AMR Achieves Service Improvements in Oregon County
American Medical Response (AMR) has sharply improved emergency service performance in Multnomah County, Oregon. The improvements come after the EMS provider negotiated a settlement with the county government regarding years of slow ambulance response times.
To solve the problem, the two sides agreed to allow AMR to staff its ALS ambulances with one paramedic and one EMT each, rather than the original requirement of two paramedics. AMR also agreed to hire more staff—specifically more EMTs, which it has been doing. With these two changes in effect, AMR can now field more ALS ambulances in the Multnomah County service area.
“This settlement is a direct response to the national shortage of paramedics in the United States,” said Robert "Rob" McDonald, AMR’s Regional Director in Oregon. “The problem is particularly difficult in Oregon, where paramedics are required to have two-year degrees. In Multnomah County, the impact of this shortage—fewer-staffed ambulances resulting in slower response times—was exacerbated by the contract stipulation requiring two paramedics for every ALS support unit. Once we were able to negotiate this settlement agreement, which is essentially an overlaid contract that supports our underlying contract with Multnomah County, this allowed us to deploy paramedic/EMTs for ALS.”
Having reached this settlement with Multnomah County in July 2024, AMR launched “an enormous hiring effort,” McDonald said. “We've hired over 163 EMTs since August 2024 and 43 paramedics. This has allowed us to increase our ambulance deployment by well over 40% from what the baseline was prior to the settlement agreement.” It helps that this department is an employee-run unionized operation with "profoundly competitive wages,” he said.
To broaden its base of hirable EMTs, AMR has been pursuing “nonstandard ways” of attracting new talent, said McDonald. “We bolstered up a lot of our social media work to generate more interest in EMS as a career. We've also engaged several local high schools to educate students about EMS as a career option.”
AMR is providing well over 100 people with fully-paid EMS training scholarships, with after-graduation work agreements as a condition of eligibility. “We're also providing full paramedic scholarships for EMTs who are interested in advancing their career in EMS,” McDonald said.
The results of AMR’s efforts to improve ALS service in Multnomah County are impressive. “Before the settlement, our overall response time compliance to the 90th percentile was around 66.7%,” McDonald said. “Today, our compliance to the 90% benchmark is 88.5%, so we've made incredible strides from August of 2024 to now. But what we're really appreciating is the decrease in Level Zero/No Ambulance hours. In July/August 2024, we were hitting 20 to 35 hours of Level Zero a week where no ambulance was available to respond. We're now down to minutes a week.”
There’s still work to be done to consistently hit all of Multnomah County's EMS requirements, but AMR is on the right road for getting there. “It has been an incredible effort, whether it be through expanding our training team from 12 FTOs to 60 FTOs, or onboarding 10 to 20 employees a month compared to one to two previously," McDonald concluded. “We are really proud to be able to do this for the people of Multnomah County.”
