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When Falck USA took over the delivery of ambulance services for the city of San Diego a year ago this week, replacing longtime provider American Medical Response, city leaders made the change in part because of concerns about AMR’s performance but also because of bold promises from Falck to increase daily ambulance hours across the city from 840 to 1,008. This has not gone well. A report to the City Council this month said that not only has Falck not come close to meeting this promise, it’s failed to meet — even once — the minimum monthly average of 900 daily hours required under its contract.
It’s no wonder that Mayor Todd Gloria and council members are frustrated and may be ready to consider dramatic moves as early as January to shift to in-house ambulance service, using the city’s Fire-Rescue Department, or to add another service provider to supplement Falck. AMR remains a large presence in the county with plenty of government and private contracts. The city’s present ambulance service is often unacceptably and dangerously slow, and even Falck officials don’t sound optimistic that they can resolve chronic staffing shortages. As of mid-November, Falck had 109 full-time paramedics — 25 short of the minimum it says it needs — and 162 emergency medical technicians, 32 fewer than minimum. Despite Falck’s promises to address this problem, the number of paramedics and EMTs it employs is down significantly from May. That’s the opposite of progress. Falck says the shortage of health care workers is a national problem, which is very true. But with AMR boasting full local staffing, Falck can’t minimize its poor record.
The company was fined $351,000 by the city for its poor service record for the quarter ending June 30. On Wednesday, the mayor’s office said Falck had also failed to meet performance goals for the quarter ending Sept. 30, so more fines are looming, as well as for the quarter ending Dec. 31. Barring much better work by Falck — a possibility that seems far-fetched based on recent history — the time for a new direction in city ambulance services grows near.