The loss of several personnel in recent months has led to reduced availability and longer response time for the county’s primary ambulance service.
Jeff Mathia, general manager of Pacific West Ambulance, told the Lincoln County Board of Commissioners Monday the ambulance service weathered most of the pandemic without facing the staff challenges seen by many emergency medical providers around the U.S. — up until this summer.
Pacific West Ambulance provides medical ambulance services in the county under the Lincoln County Ambulance Service Area Plan, which establishes Oregon Health Authority approved ambulance services for the county, their contractual response time and staffing levels, and other standards for operation.
Pacific West is responsible for coverage from north of Yachats to the northern county line, Ambulance Service Areas one through four, while South Lincoln Ambulance provides services in the Yachats area.
Mathia told commissioners Pacific West used to maintain five staffed ambulances day and night, one for each service area and one extra, and would sometimes add an additional daytime unit during busy seasons.
Since June, they’ve seen the resignation of several staff members. “We’re struggling to replace those folks who have left us,” Mathia said. “Right now, we’re able to meet the minimum contract obligation with Lincoln County,” which is four units on call per shift.
However, Mathia said, due to the staff shortage and other factors, response times were lengthening, some in excess of the limits in the county ambulance service area plan.
The plan establishes a maximum response window to be met 90 percent of the time depending on the accessibility of the call location. In urban areas, response should be within eight minutes nine out of 10 times; in suburban areas, the window stretches to 12 minutes; the ambulance crew should respond within 20 minutes to rural areas; and response is expected to frontier locations in one hour or less. In regions dubbed wilderness, “no set response time is required due to the geographical nature and limited access into these areas.”
Mathias said ambulance crews were experiencing some delayed response time, for example, on occasion taking 15 to 16 minutes to respond to areas that should be reached in 12.
“A lot of it has to do with call volume,” Mathia said, which is up 18 to 24 percent since pre-pandemic. Where before they saw 500 to 600 calls a month, he said, now they were seeing from 700 to 950.
Also contributing to delays was a modest increase in the number of hospital transfers to locations farther away, often to extreme ends of the state, which can keep an ambulance out of service for response for five hours or more.
Another factor was that EMS personnel were being held in the hallway at the hospital for extended periods of time when leaving patients, sometimes more than an hour, Mathia said. He noted that this was not the fault of the hospital.
The prior average clear time for a call was 48 minutes, but it has increased up to one hour and three minutes, the Pac West general manager said.
Also, Mathia said, especially on the north end of the county, the ambulance service was seeing frequent occasions with multiple back-to-back calls, sometimes three to four calls within 30 minutes to Lincoln City, leaving just one ambulance for the rest of its coverage area.
Mathia said on Thursday he would appear before the county’s Ambulance Service Review Committee, which makes recommendations to the board of commissioners regarding the service plan, and request it to recommend temporary suspension of compliance with the plan’s response time requirements.
He said he would also ask it to recommend expanding the use of basic life support ambulances, which do not require a paramedic to staff, thus reserving advanced life support units for the most serious calls.
Mathia said the ambulance company was doing all it could to attract more staff, including the use of recruiting websites and hiring an outside recruiting agency.