San Diego to Ambo Bidders: Revive High-Utilizer Program

Sept. 25—San Diego officials say the city's new ambulance provider will be required to revive a program that targeted unnecessary 9-1-1 calls.

The "request for proposals" for new ambulance providers that city officials plan to circulate this fall will require applying companies to agree to revive the program and cover the costs of potentially expanding it.

The program, which ceased operations a year ago, used a software filter to identify and reroute the most frequent 9-1-1 callers: the homeless, the mentally ill and drug addicts.

It drew national praise and saved the city money from 2010 through 2016 by allowing ambulances to focus on the most urgent emergency calls. But financial concerns prompted ambulance provider American Medical Response to stop providing the four paramedics required to operate the program.

That company's contract to provide San Diego ambulance services expires on June 30, giving the city an opportunity to require the program be revived after that.

In June, the county grand jury issued a report criticizing the city for allowing the program, called the Resource Access Program, to cease operations.

City officials last week said they had little choice in the matter and that they are in ongoing discussions with American Medical Response about possibly reviving the program before June 30.

The program's software filter allowed city officials to build a history for each individual who was placing multiple calls to 9-1-1. It included the number of calls, length of time between the calls, the nature of the incidents and the treatment required.

Paramedics contacted frequent callers to let them know about social services, mental health resources, shelters and other help. Some were also assigned case managers.

Meanwhile, the city started to flag 9-1-1 calls from frequent callers and route them differently than an ordinary 9-1-1 call. Instead of sending those calls only to paramedics, they were sometimes routed to a wider network of service providers, including law enforcement, homeless outreach teams and social workers.

In a response to the grand jury approved last week by the City Council's Public Safety committee, city officials say the program was a success but that its elimination didn't create the logistical strain described by the grand jury.

The response says San Diego's emergency call system can handle the extra volume of calls created by the city's roughly 1,400 frequent callers, who generate 15 percent to 20 percent of all calls.