After a recent newspaper report saying ambulance service in Alameda County may be facing cuts driven by the COVID-19 coronavirus pandemic, the company that provides that service says there will be no cuts for the foreseeable future, despite a substantial drop in calls for service since the shelter-in-place order took effect.
Such cuts wouldn’t have direct consequences for Piedmont, or for Albany, Alameda and Berkeley, the only four Alameda County cities that operate their own ambulance services. But Piedmont Fire Chief Bret Black said even those four cities would suffer, as furloughs would compromise Falck’s ability to provide “mutual aid,” help needed when local crews are spread thin. The Piedmont Fire Department could ask for such help to serve patients in a major disaster, a fire or accident with multiple casualties – or offer help to other communities..
“That would be a big question mark, the availability of extra ambulances in the system,” Black said last week. The Chronicle story got the attention of area fire chiefs and other emergency responders, he said.
“And we have yet to see the full extent of the (COVID-19) surge and its demand on the system.”
Black said he and other county fire chiefs heard from Falck this past week, with assurances that ambulance crews are not being cut back,
“To be honest, we are not sure what to believe. If they are backing away from the details in the original (newspaper) story, that’s promising,” Black said Friday. “My only hope is we do not have any reduction of healthcare, EMS personnel, EMS administrative or support staff.”
Falck in December 2018 signed a contract to provide 911 ambulance services in Alameda County through June 2024. The four cities, including Piedmont, that handle their own ambulance service would still take part in mutual aid.
From July 1, 2019 through Jan. 30 of this year, Piedmont received mutual aid from Falck crews four times, and provided aid to Falck nine times, according to statistics provided by Falck.
A March 6 story in the San Francisco Chronicle reports that Falck was considering furloughs of unspecified “union employees” because of a substantial downturn in business since March 13. Parts of that email, sent to Falck by human resources business partner Kenya Howard, were published by the Chronicle: “In these turbulent times, businesses nationwide are facing difficult decisions … We are working closely with your union and have already been in discussion about the possibility of Falck ALCO implementing furloughs for union employees.”
Falck spokesman Jeff Lucia said this week that, despite the various reports and rumors, no ambulance crew EMTs or paramedics are being furloughed in Alameda County.
“Some reports and social media posts have confused the temporary reductions we’ve made in our administration and support staffing with furloughs of EMTs and paramedics, but those reports are untrue,” Lucia said.
Lucia did not clarify which specific employees to whom the March 30 email referred.
There have been markedly fewer patients in Alameda County since the shelter-in-place order went into effect March 13. According to figures compiled by Falck, the company provided 3,953 ambulance transports in Alameda County from March 17 through March 31, 2019. For that same two-week period in 2020, during the coronavirus pandemic, that number dropped to 2,428. That’s a 38 percent drop.
Falck is paid for its ambulance services primarily through “fee-for-service reimbursement of patient charges,” by the patients themselves or their insurance carriers. Lucia said there is no subsidy from Alameda County; fewer transports, he said, mean less revenue.
That patient-transport drop, Lucia said, is partly a matter of fewer people on the streets getting into vehicle accidents, taking part in risky hobbies and committing crimes. But there’s also been a drop in heart attacks, strokes and other acute health emergencies to which ambulances typically respond. That, he said, is harder to explain.
“Perhaps some of those people are already compromised” with COVID-19 related issues, Lucia said. And the response to the coronavirus hasn’t ramped up significantly – yet.
An April 6 story in the New York Times discusses that question. Among the theories it presents are that people with acute medical events are afraid to go to the hospital out of fear of contact with coronavirus, and instead suffer at home, sometimes until it’s too late. Another idea is that with social distancing, there are fewer gatherings at which “trigger” behaviors for medical problems (heavy eating and drinking, or overly strenuous exercise).
Despite the drop in revenue, Falck’s Lucia said, the ambulance service is on a solid foundation, and will continue to operate at previous levels. Alameda County health officials said they are confident about that.
“Falck has assured the county that they are committed to serving the residents and visitors to Alameda County, and have no intention to furlough any of the 911 field personnel serving Alameda County,” said Jerri Applegate Randrup, a spokeswoman for the Alameda County Health Care Services Agency.
Lucia said there’s no reason for fire departments to worry about mutual aid. “We remain fully staffed with EMTs and paramedics in our Alameda County operation, and we have a surge plan in place should it become necessary to increase our coverage.”
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