City of San Diego Lays Out Demands For Rural/Metro, Threatens To Terminate Contract

Ambulance company has missed mandated response times for 911 emergency calls within the City prompting City leaders to request staffing and billing records, along with a sufficient ambulance deployment plan.

What to Know

  • City of San Diego lays out demands for Rural/Metro ambulance company.
  • From July to November 2016, Rural/Metro failed to meet mandated emergency response times resulting in fines.

After months of reportedly responding late to emergency calls, the City of San Diego’s ambulance service, Rural/Metro, has been given a strict list of terms to abide by in order to avoid what the city calls a “material breach of the terms of the EMS agreement.” 

The list of terms were laid out in a letter sent by the City of San Diego’s Chief Operating Officer Scott Chadwick on December 1, 2016 to the company’s top west coast management. In 2015, Rural Metro was acquired by AMR, which took over all Rural/Metro operations. 

The letter along with other documents pertaining to the city’s new requests about Rural/Metro’s services within San Diego, was released to NBC 7 Investigates through a California Public Records Act request. 

NBC 7 Investigates first reported Rural/Metro’s non-compliance with mandated response times in October 2016, when the city fined Rural/Metro $291,000 in penalties. According to the company’s contract with the city, it is required to meet a response time of 12 minutes or less, 90% of the time. 

To read that story, click here.

In the letter, Chadwick states Rural/Metro has failed to meet the response time standards in multiple medical response zones for the months of July through November, 2016. 

“Repetitive quarterly fines for failure to meet response time standards will not be tolerated,” Chadwick said. 

To read the letter, click here.

Throughout the letter, the city spells out demands for AMR, requesting new data, setting specific deadlines and asking for in-person meetings. 

According to the letter, the city requested: 

  • AMR “provide the city a robust ambulance system deployment plan” on how the company can improve response times based off of 911 incident demands from December 1, 2015 to November 30, 2016.

  • The company provide, by January 31, evidence the company can build and maintain a stable workforce, showing the steps the company plans on taking to “permanently secure and retain a stable, long term workforce.”

  • AMR provide turnover rates for employees who worked in San Diego in 2015 and 2016.

  • The ambulance company provide monthly reports that detail wages, hours and working conditions of AMR employees, as well as plans to “retain and grow veteran Paramedics and EMTs so as to sufficiently staff it’s workforce to meet the EMS Agreement’s response time requirements.” 

The letter provides a deadline for AMR to comply with the demands. In an email to NBC 7 Investigates, San Diego Fire-Rescue Captain Joseph Amador said, “AMR has complied with all of our requests for information and deadlines.”

The city and fire department declined to talk on-camera or answer any additional questions, “until after he [Fire Chief Brian Fennessy] reviews the end of Q2 data and the Mayor & City Council have received the information.” 

AMR did not answer questions on-camera for this story. Jason Sorrick, Director of Communications and Government Relations for AMR sent an email to NBC 7 Investigates and said, “AMR has provided the city of San Diego with all the information that was requested last month, and we are pleased to report that we have exceeded all response time requirements for the months of November and December." 

The city did not confirm AMR’s claim of compliance for the month of December. “Until we have completed our review of the Quarter 2 data, we won’t know whether AMR-RM has been contractually compliant Citywide and in all eight (8) zones,” Amador said.

In the letter it states if the company does not accept the terms of this “Plan-to-Cure” notice by the end of December, “the city of San Diego may have no choice but to begin drafting in January of 2017 a Notice of Breach and Intention to Terminate the EMS Agreement.” 

Last month, NBC 7 Investigates spoke with Joseph Ross, a former Rural/Metro Emergency Medical Technician, EMT, who spoke about, what he called, “unethical business practices” and staffing shortages he witnessed. 

“We’re not having enough ambulances in service on our city streets,” Joseph Ross told NBC 7 Investigates. “If you have somebody who’s gone on a chest pain [911 call] 500 times in their career versus someone who has gone on a chest pain [911 call] five times in their career, it’s a lot more smooth when you have an experienced person.” 

To read more about that story, click here.

To help the company meet mandated response time standards, the city offers to help staff a limited number of Rural/Metro ambulances with San Diego Fire-Rescue Department Firefighters and rated Paramedics per day, for a predetermined length of time, according to the letter from the city. 

If AMR takes advantage of the offer, the city would require personnel and other incidental costs reimbursed per normal city cost recovery formulas. 

“It is AMR’s responsibility to fund what is necessary to staff the requisite number of ambulances,” Chadwick states in the letter. 

In addition to the letter, NBC 7 Investigates received a memo sent to the Mayor’s office and San Diego City Council members on December 7, 2016, a week after the “Plan-to-Cure” letter was sent to AMR. 

In it, City of San Diego Fire Chief Brian Fennessy said AMR responded to the city’s latest letter four days after it was sent and acknowledged response times were negatively impacted in select zones for the FY 2017 Quarter 1 and 2 (July 1, 2016 through November 30, 2016.) However, according to the memo, AMR told the city, they were in full compliance in all medical response zones for the month of November. 

To read the memo, click here.

According to the memo, the city and AMR have a scheduled a meeting to discuss the city’s concerns that were not addressed in the company’s initial response.

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