By John Donegan
The Bakersfield Californian
KERN COUNTY, Calif. 鈥擳he look and shape of calling 911 in Kern County is changing, and officials say it鈥檚 for the better.
On Tuesday, the county Board of Supervisors received the mandatory 2022 Ground Ambulance Report, which maps out the health of the county鈥檚 ambulance services, measured in response times, customer anecdotes about service and ambulance offload times, among other metrics.
The report cited 20,000 more 911 calls in 2022 and a continued staffing shortage. Despite the excess in emergency dials, the amount of calls that resulted in a trip to the hospital dropped by 10%. Officials explain this is an unfortunate trend in which false-alarm calls are made by patients that put paramedic crews out of action for hours.
Kern EMS Program Manager Jeff Fariss said that in his time he鈥檚 seen callouts by someone suffering from 鈥渁thlete鈥檚 foot, or toe pain.鈥� Other common examples can include a patient who forgot to take medication or who has an empty inhaler.
鈥淭here are many times a day when people call 911 for very minor injuries or illnesses that could and should be treated by calling their personal physician, insurance nurse line or visiting an urgent care,鈥� said Mark Corum, a spokesman for Hall Ambulance. 鈥淧eople call 911 because they think it will get them seen more quickly. But when we get to the hospital, the hospital sends them to the waiting room for a very long wait.鈥�
These types of calls waste valuable time and resources, Fariss continued, and demoralize paramedic crews who crisscross the county answering frivolous calls. The result is that it still takes too long for patients with real emergencies to get into the hospital.
In response, Hall Ambulance 鈥� which provides services to 96% of Kern residents 鈥� and county health officials are implementing a number of new policies and programs to weed out nonemergency calls and improve response times.
The review is separate from the price increases the county approved in April for ambulance service. That process raised new baseline rates for Hall Ambulance鈥檚 Basic Life Support 鈥� operated by a paramedic instead of an EMT 鈥� by $497.63 to $2,912.12. Advanced Life Support services were increased by $561.47 to reach $3,285.76.
鈥淓verybody鈥檚 bill will change,鈥� Kern Public Health Services Director Brynn Carrigan said at the time. 鈥淒epending on what the payer source is, they鈥檒l either pay part of it, all of it (or) none of it. But everybody that uses the ambulance will see an increase on their bill.鈥�
On Monday, paramedic crews across Kern were briefed 鈥� and then quizzed 鈥� on a Direct to Triage system, which sorts incoming patients based on their 鈥渃linical severity鈥� instead of sending them all to the emergency room, which can lead to time-consuming offload times.
It鈥檚 a common sorting system used in various forms across the country, as many hospitals facing similar staffing shortages have limited resources to handle patients.
鈥淔or the most part, it鈥檚 all positive,鈥� Fariss said of the response. 鈥淣obody likes change 鈥� change is always scary because it represents the unknown. But for the most part, it鈥檚 all positive.鈥�
Fariss explained that this is one of the largest policy overhauls in Kern鈥檚 history, and it only starts at the new triage system. The county also introduced this year a tele911 system 鈥� the first in the state 鈥� where EMS crews at the scene connect physicians to people over video call, where those who call 911 can be diagnosed quicker. Since its start in July 2022, officials said they鈥檝e tele-called 798 patients. Only 211, or 26%, needed an ambulance.
鈥淥ften, they鈥檙e people who cannot get an appointment to see their doctor, so they call 911,鈥� Corum said.
Since February, Hall Ambulance has been five cars deep into its new Fly Car program, whereby paramedics, who ride separately from the ambulance, only stay with the patient if necessary. Otherwise, they give instructions to the EMTs on hand and go to the next call.
Two trials in November and December proved a success, officials said, resulting in a 64% faster turnaround rate, a difference of 46 minutes.
鈥淚f the patient does not need a paramedic, they can leave the scene and go back into service that much quicker,鈥� Corum said. 鈥淲e have several paramedics who now work the (Fly Car Program) as their regular shift by choice.鈥�
The county is also tracking people who misuse the 911 system and allows officers to send them three cease-and-desist orders before putting them on a no-ambulance list. The county has a three-strikes rule that, following the final strike, bans that 鈥渦ser鈥� from calling an ambulance.
Dozens of cease-and-desist orders have been filed this year, Fariss said. EMS staff decide once they arrive whether a patient is allowed transport.
鈥淲e will still always respond to a 911 call,鈥� Fariss said. 鈥淚t would just fall on the provider to decide, not the patient.鈥�
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