TO: Mayor and City Council
THROUGH: Keith Stahley, City Manager
FROM: Mike Niblock, Fire Chief
SUBJECT:
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Information on Salem Fire Department Implementing the approved Ambulance Operator Model with Fire Department Oversight.
Ward(s): All Wards
Councilor(s): All Councilors
Neighborhood(s): All Neighborhoods
Result Area(s): Safe and Healthy Community
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SUMMARY:
summary
The City of Salem is actively implementing the Ambulance Operator Model, set to launch on July 1, 2025, following City Council approval in March. Under the leadership of the Fire Department, significant progress includes initiating an external oversight committee with the Mayor, scheduling strategic planning meetings, and enhancing operational capabilities, such as increasing annual billing calls and securing a new ambulance fleet. The transition aims to address longstanding challenges with the current service provider, Falck Ambulance, and to reinstate the Fire Department as the primary ambulance service provider, supported by the strategic use of Ground Emergency Medical Transport (GEMT) Funds and new staffing strategies. This move is part of a broader effort to ensure sustainable, efficient EMS service delivery that aligns with community healthcare needs.
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ISSUE:
Information Only.
RECOMMENDATION:
recommendation
Information Only.
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FACTS AND FINDINGS:
Following Council approval in March, we have been actively working on implementing the Ambulance Operator Model, set to launch in July 2025. Deputy Chief Brian Carrara and Deputy Chief Kyle Amsberry from the Fire Department lead the transition and represent the department on external and internal committees. Here are some key accomplishments over the past two months:
• We plan to work with the Mayor to initiate the requested external oversight committee, including multiple community partners. Their insights and contributions will be invaluable to us.
• We have organized the first internal EMS Strategy and Planning Team Meeting, a pivotal step in our journey, scheduled for May 14, 2024. We look forward to the valuable input and collaboration of stakeholders from the Fire Department, Budget Office, Human Resources, EMS Division, and the Union.
• We are engaging a consultant to guide and provide expertise throughout the evaluation of EMS deployment and implementation models.
• We are working with our outside billing agency to significantly increase our billing capabilities from 2,700 calls annually to under 20,000.
• We are securing a complete ambulance fleet delivery with manufacturing companies by Spring 2025.
• We are coordinating with Public Works on necessary upgrades to the Hertz Building to support EMS operations at market rates.
• We have determined the administrative personnel needed to support operations effectively. We worked with our Human Resources Business Partners and the Budget Office on positions, position descriptions, and overall personnel costs.
• We are working with the Budget Office to secure funding for Capital Costs.
We have developed a dynamic timeline that we regularly update to monitor our progress closely. This timeline helps us identify and track critical benchmarks, ensuring that each project phase meets our scheduled goals and deadlines. Keeping all team members informed and engaged is crucial, facilitating effective management and timely adjustments as needed.
BACKGROUND:
The City of Salem has been using a contracted private ambulance service for the past two decades, transitioning in July 2005 when financial pressures, particularly low Medicaid and Medicare reimbursement rates, necessitated a shift away from direct management of ambulance transports by the Salem Fire Department.
Currently, the private ambulance service provider, Falck Ambulance, needs help maintaining the deployment levels mandated by their contract. This has led to the Fire Department incurring $3.3 million in overtime since November 2021 to support the EMS System and ensure adequate service delivery. Despite these challenges, we will continue relying on Falck Ambulance as the Advanced Life Support Ambulance Provider through June 2025.
Considering these circumstances, the City is reassessing its service delivery model and strategically moving towards reinstating the Salem Fire Department as the primary provider of ambulance transport services. Recent fee recommendation increases to support this transition, the availability of Ground Emergency Medical Transport (GEMT) Funds-exclusive to public entities-and the introduction of single-role medics and basics within the department's structure.
Moreover, it is important to note that the third-party contracted study that informed this strategic shift included contributions from the Salem Fire Department and Falck Ambulance. This cooperative approach ensures that the new ambulance service delivery model is effective and sustainable, addressing the current operational challenges and aligning with the community's evolving healthcare needs.
Following Council approval in March 2024, we are actively moving forward with the Ambulance Operator Model and diligently working towards its implementation for a July 1, 2025 deployment.
MIKE NIBLOCK
FIRE CHIEF
Attachments:
1. Summary of AO Timeline
2. Ambulance Operator Timeline