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Team 10 investigation: Were ambulance strike teams used efficiently?

Hundreds of thousands of dollars spent on strike teams
Ambulance strike team
Posted at 3:00 PM, Feb 24, 2022
and last updated 2022-02-24 22:32:51-05

SAN DIEGO (KGTV) — The County of San Diego spent hundreds of thousands of dollars for several ambulances during the height of the omicron wave, but there is discussion on whether they utilized them in the best way possible.

In January, the ambulance strike teams brought into the county were supposed to supplement current resources temporarily. The goal was to help offset service delays.

Medical calls are a huge part of the job for many fire departments. According to the latest statistics released on the department's website, emergency medical response accounts for nearly 70 percent of calls in the City of San Diego. In 2021, San Diego Fire-Rescue responded to an average of 326 emergency medical calls a day.

However, staffing shortages and delays at the hospital during the pandemic have made 911 responses complicated.

"Do we have all the resources we need? The staff, the stuff and the structure… And to be honest, it's pretty tight right now," said County EMS Medical Director Kristi Koenig at the end of December.

The county brought in two ambulance strike teams to help with limited resources.

"To my knowledge, I don't believe the bringing in strike teams of ambulances has been done before for a situation like this, but we haven't had a pandemic situation like this before," said Escondido Fire Chief Rick Vogt, who also serves as the San Diego County Fire Chief's Association President.

A county spokesperson confirmed one strike team comprised of five ambulances helped with basic life support (BLS). Another strike team of five ambulances helped with advanced life support (ALS), equipped with more life-saving equipment and paramedics. One team was made up of resources within the county and the other came from out of the county.

"You not only get the benefit of the vehicle, but you get the benefit of the personnel being utilized to supplement existing personnel allocation within a certain area," said emergency medical services expert and paramedic John Everlove, who understands how these teams work.

According to the county, both strike teams started on January 22nd. One was released on the 28th and the other on the 31st.

The estimated price tag was roughly $341,000, according to numbers released by the county. The county footed the bill with money from the American Rescue Plan Act—funding to help with the pandemic.

While the strike teams were in the county, there were 53 requests for 911 responses and just 19 transports. That comes out to nearly $18,000 per ride if you look solely at transports.

Estimated ambulance strike team cost

The county also said the strike teams were used to back fill departments in at least two instances.

"I feel like bringing in the capacity to San Diego County was absolutely a prudent move and money well-spent simply because we had a need," Vogt said. "We had a crisis that we were right on the edge."

It is unclear why the ambulances were not utilized more often.

At least two other fire officials told Team 10 they made clear to the county the main issue was offloading at the hospital, which is the process where a patient is transferred from the ambulance to a hospital bed.

Carlsbad's Fire Chief Mike Calderwood said that he "did make their concerns known" to the county about that issue.

The county confirmed strike teams were used for at least four offload assistance assignments, helping relieve paramedics waiting for a bed for the patient.

Vista Fire Department's Operations Chief Bret Davidson said when their department tried to use the strike team to help with offloading because of the long wait time, the county duty officer denied it. He does not know why.

"I want to be really clear about what the request was from the fire departments… and ambulance providers throughout San Diego County and that was for capacity," Vogt said. "What we didn't want to have is a time where somebody called 911 and there wasn't an ambulance at all available for an extended period of time, so the solution that was brought forward by the county to bring in some extra ambulances was a prudent one."

"How they were used, that really is a decision of San Diego County Emergency Medical Services," he added.

Falck and AMR—two of the largest local ambulance providers—both said they were not involved in the decision to bring strike teams here.

Nobody from the county would comment on camera. A spokesperson confirmed they requested the teams after "fire chiefs reached out to San Diego County Fire with a plea for assistance."

When Team 10 asked why the strike teams were not primarily stationed at hospitals to help with the delays, the county said the teams were "to prop up resources needed at that time."

Team 10 questioned the major local hospitals if they communicated with fire departments and the county about the strike teams to help with wait times.

Representatives for both Sharp and Scripps redirected Team 10 back to the county.

UCSD Health said Team 10 needed to put in a public records request for information.

Kaiser said they did tell the county they needed support and "submitted the required paperwork."

"To our knowledge, we did not receive any assistance from the strike teams while deployed," said Kaiser spokesperson Jennifer Dailard.

Tri-City never got back to Team 10.

Everlove said when used correctly, these strike team ambulances "can be the difference between life and death for people that need it."

"Although this step was somewhat unprecedented and didn't have a more significant impact, other measures taken by county EMS, improved conditions on the ground and declining rates of infection lead to a decreased need for the strike team ambulances," said Jeff Collins, the Director of the San Diego County Fire Protection District.

The statement from the county did not specify what other measures were taken.

"Anytime we have a deployment or a situation like this, you can always look back and learn from. That's why we do after action reports. I'm not going to at this point, say that things could have been done better or things doing go well. I know that that's certainly going to be looked at," Vogt said.

The fire officials I spoke to were glad the county took some action, although it remains unclear if this was the most efficient move.

The final report on the strike teams with the official cost to the county could take several weeks to complete.