The Multnomah County Board of Commissioners recently voted to re-evaluate the Ambulance Service Plan (ASP) — two years ahead of schedule. Revising the 2016 Plan is needed so that the County’s Emergency Medical Services team can make informed recommendations to the Board of Commissioners on material changes to the system.
The vote approved the Health Department’s request for $167,086 from the County’s General Fund contingency to immediately initiate an early review of the Plan. That work includes hiring an expert consultant, analyzing data, and extensive interviews, focus groups and meetings with stakeholders such as fire departments, first responders and emergency departments. The goal of this process is to ensure that all partners can weigh in, and the public understands the impact of any changes to ambulance services to the emergency medical system, including staffing.
Board Chair Jessica Vega Pederson acknowledged several fundamental policy issues around the County’s current Ambulance Service Plan — including appropriate staffing, required ambulance response times, the 911 dispatch system and the formal and informal roles of fire agencies — that the Board, jurisdictional partners and other stakeholders want to reevaluate.
The state requires each county to have an ambulance plan that specifies how emergency medical services are delivered, including the role of fire agencies, ambulance deployment, staffing, response times, medical direction and quality improvement.
Re-evaluating the Plan is one part of Chair Vega Pederson’s four-point plan to address the Ambulance Service crisis that was announced on Feb. 20.
“The appropriate and responsible process to examine these major elements of our emergency medical system is an assessment of our Ambulance Service Plan,” said Vega Pederson. “To do that full picture analysis, the ASP assessment process is the appropriate tool and we should start now, because it is — by nature and by necessity — an in-depth process.”
Reviewing the plan requires both Health Department staff and an external consultant with subject matter expertise in emergency medical service systems. Emergency Medical Services administrator Aaron Monnig explained the assessment will identify the strengths and challenges of the County’s current system, explore possible system wide changes — including potential benefits and tradeoffs — and produce recommendations to build a stronger County EMS system.
Monnig said the assessment is the appropriate process to reexamine major elements of our system.
“Typically, we would do this within the contract term of our ambulance service provider, which would be assessed in 2026 to 2028, but it is clear there is urgency to evaluate these big system questions sooner than that,” said Monnig.
Monnig explained the ASP assessment is a consultant-facilitated process that includes stakeholder engagement and data analysis and review.
“The ASP assessment is expected to take around nine months, and at the conclusion of the assessment phase, recommendations would come to the Board of County Commissioners for consideration,” said Monnig.
During the Board meeting, four local paramedics and Portland Fire Chief Ryan Gillespie testified in support of a full assessment of the Plan.
“It is time for change. Our EMS professionals deserve better. Our community deserves better,” said Tim Mollwan, a current Multnomah County paramedic who has 25 years of EMS experience. “Allocating these funds is the first step in creating an EMS system that serves the people, not only the profit margin. Today you have the opportunity to take the first steps in positive change for our communities. Reducing the quality of care your neighbor, your friend, or your family receives is a step in the wrong direction.”
Vega Pederson outlined several actions she has asked the County’s ambulance service provider to take to improve their contract compliance with ambulance availability and response times including:
• Shore up their staffing by subcontracting;
• Provide hiring and retention incentives to hire and retain staff in Multnomah County;
• Fully staff Basic Life Support ambulances to take pressure off the system — there is still a lot of room to fully realize the benefits of this program.
“With today’s action, we are one step closer to where we need to be and my hope is that this will pay off in a resolution to this crisis that meets both the needs of our providers and the needs of our community,” said Chair Vega Pederson.
