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County outlines tiered, demand‑match approach in draft 2028 ambulance service plan
Summary
Multnomah County staff briefed the county commission on a draft 2028 ambulance service plan that would move the county from a single-tier deployment to a tiered, demand‑match model and shift some response-time accounting to ambulance arrival rather than first EMS provider arrival. Staff said the plan meets or exceeds state minimums and sets the foundation for later code and contract changes.
Multnomah County staff presented a draft 2028 Ambulance Service Plan during a board briefing Wednesday, saying the document is intended to replace the county's current ordinance and underpin later updates to county code, administrative rules and procurement. "This draft plan transitions Multnomah County away from a rigid, single tiered deployment towards a dynamic demand match response model," EMS administrator Aaron Monnick told the board.
Monnick said the assessment leading to the draft found staffing shortages, rising call volume and regional pressure that require a different operational framework. The plan establishes a tiered response: some low‑acuity calls may receive no ambulance or a basic life support unit staffed by EMTs, moderate calls may receive a single‑paramedic ambulance, and critical calls would be augmented by a smaller cadre of "advanced care paramedics" trained for low‑frequency, high‑risk procedures. Monnick said the county would hold ambulance vendors accountable for ensuring advanced-care clinicians are available on high‑acuity scenes.
The briefing emphasized that the ambulance service plan itself is only one piece of a multi-step process. Monnick said county staff will bring related county-code changes, administrative rules and contract selection processes after the board aligns on baseline service standards, and that the AMR contract currently in place runs through Sept. 1, 2028. Chair Gregor Peterson confirmed the board will consider the plan as an ordinance with a first reading tentatively scheduled for Sept. 3 and a second reading about two weeks later; the county must submit any adopted plan to the Oregon Health Authority for state review and approval.
