San Francisco Fire Department ambulances are still not responding to emergency medical dispatches often enough or fast enough, according to a report released Thursday by San Francisco’s Civil Grand Jury, designed to be an independent watchdog of local government.
The report attributed those failures largely to a chronic lack of serviceable ambulances and an insufficient dispatch process.
The fire department’s ambulance response time has improved in the last six months, but still fall short of the performance standards established by the state, according to the report.
The jury conducted research as well a 33 interviews with fire department leadership, rank-and-file firefighters and paramedics plus various city department heads and found that ambulance response times was particularly slow in the western part of the city. The jurors said the response times are often longer than mandated by regulating agencies.
Jurors said the SFFD is required to respond to life-threatening dispatches in 10 minutes or less 90 percent of the time, but don’t.
They are also required to respond to dispatches not considered life-threatening in 20 minutes or less 90 percent of the time, but don’t, jurors said.
The jurors found that the fire department was also not fulfilling the mandate of its Exclusive Operating Area agreement with the state, that requires them to respond to 80 percent of all emergency dispatches issued by the Department of Emergency Services, with the remaining 20 percent of dispatches handled by contracted private ambulance providers.
San Francisco’s Ambulance Working Group, created with the goal of bringing down ambulance response times, in February 2015 found a roughly 6 percent decrease in overall medical response times since August 2014, indicating that progress was being made.
Additionally, the report found that “when a private ambulance and an SFFD ambulance are equidistant to an incident, the private ambulance is more likely to be dispatched because all private ambulances have paramedics on board while not all SFFD engines have assigned paramedics.” Without paramedics on board all SFFD ambulances, the department continues to struggle to respond often enough.
“First responder crews often do not have a paramedic on board, leaving patients with life-threatening emergencies waiting for a medic to arrive later,” the report states.
Jurors recommend new training classes so that all engines have a paramedic in every crew.
The jury also recommends the fire department bring response times within required levels within the next year and recommends that the San Francisco Fire Commission review monthly performance reports on ambulance response times.
Additionally, jurors recommend that SFFD institute a modified deployment for ambulances to ensure ambulances can respond to all locations in the city within the required time.
Other issues identified by the report include a lack of strategic planning for the department’s training center on Treasure Island, which is slated for removal without a planned replacement site, as well as absent or outdated technology at firehouses, and deferred maintenance needs in the hundreds of millions of dollars.
All city agencies identified in the report receive copies of the jury’s report and must respond with agreement to implement the recommendations, in whole or part, or to not accept them.
The Board of Supervisors must also conduct a public hearing on the Civil Grand Jury’s report.