Calif. County`s EMS Agencies Could Face Late Fees

April 16--STANISLAUS COUNTY -- Ambulance services could pay stiffer fines for failing to respond quickly enough to life-threatening emergencies.

This evening, Stanislaus County supervisors will consider new five-year agreements with urban and rural ambulance providers. Stanislaus is second only to San Joaquin County in having the highest standards for ambulance response, but its outdated penalty structure goes easy on companies that miss the mark.

Richard Murdock, executive director of the Mountain-Valley Emergency Medical Services Agency, which is designated to regulate ambulance service, noted the current fines have been in place for 15 years. "It was cheaper to pay the fines than put another ambulance in service," he said.

In Stanislaus County, ambulance crews responding with lights and sirens to a life-threatening emergency are expected to get there within 7 1/2 minutes in urban areas, within 11 1/2 minutes in suburban areas and within 19 1/2 minutes in the country.

The agreements, which would take effect May 5, have different terms for companies that serve the larger cities, such as American Medical Response, and smaller providers in rural areas.

AMR could be fined $250 for each time an ambulance response is slower than the standard by three minutes or less. The penalties would rise to $1,000 for missing the standard by five to 10 minutes; $2,000 for 10 to 15 minutes; and $10,000 for 25 to 35 minutes.

The Mountain-Valley agency also will monitor compliance with response time standards over time. If a company falls below 90 percent compliance over a 100-call period or 12 months, whichever comes first, the fines would range from $7,000 for a 89 percent compliance rate to $25,000 for an 85 percent rate.

Failing to meet the standard for three consecutive time periods could result in a $50,000 fine for the first violation, double for the second and $250,000 for the third occurrence. The agreements also would impose fines for not meeting response times for less urgent Code 2 calls.

An AMR spokesman said Monday that the company is not opposing the new agreements. "The fine structure is similar to what we see in other areas where we operate," said Jason Sorrick, an AMR spokesman in Sacramento. He said the company puts the necessary number of units in service in Stanislaus County and did not take advantage of the weaker penalties.

Murdock said no fines have been assessed since AMR paid a "hefty" penalty in 2010. Ambulance providers could ask for exemptions for units delayed by trains, severe weather or mechanical problems. Mountain-Valley either approved or denied the exemption.

Murdock became executive director after a shake-up in the agency in late 2010.

The penalties for rural providers such as Oak Valley or West Side ambulance services are designed to get compliance but not put them out of business, Murdock said. The fines would be from $75 for missing the response standard by three minutes or less to $3,000 for arriving 20 to 25 minutes late.

Rural providers could be fined $1,000 to $16,000 for failing to achieve 90 percent compliance over a year's time.

The proposed agreements make adjustments to the response-time maps for urban and suburban areas based on information from the 2010 census.

Officials also are looking at improving the dispatch system for emergency medical calls. According to a county staff report, a 911 call from a cell phone may be handed off three or four times because of a variety of factors.

AMR's LifeCom dispatch center in Salida may obtain key information from a caller, but has no way of sharing it via computers with other responders in the field. By integrating computer systems with Stanislaus Regional 911, LifeCom could share information that a medical emergency resulted from a violent crime and Stanislaus Regional would dispatch police to protect fire and ambulance crews and residents.

Murdock said the county could explore consolidating dispatch services under one roof, or consider options such as sharing information on computers or dispatching ambulance and fire units on one channel.

"It's about getting everybody on the same page," he said.

County supervisors meet at 6:30 p.m. in the basement chamber of Tenth Street Place, at 1010 10th St. Modesto.

Bee staff writer Ken Carlson can be reached at kcarlson@modbee.com or (209) 578-2321.

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