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Orange County leaders may soon be looking to unify ambulance response across the regions amidst concerns the existing system is too broken up between different operators.
Those concerns are coming from a new report unveiled last week by Citygate Associates, a consulting firm that recommended the Orange County Fire Authority consolidate the ambulance and dispatch services across the county under one umbrella via a public-private partnership.
While the study made it clear that “the system is not broken,” it also highlights a system “stuck in a decades old bureaucratic framework,” that makes it hard to measure if ambulance and dispatch providers are actually giving residents the best service possible.
Currently, the fire authority is responsible for ambulance service to over 1.9 million county residents, and answered on average at least 20, 9-1-1 calls an hour last year, three quarters of which were calls for medical service.
But across its operating areas there are at least nine separate entities involved in emergency medical services including individual cities, the county government, OCFA, and private contractors.
“There is little to suggest that a newly designed, purpose-built organization and operational coordination would have so many ‘owners’ under different contracts and responsibilities,” auditors wrote. “OCFA, despite its large service area, is not being used as an integrator.”
Right now, there is not a single entity that oversees patient care from the time they call 911 to the time they are delivered at a local hospital, a role that auditors say the fire authority should step into.
“There are many positive ways the OCFA could bring its scale and leadership to smooth out and improve the ambulance transport system,” auditors wrote. “It should try to do so.”
County and city leaders had a chance to discuss the report for the first time last week at a meeting of the Orange County Fire Authority board of directors and voted to move ahead with further study, saying they wanted more details on what any partnership with ambulance companies could look like before they move forward.
“The one thing this is going to do for this agency is it’s going to define responsibility for all stakeholders,” said Stanton Mayor and OCFA board member David Shawver, who’s served on the board since the agency’s founding. “It’s going to give, finally, the stability that we need for this program.”
The report also stated that a single entity from the 9-1-1 call to delivery at the hospital would increase transparency, making it more obvious who was responsible for what, along with consolidating broken up dispatch centers and coordinating emergency services quicker.
“You really can’t, efficiently, economically, operate these five or 10 ambulance service areas as silos,” said Stewart Gary, a representative from CityGate Associates at the meeting. “They lean on each other.”
He also noted that all these different agencies track success differently.
“If you looked at a single owner system…you would have more performance score measures and you would hold the system managers accountable,” Gary said. “That doesn’t exist today.”
It remains unclear what the final details on any partnership would look like, with OCFA staff assuring board members it would have to be put out to bid and that there would also need to be negotiations with the firefighters and emergency responders’ unions.
The fire authority also has to negotiate with the county government, which ultimately enters into ambulance contracts and would have the final say over whether or not a system like this could move forward.
Noah Biesiada is a Voice of OC reporter and corps member with Report for America, a GroundTruth initiative. Contact him at nbiesiada@voiceofoc.org or on Twitter @NBiesiada.
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