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San Diego gets what it expected, more ambulances serving the city

FALCK ambulances parked outside Scripps Mercy Hospital in San Diego, Calif. Feb. 16, 2023.
Matthew Bowler
FALCK ambulances parked outside Scripps Mercy Hospital in San Diego, Calif. Feb. 16, 2023.

City of San Diego residents are finally getting what they were promised for ambulance services. For the first time since taking over San Diego’s ambulance contract in November 2021, Falck San Diego officials reported they hit their staffing requirement for the month of June.

Falck officials said that is thanks in part to the San Diego City Council recently allowing Falck to subcontract missing hours to competitor American Medical Response (AMR).

Combined, Falck and AMR averaged 927 daily hours of ambulances with advanced-life-support capabilities on the road in June. The contract with the city requires a 900 daily hours on average each month. Falck officials said its ambulances made up the vast majority of those hours — 879 — with AMR averaging around 48 daily hours. In March, Falck officials said they averaged 788 hours, 795 in April and 845 in May.


“We knew this was taking time,” said Falck San Diego’s managing director John Goward. “We’ve been committed to the city since the very beginning here.”

Falck officials had pointed to pandemic delays and a nationwide shortage of paramedics as the reason they had not consistently met the contracted hour requirement. The company did meet it on some days but never for an entire month. That spread crews out across the city and drove up response times, resulting in around $3 million in fines since late 2021. Instead of paying those fines to the city, officials are letting Falck pay AMR with the money.

“We know about the workforce shortage. We worked through that and we realized it would take time and we have gradually built it up and brought up the retention,” Goward said. “So we knew we were on the trajectory to get there, it just took some time.”

Falck attributed the increases to boosting recruitment efforts with a $50,000 sign-on bonus for new paramedics and giving existing employees a pay raise. Under a new bargaining agreement, paramedics and emergency medical technicians (EMTs) will see a 17% raise over three years.

“If you put good pay, good working conditions — and we have the employees now — we expect to keep them through,” Goward said. “There’ll always be some variation but I don’t see a return to where we were.”


Goward said the increased staffing levels has also improved response times.

The San Diego Association of Prehospital Professionals (SDAPP) represents Falck paramedics and EMTs (emergency medical technicians. Union President Tony Sorci said this was a longtime coming.

“We had a rough startup,” Sorci said. “We started the operation in Nov. 2021 and we were short staffed at start-up. In addition to that, we were underpaid against a mid-contract raise with one of our competitors.”

Sorci said being understaffed meant crews were driving around the city trying to respond to calls and some paramedics were burning out. Now he said ambulances should not have to drive from one side of the city to another to respond to emergency calls.

“We’ve increased our service levels to the citizens,” Sorci said. “The men and women of our workforce are experiencing exceptional changes in our working conditions and consequently a happier workforce is a sustainable workforce.”

Sorci credited the San Diego City Council for allowing Falck to subcontract any missing hours. He said he expected Falck will be able to stop subcontracting to AMR soon.

Later this month the San Diego Fire-Rescue Department, which oversees emergency medical services and Falck's contract, will present a plan to take more control over 9-1-1 services. That would mean the city would take over billing responsibilities and contracting with Falck, and possibly other providers like AMR, to fulfill ambulance services.

“We appreciate the city council and Falck being willing to explore alternative approaches to delivering critically needed emergency ambulance service in the city,” said San Diego Fire-Rescue Chief Colin Stowell in a news release from Falck. “We look forward to continued collaboration and improvements to the system.”

Corrected: July 7, 2023 at 6:10 PM PDT
Editor's Note: San Diego Association of Prehospital Professionals President Tony Sorci's name was misspelled in an earlier version of this story. We regret the error.
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