After failing to meet response times amid a spike in 911 call volume, San Jose firefighters are asking the county to consider opening an ambulance contract to competitive bidders.
The county contract, which was extended for three years in December, follows a model in which the county works with a private, for-profit ambulance company to provide services to cities within the county. The ambulance company, Rural/Metro, which was acquired by American Medical Response, holds the San Jose Fire Department to a specific response time and pays the department funds if it responds to emergencies within 8 minutes or less at least 90 percent of the time, abiding by Santa Clara County standards.
However, the city’s goal is different than the county’s, responding at the industry standard of 8 minutes but at only 80 percent of the time. Opening the county contract to other bidders, or renegotiating the current one, would reduce the strain on the fire department by diverting medical calls and freeing up firefighters for serious emergencies.
“A city our size makes up a majority of the countywide EMS responses. The county is vehemently opposed to opening the contract up — that’s simply why we saw an extension,” said Sean Lovens, communications director for the San Jose Firefighters, IAFF Local 230. “If the fire department continues to see the steadily increase in EMS call volume without building and staffing adequate resources, the department will continue to be stretched thin. Finding a way to reduce low-level, non-emergency calls for the fire department is one approach that could help.”
Low-level medical calls accounted for about 13 percent of the department’s overall call volume in 2015, according to fire department documents. Although response times have improved, the department fails to meet its mandated response time rates set by the county, which results in penalty fees and a withholding of funds for the department.
According to Lovens, the fire department faces an increase in service demand and a lack of resources. The county policy to withhold funds exacerbates this problem, he added, and further prevents firefighters from meeting response times.
Another significant problem is how a countywide EMS contract doesn’t take into account the differences and demands between big cities and smaller communities. The needs and resources of a large city are different than those expected in a smaller community, Lovens said.
“To have an EMS contract that blankets across the county is not working. No wonder we’re not making our times.” said Sean Kaldor, president of the San Jose Firefighters, IAFF Local 230.
“Opening the contract is absolutely one way to address this issue,” added Kaldor. The fire department is also willing to work within the current contract to make a change, which “would require collaboration and cooperation of all partners in the EMS system in Santa Clara, perhaps as a pilot program to be tracked and monitored for favorable and unfavorable outcomes.”
But changes to the contract, Lovens said, would require renegotiating the county EMS contract. County officials could not be reached for comment.
City officials seem to agree. In a memo released this month, Mayor Sam Liccardo addressed concerns about the strain that non-emergency, low-level medical calls have on the department.
“We must look critically at our capacity to determine whether the fire department should be responding in the same way to non-emergency calls, or whether we could achieve better efficiencies with alternative responses from other service providers,” Liccardo wrote in the memo.
According to Liccardo, using a Lyft or Uber ride to a county clinic “will save both dollars and precious SJFD time.”
AMR, the county’s ambulance provider, often transports patients for routine visits, taking ambulances off the streets and increasing the dependency on the fire department to transport patients who are rarely experiencing a medical emergency from one building to another. Sometimes those two buildings are across the street from one another.
“These and other calls represent an irrational expenditure of public resources that can distract and delay our SJFD firefighters from their life-saving mission,” added Liccardo.
Fire Chief Robert Sapien Jr. said his department “loses local resources” under the current model.
“Some of the revenues are basically profits for a corporation,” Sapien said. “In that regard, I’d like to see a system that is contained where revenues support the system overall and aren’t used as profit.”
Sapien thinks that the issue is a “larger question” than San Jose. Despite the differences in population needs, Sapien realizes that all cities within the county must have the same emergency response procedures to function well.
“We can certainly try to affect some change with the county, but we have to do that recognizing that our county has to have standardized protocols all across,” he added. “We’d have to work with county partners to address change but the work has to occur at a statewide level for us to do real change.”
Contact Nadia Lopez at email@example.com or follow @n_llopez on Twitter.