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Published September 6th, 2015
Lafayette ambulance response times drop under Alliance
Faster to the scene in 2016 Photo courtesy ConFire

Thanks to dynamic resource management and increased efficiencies in the district dispatch center, the partnership between the Contra Costa County Fire Protection District and American Medical Response - the Alliance - has lowered ambulance response times into Lafayette an average of nearly two minutes in its first full year of operation.
The Alliance began delivery of ambulance service to most of Contra Costa County in January 2016 under a first-of-its-kind arrangement in California. Fire Chief Jeff Carman said at the time that the union of the two providers of pre-hospital emergency medical care under a single governing body would allow for faster and more efficient emergency response.
For Lafayette, the chief's prediction has been on target.
According to district records, in 2016 AMR reported 1,710 ambulance calls into Lafayette at an average response time of 10 minutes and 37 seconds. In 2017 the number of calls reported by the Alliance into the city increased to 2,015, with an average response time of 8 minutes and 44 seconds.
Terence Carey, ConFire assistant chief-emergency medical services division, credits much of the improvement to a more functional dispatch center. The AMR dispatchers moved from Sacramento to district headquarters in Pleasant Hill in February 2016, and between the two agencies, nine dispatchers are on duty at any one time under one roof.
"Under the old system, you would pick up the phone, the call went to the sheriff's office, then it was given to ConFire, ConFire determined the problem and dispatched the call to Sacramento. Then AMR would dispatch an ambulance," Carey said. He attributed 51 seconds of shorter processing time to the consolidated dispatch model.
With the changes in the dispatch center, fire and ambulance units now share the same radio channel and can communicate directly to manage field resources. Carey said the resultant dynamic reassignment of apparatus added depth to the system, which also helped reduce Lafayette response times.
Carey, a 34-year fire service and EMS veteran, grades performance not only of the ambulance response times, but of the entire EMS system. "The local EMS agency sets our response standards," Carey said. "The other components of the system are the dispatch center, the fire units, ambulances and the hospitals. We work with all five legs to provide a streamlined and more efficient EMS model in order to deliver better customer service."
It's well and good for the Alliance to provide an improved service model, but the Board of Supervisors approved the partnership with the expectation that the venture would also be profitable. Based on data the Alliance supplied to the board in the spring, collection revenue will exceed expenses by more than $6.7 million for 2016, though ConFire administrative services director Jackie Lorrekovich said in August that figure will likely drop but that the program will show a profit. ConFire advanced the Alliance $3 million for startup costs, and Carey said after that money is repaid, any profit will go back into the system.
Looking ahead, Carey would like to better assist those with mental health issues. "How do we do a better job on the 14 percent of calls that are psychiatric?" he said. Carey believes that further response time improvement can come with freeing up ambulances from the 90 minutes spent on each mental health-related call at psychiatric hospitals.
"We expect more improvements in 2017," Carey said. "While we are compliant with the LEMSA response time standards, we will not rest on those laurels."

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