WASHINGTON COUNTY, Ore. — Washington County commissioners unanimously voted to approve a new EMS contract with ambulance provider American Medical Response (AMR) on Tuesday. AMR will take over ambulance services in the county starting on Aug. 1.
Washington County leaders decided to switch from Hillsboro-based Metro West Ambulance as part of its "modernization" of the county's EMS systems.
The new contract with AMR includes modified standards for emergency response times, provisions to work around long wait times at hospitals, a centralized dispatch system and new ways to track the quality of ambulance medical care.
"That's one of the things we really want to be able to do is look more at the quality of the care and at outcome," said Adrienne Donner, Washington County's EMS program supervisor, in an interview with KGW this past spring. "Everyone is enthusiastic and excited about the new system and I think that’s a really important message because we’re really taking EMS to the next level."
Ambulance response times had dropped below acceptable standards in Washington County in recent months but county leaders said an EMS upgrade has been in the works for years.
Washington County's contract with AMR will last five years, with options for two 3-year extensions, resulting in a maximum of an 11-year agreement.
The county is switching to AMR at a time where AMR is being criticized for its poor performance in Multnomah County due to lagging response times and thousands of "Level Zero" 911 calls.
AMR, in a June statement, said Multnomah County's requirement of two paramedics per ambulance has worsened a "critical nationwide paramedic shortage," resulting in staffing challenges and other issues.
The company argues that "fundamental changes" are needed in Multnomah County, namely switching to a model with one paramedic and one emergency medical technician, a system used by surrounding counties, including Washington County.
Paramedics require more advanced medical training than EMTs and can administer more advanced life-support services, including EKGs, certain medications and other medical interventions. EMTs are also frequently paid less than paramedics.
"AMR firmly believes that temporarily changing the required staffing model to paramedic/EMT ... would mitigate the impacts of these shortages and improve service to the public while maintaining the same level of clinical care for the community," the company statement said.
Multnomah County health leaders responded by saying they have a "fundamental difference of opinion" about how paramedics and EMTs should be used.
"Two well-trained paramedics are always better prepared, less stressed and experience less fatigue and burn out than one paramedic working alone," said the county's response.
AMR leadership has said expanding service into Washington County has clear differences to its performance in Multnomah County.
For one, AMR gave preference to current Metro West Ambulance employees in the hiring process, offering many a chance to keep working in EMS in Washington County.
Secondly, Washington County's system is comprised of 1-and-1 paramedic and EMT crews and some 2-EMT crews, which AMR leaders credited with making it easier to fulfill hiring needs.
According to a county release sent Wednesday, AMR has hired 117 out of the 126 paramedics and EMTs needed to fully staff Washington County. AMR also purchased 30 new ambulances and leased a facility in Aloha for its primary operations.
"We are thrilled to bring our expertise and passion for health care to the communities of Washington County starting Aug. 1. We are committed to delivering the best possible care to our customers," said Jennifer Romero, AMR operations manager.
Metro West protested the county's proposal to switch to AMR earlier this year. A Metro West spokesperson said the company's protest was denied, while Donner said Metro West "accepted the [county's] response and dropped the protest."
Either way, Metro West will be relegated to providing non-emergency transport in the county
The franchise agreement with AMR includes different standards for acceptable ambulance response times depending on where the emergency is in Washington County:
- Urban: within 10 minutes
- Suburban: within 12 minutes
- Rural: within 30 minutes