The head of Riverside County’s Emergency Medical Services Agency, Bruce Barton, spoke at last week’s County Service Area 38 (Pine Cove) meeting. He explained and answered questions about how the county’s new ambulance contract with American Medical Response will affect Pine Cove residents.
He was emphatic that beginning July 1, AMR will be the primary provider of ambulance service to Pine Cove and Zone 3 (north of Pine Cove). If AMR’s Pine Cove ambulance is sent on a call, AMR will be responsible for assuring a back-up ambulance is available for the Mountain Zone.
“We will have a new system and we will make it work,” Barton stated. AMR and the county’s EMSA and Fire Department have been developing a transition plan for the change from Idyllwild Fire ambulances.
The response-time standard for Pine Cove will remain 12 minutes, according to Barton. “To hit the 12 minutes they’ll need an ambulance here and a move-up plan,” Barton said.
CSA 38 will no longer have to subsidize the ambulance service to its residents as a result of the new contract. Riverside County Fire Chief John Hawkins, who also attended the meeting, reiterated this point, “No more public tax money will be paid by Pine Cove residents for ambulance transports.”
However, EMSA does not have money set aside for this purpose either. Consequently, the county’s option was to grant AMR a rate increase across the entire county service area.
The contract has provisions for customer-service programs to incorporate patient-satisfaction reports.
“I’ll come back in a year to see what you say,” Barton said, then added, “I won’t wait a year.”
Barton began with a description of the timeline over the past three years as the county began studying its emergency medical services through the negotiation of a new contract with AMR and the development of a new Strategic Plan for the EMS agency.
Among his major points was a description of how the contract will require AMR to invest in new and standard equipment such as ambulances and implementing an emergency medical dispatch.
AMR investments
The new contract increases performance standards AMR must meet, and these will include new equipment.
“Riverside County asked for a lot, including the replacement of [AMR’s] entire ambulance fleet,” Barton began. All of its ambulances must be upgraded from Type 2s to Type 3s. And equipment, ambulances and defibrillators must be on a five-year replace schedule.
“We want a continual commitment to enhancements of the system,” he added. “And we don’t want to wait until the end of the contract; we want them to continually invest.”
The ambulance serving Pine Cove will have 4-wheel drive, Barton assured the committee, and added that that has already been discussed with AMR.
Emergency medical dispatch
Barton expressed his intent to expand the emergency medical dispatch. One important criterion is the ability to know the location of every emergency medical vehicle. The new contract requires AMR to install automatic vehicular locators on all of its ambulances.
“That way [dispatch] will know where all the resources are,” Barton said. “Dispatch can see every fire or emergency resource vehicle on the Hill and send the closest.” Even Idyllwild Fire has three mobile data computers with AVL capability.
The county Emergency Command Center is already implementing the first phase of EMD. The dispatcher interrogates the 911 caller to establish an emergency’s priority. “There is excellent agreement [among stakeholders in Riverside County] on the first phase,” he stated.
But he differed about the commitment for Phase 2, which will use the in-depth evaluation of the patient from the 911 call to modify the level of response and its priority.
“We might not need to send multiple vehicles or they could be dispatched on Code 2 [semi-life threatening] rather than Code 3 [life threatening]. I don’t feel we have consensus on the second phase,” he said. “Riverside County will not impose it on sovereign municipal governments.”