FOREST GROVE, Ore. — When responding to emergency medical calls, the role of a local fire department is often to arrive quickly and stabilize the patient. Then it's the ambulance provider's job to take the patient to the hospital — at least it's supposed to be. But when ambulances take far too long to arrive, firefighters have to make a choice about whether they should take the patient to the hospital themselves.
Usually a fire department transport to the hospital is a last resort. But in a number of Portland metro counties where American Medical Response is the ambulance provider, there's a growing reliance on fire crews and an expectation that they'll do whatever is needed to fill the gaps as AMR response times have fallen off.
Jim Geering, fire chief for the Washington County cities of Forest Grove and Cornelius, said that he's drawing a line beginning Friday. His firefighters will no longer transport patients to compensate for AMR, only transporting when they believe it's absolutely necessary.
"AMR (is) struggling to provide staffing on a day-to-day basis, 24/7, on their ambulances, and there's a trickle-down effect that departments like ours are feeling," Geering said.
According to Geering, his firefighters are transporting patients to hospitals daily as AMR ambulance crews remain chronically understaffed or unavailable. In most Oregon cities and counties, fire department ambulances are supposed to be used for quick response and initial treatment.
"When we take our staff and we take our units and place them on an ambulance and send our ambulance to do a transport to the hospital that's out of the city or out of the area, it diminishes our capability to respond to emergencies right here in, in our own city," Geering said.
But starting Dec. 1, the Forest Grove and Cornelius fire departments will be calling their own shots. They're removing their ambulance transports from "available" status in the 911 system. Geering sent an email to Randy Lauer, vice president of operations at AMR, to explain his decision.
"The operational impacts of continuing to utilize our publicly-funded fire department transport units to subsidize a private business has become unsustainable," he wrote. "While this is less than ideal, we feel that we have no other choice."
In a recent wide-ranging interview, KGW investigative reporter Evan Watson asked Lauer about the frustration that local fire departments are feeling.
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"They want to get out of the ambulance transport line of work, and that's one of our goals too, is to get our staffing up in Washington County so that we can respond to all calls and relieve the fire department of what they necessarily had to do with the transport role coming out of the pandemic," Lauer said.
AMR took over ambulance services in Washington County from Metro West, the previous provider, at the beginning of August, after Metro West's response times dropped below acceptable standards for a period of months. But AMR has also faced criticism for chronically lagging response times in several Portland-area counties, particularly in Multnomah County.
Leaders at AMR blame a shortage of paramedics, and say that Multnomah County's requirement that ambulances be staffed with two paramedics has become a major hindrance to achieving better outcomes. In all other areas of operation, AMR staffs ambulances with either one paramedic and one EMT or even two EMTs, and that includes Washington County.
In his interview with KGW, Lauer expressed optimism about AMR's performance in Washington County.
"We're on a very good trajectory in Washington County in terms of staffing and response times, we're improving week by week. The incidence of Level Zero, where we have no ambulance to respond, is reducing dramatically," he said. "So, Washington County is definitely on the right path."
But any improvements that AMR is tracking have not made enough of an impression on Geering. When there's a critical, life-threatening emergency, Geering said that Forest Grove and Cornelius crews may still use their ambulance for transport instead of just the initial on-scene treatment. But his crews will be making those calls on their own, not because they have to routinely fill gaps left by AMR.
"Until we can see some really significant progress, we need to take some actions to ensure that we maintain the service and continuity right here in Forest Grove," Geering said.