The Multnomah County Regular Meeting held on July 25, 2024, focused on the ongoing ambulance service crisis affecting the region. Key officials, including representatives from Portland Fire and Rescue and other local fire departments, voiced urgent concerns regarding the current two-paramedic staffing requirement for ambulances, which they argue is contributing to significant delays in emergency medical response times.

Deputy City Administrator for Portland, representing Mayor Ted Wheeler, opened the discussions by emphasizing the need for change in the ambulance service delivery model. He highlighted that Multnomah County is the only jurisdiction in the U.S. requiring two paramedics on every ambulance, a policy he has opposed since his arrival in Portland in 2016. He pointed out that this requirement has led to frequent instances where no ambulances are available to respond to emergencies, with reports of AMR (American Medical Response) being at "system status zero" multiple times a day.

Fire Chief Ryan Gillespie of Portland Fire and Rescue echoed these concerns, detailing how the ambulance shortage has forced firefighters to transport critically ill patients in fire apparatus, which are not designed for such purposes. He described several alarming incidents, including a recent case where a firefighter was injured and had to be transported in a fire truck due to the unavailability of ambulances. Chief Gillespie stressed that the current system is broken and needs immediate attention from Multnomah County.

Scott Lewis, Fire Chief of Gresham, also contributed to the discussion, sharing his experiences with the ambulance service crisis. He recounted a recent stabbing incident where the closest ambulance was coming from outside the county, resulting in a delayed response. He emphasized that the existing two-paramedic requirement does not necessarily improve patient outcomes and suggested that a one-paramedic and one-EMT model could enhance response times without compromising care quality.

Dr. Stephen Dean, an EMS patient advocate, provided a broader perspective on the issue, arguing that the county's current staffing model is not supported by medical research and that changing to a one-paramedic and one-EMT model could significantly improve response times and patient outcomes. He noted that the national shortage of paramedics is a pressing issue that cannot be resolved through fines or mediation alone.

Councilor Ian Todd from Fairview added a personal touch to the discussion, sharing his own experience with emergency medical services and advocating for a change in the staffing model. He criticized the outdated policy and called for immediate action to improve ambulance availability.

Commissioner Gonzalez, a Portland city commissioner, highlighted the need for collaboration between the county and local fire departments to address the crisis effectively. He pointed out that both Portland and Gresham have unanimously approved resolutions urging a change to the one-paramedic model, reflecting a unified call for action from local governments.

The meeting concluded with a consensus among officials that the current ambulance service model is inadequate and that immediate changes are necessary to ensure the safety and well-being of Multnomah County residents. The discussions underscored the urgency of addressing the ambulance shortage and the need for a more flexible staffing model to improve emergency response times.