for the worst. He commissioned a study to look into what it would take for the city to take over emergency medical services. Von Wilpert is eager to see options presented during a meeting in January.

“Whether it’s an amendment to the contract or if we have to do some kind of bond or takeover of the program, or bring another program in to help — we have to do something,” Von Wilpert said.

Falck officials also maintain one reason for delays: their ambulances are being held too long at hospitals. Some local hospitals push back on the reason. Scripps Health said in a letter to council members that emergency rooms are busy. They point to county data that shows most patient transfers happen on-time.

“We see the percent offloads in under 30 minutes in San Diego was 74% for that month (September),” wrote Monica Montano, Scripps Director of Government and Community Relations. “We would like to understand why the Falck data is different.”

A letter from the President of the Hospital Association of San Diego and Imperial Counties pointed out the same data. Officials from Sharp Grossmont Hospital said they are also busy, and that is when delays can happen.

“Our department is always open to opportunities to reduce offload delays and we look forward to partnering with our EMS (Emergency Medical Service) colleagues to ensure that people are getting the necessary attention and treatment they need as quickly as possible,” said Marguerite Paradis, director of Emergency Services and Critical Care at Sharp Grossmont Hospital.

Councilmember Monica Montgomery Steppe said bottom line, no more excuses.

“I just don’t want to hear that anymore — we need to put solutions on the table,” she said. “And I’m glad that we’re going to be coming back in January.”

Falck, the city and other stakeholders said they will continue to collaborate.

“We’re working closely with the San Diego Fire-Rescue Department and making investments that will bring more paramedics to the system,” said Jeff Lucia, Falck San Diego spokesperson.

Falck officials said they have invested over $30 million in San Diego, including a fleet of new ambulances and equipment. The company signed a five year contract with the city in 2021.

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