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Alameda County — Pressure on Falck Northern California, the provider of emergency ambulance service for much of Alameda County, appears to be building in the wake of increasing emergency medical response times across the county.

Officials have called for an investigation, while local unions have questioned the company’s business practices.

Reginald Freeman, fire chief with the Oakland Fire Department, requested an investigation into Falck ambulance response times in the City of Oakland between Jan. 1, 2020, and Aug. 31, 2021 in a letter sent to the Alameda County Emergency Medical Services Agency (ALCO EMS), the organization in charge of managing countywide ambulance service.

“Between July 1, 2021, and Aug. 17, 2021, there were a total of 462 response delays,” wrote Freeman. “That’s an average of 11 per day. The incident descriptions for these calls include but are not limited to stabbing, gunshot, sexual assault, seizures, breathing problems, stroke, traumatic injury, chest pain, overdose and hemorrhage laceration. Our residents and visitors deserve to have the best services, which includes their loved ones being transported to the hospital in an expeditious, safe and orderly manner when there is a medical emergency.”

Response time concerns have not been limited to the western part of the county. Impacts of extended response times have also been felt in the Tri-Valley.

“We have seen Chief Freeman’s letter, and we do share many of his concerns,” said interim-Fire Chief Joe Testa of the Livermore-Pleasanton Fire District. “We have experienced some extended response times for Falck ambulances in Livermore and Pleasanton. At times, the Alameda County Fire Department has dispatched their paramedic ambulance from the Lawrence Livermore National Laboratory to respond to calls in our jurisdiction when there was a lack of Falck ambulance availability or an extended estimated response time.”

In an email to The Independent, Falck USA Director of Marketing and Communications Jeff Lucia said he wasn’t aware of Freeman’s letter, but that he shared Freeman’s concerns about increasing response times. He noted that average response times in the county have increased in recent months, a result he attributed to delays experienced by ambulance crews while waiting to transfer patient care to hospital staff, referred to as wall time.

“We've seen a slow increase in response times countywide of approximately 60 seconds in the past three months, in tandem with an increase in time spent waiting with patients for beds at hospitals of approximately 12 minutes, due to the hospital labor shortage up and down the state and across the nation,” Lucia said.

ALCO EMS acknowledged Freeman’s concerns and said that efforts are underway to make improvements.

“We have identified some systemic problems that are contributing to longer response times,” said Jerri Applegate Randrup, communications officer with Alameda County Health Care Services Agency. “We have multiple mitigation efforts in place, and we advised Chief Freeman that we would keep the fire chiefs apprised of our progress.”

Speaking before the Sept. 9 meeting of the Alameda County Board of Supervisors’ Public Protection Committee — comprised of supervisors Richard Valle and Nate Miley — representatives of NAGE EMS Local 510 presented a more complex picture of the factors behind Falck’s diminishing services levels. They discussed an array of concerns regarding the company’s business practices. Local 510 represents emergency medical technicians, paramedics and support staff that provide emergency medical services and transport.

Admitting that wall times have increased, particularly since the onset of the COVID-19 pandemic, Gary Breazeale, Local 510 treasurer, said the ambulances can routinely take 30 minutes or more to respond to a 9-1-1 call. Falck’s staffing practices, he said, are a significant factor in those delays.

“alck has blamed the long response times on hospital wall times,” Breazeale said. “This is a red herring argument by Falck to detract from their staffing shortcomings. Hospital delays are nothing new for Alameda County EMS. However, hospital wait times have increased exponentially since COVID … County LEMSA, the county local EMS authority, is now giving exemptions to Falck for long response delays. This exemption absolves Falck of the responsibility to upstaff their ambulances. There is no motivation for the company to fix the issue by adding extra ambulances because there is no penalty for any delays.”

Dominic Curcuruto — the chief shop steward for Local 510 and a current Falck employee serving Alameda County — outlined other concerns. He asserted that Falck staffed a large number of basic life support (BLS) ambulances to meet contractual unit hours, instead of staffing advanced life support (ALS) crews. According to Curcututo, BLS crews are limited to responding to less serious calls and often sit idle while urgent incidents wait for an ALS crew to become available.

Additionally, Curcuruto alleged that Falck has failed to meet its contractual obligation to provide comfort stations for on-duty ambulance crews. Falck was awarded the contract to provide ambulance service to Alameda County in July 2019. During the county’s analysis of the bids for that contract, Falck received 85 points for its promise to provide 17 of these stations. Cucuruto asserted that those points allowed Falck to beat the other bidders, Paramedics Plus and American Medical Response. To date, Curcuruto said, Falck has only made three stations available.

“We ask only that Falck be held appropriately accountable for their actions, or lack thereof,” he said. “Our families and this community deserve at least that much.”

The director and chief of Falck Alameda County, Carolina Snypes, resigned from her position after 18 months in the role. Snypes announced the move Sept. 9 in posting on the company’s Facebook page.

“For me, it’s something that I’ve been working with the administration on for quite some time,” Snypes said in an interview with The Independent. “Obviously, I couldn’t share that earlier than it was appropriate to. I’m a full-time student. My wife is a full-time student. Our lives are kind of crazy. For me, I pretty much set out to get a couple of major things accomplished. I’ve been with the county a really long time. So, I wanted to get through transition. There were a couple of major milestones for me once I took the director and chief role that I wanted to finish. I felt like I finished those, and I just felt like it was time for me to move on to something that was a little less demanding.”

Snypes’ successor has not yet been named. The day after her resignation, Falck announced that Scott Ensminger had been hired as the company’s new director of operations. Lucia said that Ensminger’s hire fills a role that had been open since May.