By Jeff Horseman
The Press-Enterprise
RIVERSIDE COUNTY, Calif. — Arriving too slowly to calls too often has cost Riverside County’s emergency ambulance provider a one-year renewal of its long-running contract.
American Medical Response’s contract with the county doesn’t expire until July 2026. But in an unusual move, officials earlier this month rejected an extension, citing the private company’s failure to meet response time standards and other expectations.
An AMR representative told the Board of Supervisors on Tuesday, March 28, that the company is taking “extraordinary steps” to hire from a scarce pool of paramedics and remains dedicated to provide the county with top-quality service.
Headquartered in Colorado, AMR has long been the county’s choice to take patients dealing with medical emergencies to hospitals.
The current pact, agreed to in 2015, was for five years and gave AMR the ability to seek 10 one-year renewals starting in 2020. Every year, AMR submits an extension request by Sept. 1. After reviewing the company’s performance, the county Emergency Medical Services Agency approves those renewals, something it’s done six times.
Previously, AMR met the benchmarks needed for one-year extensions. But Bruce Barton, the county’s emergency management department director, told supervisors that AMR missed response time benchmarks in five of 12 months between July 1, 2021 and June 30 of last year.
In addition, Barton said that on hundreds of occasions, AMR sent basic life support ambulances to calls requiring advanced life support ambulances outside the parameters of a system designed to handle minor calls without the need for advanced medical care.
AMR also was late submitting response-time reports and its annual report lacked required response-time data, Barton added.
While the county’s emergency medical response network needs “to move to the next level … we need the medical system to be resilient going through a medical emergency, not become a victim of that medical emergency,” Barton said.
“And we’re not providing the service that we need to provide to our communities.”
Late response times also affect the county’s fire departments. In Murrieta, response-time benchmarks are currently being met 54% of the time, up from 42% in 2022, said Bernard Molloy, the city’s fire chief.
“We have two hospitals in our city and one right outside of our city,” he said. “So ambulances are never very far from us. It’s not like these are long response times.”
As a result, “Our first responders sit on scene and aren’t able to transport that patient to the hospital in a timely fashion,” Molloy said. “When we’re waiting for these ambulances to come, we no longer have a fire engine that can do fire engine work because we’re stuck with the patient.”
Jeremey Schumaker, AMR’s regional director of operations, said his company is grappling with a paramedic shortage stemming from the COVID-19 pandemic, when paramedic and emergency medical technician classes were canceled and paramedics left the profession and were sidelined by the virus.
“We share in the frustrations that these shortages have had on our response times and we’ve taken extraordinary steps to mitigate those impacts,” he said.
Those efforts include giving paramedics raises and hiring bonuses, starting an “earn while you learn” program for emergency medical technicians, spending more on overtime and funding paramedic school scholarships for 70 employees.
That said, training a new paramedic takes time, Schumacher said.
“We continue to compete for the same diminished pool of paramedics with every other EMS agency across the country (and) with all of the fire departments represented (in the board chambers).”
“I think we’re going to see some significant improvements in the coming months,” he said. “But there’s still a long way to go.”
Riverside County Supervisor Kevin Jeffries, a former volunteer firefighter, said that while AMR deserves leeway for pandemic-related problems, “we’re way past the devastation that we all experienced with COVID, and yet AMR hasn’t been able to figure out how to get back to normal operations.”
“That’s unacceptable. There’s got to be a sense of urgency to get you back to full adequate staffing … my trash doesn’t get picked up for two weeks, back to back … the trash companies have trouble hiring trash truck operators. Nobody’s dying because of that.”
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