Calif. county may fine EMS for failed response times

By Rachel Engel

ALAMEDA COUNTY, Calif. — Falck Alameda County may be required to pay financial penalties if chronic ambulance response time delays aren’t corrected by later this month.

According to an October 4 letter from Alameda County Emergency Management Services (ALCO EMS), which oversees ambulance services in the county, Falck had failed to meet the “90% on-time threshold for Code 3 service calls” in each of Falck’s three service zones, The Independent reported.

Due to the failure to adhere to contractual emergency response times, the county plans to assess fines for additional response time delays by Falck.

In the letter, ALCO EMS requested Falck provide the agency with a corrective action plan by October 19.

“These performance shortfalls represent an unacceptable progression of Falck’s poor response-time trends, which the EMS Agency has been raising with Falck with increasing alarm and to which Falck has responded with a disappointing lack of urgency,” said Lauri McFadden, ALCO EMS director. “As the EMS Agency has discussed with Falck over the past several months, it is clear there are significant problems with Falck’s operational plan. Noncompliance with response time requirements – particularly those pertaining to high priority requests for service – is a serious matter.”

Jeff Lucia, Falck USA director of marketing and communications, said the response time issue is a result of the pandemic, and said it’s not unique to his agency.

“The pandemic-induced staffing shortage is a national crisis that affects virtually the entire labor market, especially healthcare,” he said in an interview with The Independent. “But it has particularly impacted hospitals and EMS agencies of all types – ambulance services, fire departments and other public agencies alike. Ambulance services across the U.S. are finding themselves stuck in the middle of a crisis they didn’t create and can’t control.”

Rob Lawrence, executive director of the California Ambulance Association and EMS1 columnist agrees that Falck is not the only agency struggling.

“This is almost the microcosm, in Alameda (County), of the national picture right now,” Lawrence said. “I think it’s fair to say that these issues are going on across the country. We hope, of course, things get better. But right now, we are where we are.”

However, according to McFadden, issues plaguing Falck pre-dated the pandemic, and subsequent meetings regarding ALCO EMS’ concerns did not provide clarity or solutions.

“Despite the EMS Agency’s warnings and suggestions on how to improve on-time performance, Falck has consistently displayed a lack of urgency in proactively correcting identified issues, resulting in increasingly poor performance,” McFadden said.

While Falck is working to increase staffing levels, those efforts will not help the issues providers run into when attempting to offload patients at the emergency department, Lucia said.

“Unfortunately, our heroic paramedics and EMTs are spending more than 30% of their time stuck at hospitals and unable to respond to emergencies,” he said. “And equally unfortunate, no number of additional ambulances, paramedics or EMTs will free a single hospital bed or add a single nurse to a short-staffed emergency department.”