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Supervisor warns of EMS crisis, asks city attorney to draft charter amendment setting minimum ambulance standards
Summary
Supervisor Breed told the Board that San Francisco's emergency medical services are in crisis, saying ambulances are often unavailable, response times have worsened and budgeted ambulances were not purchased. She asked the city attorney to draft a charter amendment to set minimum EMS standards for the city.
Supervisor Breed delivered an extended statement to the San Francisco Board of Supervisors saying the city—s emergency medical services (EMS) are in a state of crisis and proposing a charter amendment to require minimum standards for ambulance service.
Breed said EMS—not fires—constitutes over 70 percent of the department—s calls and that the number of "medic-to-follow" incidents, when an ambulance is not available to respond, has increased more than 500 percent since 2008. She cited a recent month in which ambulances took more than 20 minutes to arrive on 374 occasions, and said individual cases included an 87-year-old man who waited 45 minutes for an ambulance and later died, and patients transported in police vehicles because ambulances were not available.
Breed criticized the Fire Department—s leadership for failing to act despite funds being appropriated: she cited the budget and legislative analyst—s finding that funds for 16 ambulances had been appropriated in multiple budgets but "not even one of these 16 ambulances has been purchased." She also described morale problems, a shortage of ambulances and medics, and reports of misconduct by some command staff.
As a response, Breed said she has filed a drafting request asking the city attorney to prepare a charter amendment that would set a measurable minimum level of EMS service. She told the board she will consult medical experts, department members and state authorities to define a standard that could be based on response times, the number of "medic-to-follow" calls, or a minimum number of ambulances and medics. Breed cited Proposition F (2005), which set minimum staffing for fire suppression, as precedent for a voter-enforced standard.
Breed framed the proposal as a measure to ensure consistent public safety: "This ballot measure will force them to improve or move on," she said in urging the board to consider the drafting request.
No formal vote on the drafting request was recorded at the meeting; Breed said she had been invited to participate in an EMS working group under the mayor—s office and that the group was drafting short-term measures including a 30-day mutual-aid contract with a private ambulance company and expedited hiring.
Ending: Breed said she did not intend to seek the board—s removal power over the chief (citing City Charter limitations) but wants voters to be able to set minimum EMS standards through a charter amendment. She asked the board to allow the drafting request and to follow the working group—s recommendations while the charter measure is developed.
