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Ore. county officials reject EMT/paramedic staffing plan

The Multnomah County Board of Commissioners rejected a plan that would change AMR staffing to make up for a paramedic shortfall and reduce response times

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Ambulances from AMR sit outside the Adult Emergency entrench of Legacy Emanuel hospital in NE Portland, Oregon.

Mike Zacchino/TNS

By Tatum Todd
oregonlive.com

MULTNOMAH, Ore. — After nearly three hours of deliberation Thursday, the Multnomah County Board of Commissioners rejected a proposal by Commissioner Sharon Meieran, an emergency room doctor, to improve the County’s ambulance response times by lowering ambulance staffing requirements.

Her proposal — which urged County Chair Jessica Vega Pederson to allow an EMT to replace one of the two paramedics the county now requires to try to make up for a paramedic shortage — came as the county is experiencing exceptionally long ambulance wait times. Meieran first proposed the idea five months ago but Vega Pederson blocked it from the commission agenda until this week.


Multnomah County commissioners are expected to decide on a plan to change AMR staffing to one medic and one EMT.

Only one fellow commissioner, Julia Brim-Edwards, voiced support for Meieran’s idea, which would have temporarily switched the county’s ambulance service to mixed EMT-paramedic staffing for months while its effects were tracked, including response times and patient outcomes. It takes three votes of the five-member commission to approve a proposal.

Thursday’s meeting happened against the backdrop of ongoing mediation between Multnomah County and AMR, the county’s sole ambulance provider, after AMR chronically took too long to respond to calls and the county fined the company over $500,000.

The mediation is supposed to wrap up no later than Wednesday, and commission members or the commission as a whole are slated to be briefed on the deal Thursday. The negotiations are confidential. Commissioners acknowledged Thursday that they know the county’s and the ambulance company’s latest proposals – but they did not hint what they are.

Meieran summoned a panel of experts, including Portland’s and Gresham’s fire chiefs and Portland Community Safety Director Mike Myers, and elected local officials to brief the commission. The experts and Portland Commissioner Rene Gonzalez, who until this month oversaw the city’s emergency response bureaus, provided a united front strongly in favor of Meieren’s plan.

The fire chiefs, who issued a joint statement in support of ambulance staffing changes in February, spared no words in criticizing the lack of immediate changes to the county’s staffing model.

Portland Fire Chief Ryan Gillespie said that firefighters have had to transport patients to the hospital in the back of fire trucks without seatbelts because no ambulances were available. Gillespie added that he felt emergency service professionals were being cut out of the decision-making process by not having a representative at the county’s mediation meetings with AMR.

“Meanwhile, this crisis continues and has gone on for far too long, with the short-term solution being proposed by those of us doing the work on the streets,” Gillespie said. “Multnomah County’s inaction and unwillingness to take immediate measures continues to put lives at risk.”

Gresham Fire Chief Scott Lewis also criticized the two-paramedic rule, saying that the healthcare credentials of an ambulance’s driver have “zero impact” on the outcome of a patient being transported to a hospital.

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