Multnomah County says it will fine ambulance provider AMR for slow response times

By Amelia Templeton (OPB)
Aug. 10, 2023 12:30 a.m.

Multnomah County announced Wednesday it plans to start issuing monthly fines to American Medical Response, the company that provides ambulance services for much of the Portland metro area.

County officials said ambulance response times have been getting worse, driven by difficulties staffing paramedics, despite efforts to address the problem.


AMR is supposed to meet an industry standard performance target of responding to 90% of life threatening calls within eight minutes in urban areas, according to its contract with Multnomah County. AMR hasn’t met that target in since March 2022.

Instead, ambulances are arriving late to critical emergencies around 30% of the time.

Last summer, AMR created a plan to increase staffing to address slow response times. That hasn’t worked, according to the county.

This study is the first of it’s kind to highlight disparity within the ambulance system. But experts think similar disparities are at work everywhere, from schools to the criminal justice system. It’s just that they can be easily illustrated in health care industry, where data is so widely available.

A file photo of an AMR ambulance in Multnomah County from 2018.

Kristian Foden-Vencil / OPB

County Chair Jessica Vega Pederson said her patience is exhausted.


“AMR’s ambulance response times are unacceptable and they have not met performance metrics in months, requiring that we take action,” she said in a statement.

The county can fine AMR up to $10,000 a month for slow response times, according to their contract. The county is required to use the money for system improvement initiatives.

A spokesperson for American Medical Response said the company disagrees with the county’s current stance.

“We have made extensive efforts to communicate the severity and external causes of paramedic staffing shortages nationwide to the County,” said spokesperson Nicole Michel.

“AMR wants to assure members of the community that we are doing everything within our power to fulfill our responsibilities and address the staffing shortages.”

The company said the staffing crisis is solvable if Multnomah County relaxes its standard requiring ambulances be staffed with two paramedics, a role that requires more training and higher pay, as opposed to pairing each paramedic with a less trained and less costly emergency medical technician.

AMR said that staffing model is used widely in other parts of the country.

Multnomah County has so far refused to change its staffing standard, apart from a pilot project sending ambulances staffed with EMTs only to less serious calls.

AMR is not the only ambulance provider in the area to struggle with slow service. Washington County is ending its contract with Metro West over similar problems.

AMR has been the sole ambulance provider in Multnomah County since 1995.