By QUINTON SMITH/YachatsNews.com
A shortage of paramedics is forcing the company that provides ambulance service to most of Lincoln County to seek two temporary exceptions to its contract.
Pacific West Ambulance is asking to cut the number of advanced life support ambulances it has available from five to four in the four districts it serves and to suspend response time requirements until March 31, 2022.
PacWest general manager Jeff Mathia is also asking that a fifth ambulance on duty during the day be a “basic life support” ambulance staffed with emergency medical technicians instead of paramedics to handle lower-priority calls.
Mathia appeared before Lincoln County commissioners last week to alert them to his request the day before taking it to the county’s Ambulance Service Review Committee.
On Thursday the committee – made up of representatives of fire departments, medical providers and two citizens — approved the two recommendations. They now go back to commissioners, who oversee ambulance contracts in the county.
PacWest has contracts to serve four of five areas of Lincoln County – the Waldport-Seal Rock area, Lincoln City and the Otis area, the Depoe Bay area, and Newport-Toledo. The fifth district is served by South Lincoln Ambulance, a private, nonprofit controlled by two Yachats Fire District administrators, headquartered at Yachats’ main station and staffed by Yachats’ firefighter/paramedics.
Mathia told the review committee that a nationwide shortage of paramedics and a surge in calls is creating the problem.
“This is a temporary solution, not a permanent solution, until this pandemic eases and staffing stabilizes for everyone,” he said. “The solution is to get our staffing up. But this is not just PacWest, it’s every ambulance company, every fire department and every law enforcement agency.”
How the system works
An ambulance with one paramedic and one EMT on board is called an “advance life support” unit. An ambulance with two EMTs on board is called a “basic life support” unit.
In an interview with YachatsNews, Mathia said PacWest’s “ideal” staffing level would have six ALS ambulances available during the day and five at night.
Currently PacWest has five ambulances at its various stations during the day and four at night, all staffed by at least one paramedic paired with an EMT.
On Thursday, the review committee approved a recommendation to county commissioners allowing PacWest to drop to four ambulances during the day and four at night. The fifth daytime basic life support ambulance would be staffed by EMTs, who have less training and have limits on what they can do.
Under PacWest’s contract with the county, it is required to have four advanced life support ambulances in service.
“That’s the minimum and that’s not good enough,” he told YachatsNews. “We should be at six (day) and five (night).”
Mathia said PacWest currently has 38 paramedics and EMTs in Lincoln County but needs 46 to fully staff five ambulances 24/7. The company was last fully staffed in May, he said.
In turn, call volume has risen to as high as 900 a month, with an average of 600 of those requiring transport of a patient. That’s 18-23 percent more than before the pandemic began and more than the 500 a month just five years ago, Mathia said.
“We’re almost double what we were doing and we’re doing it with basically the same amount of people,” he said.
Response times requirements vary depending on the location of the call – ranging from 12 minutes in a city to 20 minutes in rural areas to much longer in far-flung areas of the county.
The response time requirement in Lincoln City is 12 minutes, Mathia said, but currently is averaging 14 minutes 30 seconds.
“We’re not missing them a lot, but we’re missing them,” Mathia told the committee, which voted 4-1 to recommend suspending requirements until March 30, 2021.
Help from others in the system
Mathia and review committee members had suggestions for how fire departments, the two local hospitals and nursing homes could help with the issue.
Most involve everyone being aware of the shortage and communicating better, releasing ambulances from calls as soon as possible if it’s determined they’re not necessary. Others involve fire department paramedics helping out ambulance EMTs where appropriate, hospitals seeking other methods – medical transport, families or other means – to get patients home after discharge, and long term care facilities picking up their own residents from emergency rooms when possible.
“I don’t think anyone’s going to object to being transported by a BLS ambulance so long as the patient is stabilized,” said Depoe Bay Fire Chief Bryan Daniels.
Ambulances are also often called to transport ill people from Lincoln County into higher-care hospitals in the Willamette Valley, round trips that can take 3-5 hours. But as those hospitals fill up with COVID-19 patients from low-vaccinated counties, Mathia said, PacWest is being forced occasionally to travel to Portland and Vancouver.
Mathia said PacWest will no longer do long transports “on demand.” When fully staffed, the company can handle two long transports a day, he said, but will only be able to do one when it drops to four ambulances this week.
High demand for paramedics
PacWest has been in Lincoln County for 30 years and is working with its parent company, Metro West Ambulance in Hillsboro, to recruit more paramedics, Mathia said. That includes a $5,000 hiring bonus spread over a year.
But those same people are in high demand everywhere and if they have firefighter certification often leave for fire agencies.
But 20 months of a coronavirus pandemic is also “taking its toll on people,” Mathia said, and a lot have retired or left the field. It’s something he’s not seen in his 17 years in the business.
“It’s gone from nothing when we shut down last year to now going crazy,” he said. “I’m asking my crew members all the time to pick up an extra shift. Some are working 60-70 hours a week … and that can take a toll.
“I’m not pushing the panic button but trying to prepare for the next six months,” Mathia said. “I want everyone to know our status and what we’re trying to do about it.”
Pay your staff a living wage and start providing a service that is better than throwing someone in the back of the truck and driving yourself and we will respect your position.