Fire Chief Mike Niblock has recommended that his department take over Salem’s ambulance service, replacing Falck Ambulance, the contracted provider that the chief said hasn’t provided service for Salem as required, taking too long to reach thousands of patients.
He proposed the city move the service back to the fire department when Falck’s contract expires in July 2025. The Salem City Council will consider the recommendation March 25.
Niblock said Falck has not provided its required 1,030 hours a week of ambulance service for the past year. The Fire Department had to put crews on publicly-paid overtime to staff agency medic units to cover for gaps.
“We’re sworn to protect the community. We’re going to make sure there’s ambulances available using taxpayer dollars to subsidize a private enterprise. Quite frankly it’s not working,” he told the Salem City Council on Monday, March 11.
He said the fire department can provide faster responses to medical emergencies and increase city revenue by managing the ambulances.
Falck’s contract expires on July 1, 2025. Niblock is asking councilors to consider shifting to a new response model where the fire department would manage the ambulance services. They would be staffed with EMTs and paramedics, using fees and state public funds to turn a profit.
Salem switched from public ambulance service in 2005.
Falck, an international ambulance service company with its U.S. base in California, operates in 26 countries with over 25,000 employees, according to its website. It has provided ambulance service for the city since 2015, and employs 80 people with 19 ambulances in the city of Salem.
On Monday, David Patterson, Falck’s regional managing director, told councilors that his company had not been made aware of the proposed change until last week. He said Falck is taking steps to improve its service and address staffing challenges, and urged councilors to take more time considering the decision and its impacts on expenses and turnover.
“We simply want to be able to compete for the right to be your partner next year, and are open to discussing system design changes, but we have to be included,” he said.
Consultant group AP Triton recommended the new model for 2025 after a six-month study, said presenter Rich Buchanan during the meeting.
READ IT: AP Triton study of city’s ambulance services
READ IT: Testimony from David Patterson, Falck’s regional managing director
Niblock, City Manager Keith Stahley and Matt Brozovich, the president of the Salem Professional Firefighters Local 314 representing Salem’s firefighters, spoke in support of the change.
Brozovich said that the city is currently six ambulances short, and Falck only meets its contractual obligation 40% of the time. The fire department was first asked to staff a medic unit in November 2021, and he said they were told it was to give Falck a month to regain their footing.
“This was 27 months ago. We are not in a better position today. We are in a worse one,” he said. Now, they’re staffing a second unit as needed.
“Falck ambulance has been subsidizing their business on the backs of my members, with your money, for 27 months. Enough is enough,” he said.
The city’s expended $3.3 million in overtime costs to supplement Falck’s service since then, according to a staff report from Niblock.
The city, as a public entity, could be reimbursed for running the ambulance service through Ground Emergency Medical Transport funds from the state. Falck, as a private entity, can’t get that funding which amounts to $4.4 million, according to the study.
The study also recommends increasing transport fees to “strengthen the financial foundation” of incorporating the ambulance service into the Fire Department.
Stahley said that Salem is the only jurisdiction in the area not taking advantage of the extra state funding and the potential for revenue by operating ambulance service.
“As I look out at the future of public safety service delivery, I don’t see a lot of bright spots or opportunities. However, I think this is one that we need to understand and take advantage of,” he said.
Consultant Rich Buchanan said that Falck paid $168,850 in fines in the 2021 fiscal year for not meeting contractual obligations, and $40,700 last year. The amount was lower because service was provided by the fire department’s units.
He said 3,823 people saw delayed care in that two-year period, with Falck in most instances failing to meet the recommended 6.5 minute response time for emergency calls
Considering the amount of funding received from insurance, which in Salem the majority of calls come from Medicare patients, Buchanan said that the system is valued at $12.5 million. That excludes the potential subsidies from Ground Emergency Medical Transport reimbursement.
Buchanan said the city could show a $2 to $6 million annual profit if it ran seven 24-hour ambulance crews and one 12-hour ambulance crew.
The plan would require onboarding 50-70 personnel as single-role paramedics and EMT Basics, said Brian Carrara, spokesman for the department. If a medic unit is ever understaffed, the department would have the flexibility to assign dual-role firefighters trained as paramedics to fill in.
“We have 168 paramedics in our department. I can guarantee you, right now tonight, that we will not have a medic unit out of service because we don’t have a paramedic to put on it. Falck can’t do that,” Niblock said during the meeting.
During the meeting, Niblock said the city’s Emergency Services fund could cover up to $2.3 million in initial personnel costs.
Patterson, the Falck executive, said in a letter to council that the local and national paramedic shortage would be an issue and said the financial modeling for the new hires lacks detail or consideration for future labor contracts.
Contact reporter Abbey McDonald: [email protected] or 503-704-0355.
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Abbey McDonald joined the Salem Reporter in 2022. She previously worked as the business reporter at The Astorian, where she covered labor issues, health care and social services. A University of Oregon grad, she has also reported for the Malheur Enterprise, The News-Review and Willamette Week.
