Too many 911 calls, not enough paramedics in Multnomah County

PORTLAND, Ore. (KOIN) -- There are too many 911 calls and not enough paramedics to respond in Multnomah County.

In some cases, ambulances are arriving late because they're reaching "Level Zero," which essentially means no ambulances are available to take calls or respond immediately.

"They want to run it as close to zero as possible without hitting zero. Today they're hitting zero," said Aaron Monnig, the health operations manager for Multnomah County Health Department.

The county requires AMR to have two paramedics in each ambulance and to get to 90% of 911 calls in less than eight minutes. But currently, that's not happening.

"I'm not trying to sugarcoat it, our response times are not what they need to be," said Randy Lauer, Vice President of Operations for Global Medical Response.

Lauer told KOIN, their ambulances are getting to 80% of their calls within less than eight minutes. The county says they want to work with AMR to improve this metric and meet their requirements.

"There are moments in the county where there are no ambulances available," said Monnig. "We have an awful lot of low-acuity calls, meaning a lot of calls that you probably don't need to call 911 for that that we're managing."

With rises in violence, drug overdoses and homelessness in recent years, the health department says 911 calls are up in Multnomah County. There is also a paramedic shortage nationwide after the pandemic, partly because the school shut down for a couple of years, reducing the pool of new hires.

As the labor shortage is at a tipping point, emergency responders say something has to give.

"Burnout is a major issue in our industry. Not just our industry, healthcare as a whole," said Tim Mollman, a paramedic in Multnomah County.

When asked how the county thinks these problems should be solved, Monnig said it comes down to "training, hiring, recruiting, actually getting more paramedics into the system and working at the front end on the education pipeline into it."

Executives at AMR say they need 200 more paramedics and there aren't enough currently out there. So, they want Multnomah County to start operating like the surrounding metropolitan region.

AMR is asking the county to temporarily change their two paramedic requirement and allow ambulances to be staffed with one paramedic and one EMT, saying that would immediately add 10 more crews a day.

"All those things could be solved quickly. (It) doesn't have to be permanent. Once enough paramedics are available, we can move right back to the two-paramedic system. For now, that is the solution to this crisis we have," Lauer said.

However, some paramedics in Multnomah County aren't on board with working with an EMT.

"This isn't something that can be fixed overnight." Mollman said. "I'm personally not really for splitting up the dual paramedic system up. I think reducing the quality of care for our neighbors is not good."

While other counties in the metro area operate with a paramedic and EMT in an ambulance, other major cities operate like Multnomah County with 2 paramedics, including San Diego, Denver, Seattle, Minnesota, Boston, Houston and New York City.

The county says while the city of Portland has grown, PF&R's staffing has remained steady over the last couple of decades, so their EMTs and paramedics can't offset the increase in 911 calls either.

In the meantime, paramedics think it would help to get the 911 dispatch center accredited -- which requires increased training to triage calls more accurately and efficiently. The county says there's a way to go to get Portland's Bureau of Emergency Communications (BOEC) at that point.

"Our triage system is not 100% accurate," Monnig said. "So we're not quite to that level of accreditation."

According to Monnig, the 911 dispatch center is 70% accurate in how they triage calls. It may be two to four more years before the dispatch center is fully up to speed. Paramedics want to see that expedited.

"It's going to need a lot more city resources to actually be invested in getting accredited faster than that time frame," Monnig said.

To fix these issues, paramedics think the entire emergency medical system needs to be overhauled.

"Everything needs to be brought under the same umbrella," Mollman said.