County tries new ways to address 911 calls

In an effort to reduce response times and cut costs post-pandemic, Kern County’s public health providers are introducing new methods to help people who call 911.

At Tuesday’s Board of Supervisors meeting, Brynn Carrigan, director of Kern County’s Public Health Services Department, delivered her department’s ambulance report, the first since 2018. The report detailed the achievements and ailments they experienced from right before the COVID19 pandemic to now, and offered ideas on how to improve response times and staffing shortages.

A state report by Cal Health found that 22.6 percent of Kern residents delayed or skipped medical care in 2021 and the percentage of those with “excellent health” dropped from 26.7 percent to 17.8 percent between 2019 and 2021.

The compiled report used 2019 numbers as a baseline, before COVID19 impacted the demand for healthcare services.

Compared to 2019, 22 percent more 911 calls were made last year, a difference of more than 20,000 dials and 5 percent more than in 2021. Despite this, the percentage of calls that resulted in transport by ambulance to the hospital dropped by 10 percent in 2022, 6 percent in 2021 and 3 percent in 2020.

But even with the decreased calls, officials believe they are over responding to calls.

“We have seen unprecedented 911 medical call volumes in Kern County,” Carrigan said. “While we experienced a slight drop at the onset of the pandemic, call volume has been rapidly increasing.”

The county’s medical system is broken into nine geographical areas, each with a contract with either Hall

Ambulance Service or Liberty Ambulance.

The report reviewed the performance of the two contractors from 2019-21 and found that on several month-long occasions, largely during COVID, both fell below standard in response time and offload time.

Carrigan and John Surface, chief operating officer for Hall Ambulance, who was present for the meeting, agreed this was due to an outdated system and staffing shortages, for both ambulances and hospitals.

“COVID has been a monster, to say the least, in healthcare,” Surface said. “And I can tell you, Kern County is the only county making strides on these issues.”

Hall Ambulance, which runs its own EMT and paramedic academy, felt the nationwide shortage of EMTs and paramedics that officials expect to grow to 37,000 by 2026. Statewide, officials estimate an emergency medical services deficit of 7,000 people, and both companies average a 20 percent deficit in staff.

They’ve brought on nearly 200 EMTs since 2018, with a quarter of the hires in 2022, but have continued difficulty in hiring and retaining paramedics.

“It’s tough to find a paramedic now,” Surface said.

Surface said that during the height of the pandemic, staff left the field due to the physical and mental stress of the work, and that morale among those who stayed was “at an all-time low.”

“We had a mass exodus to other states,” Surface said. “There’s lots of arguments about how California dealt with the pandemic, so people just packed up and moved elsewhere.”

They relied on travel paramedics and California Ambulance Strike Teams that Surface said in 2022 cost Hall Ambulance an additional $7 million.

In response, Carrigan said the county tweaked how it answered 911 calls, introducing several “systems” that defer people who call 911 with non-emergencies to video calls and other over-thephone alternatives. She also stressed that residents should not call 911 unless it is a true emergency.

“At times there are individuals who continually and intentionally misuse the 911 system,” Carrigan said. “Continual misuse of this system depletes available resources for those who actually need them.”

The county has a threestrike rule that, following the final strike, bans that “user” from calling an ambulance.

The Tele911 system connects physicians to people over video call, where those who call 911 can be diagnosed quicker. Since its start in July 2022, officials said they’ve telecalled 798 patients. Only 211, or 26 percent, needed an ambulance.

“There’s a lot of people who call 911 because they don’t know what to do,” Surface said. “And they need someone to explain stuff to them.”

Oftentimes, Surface explained, it can be as simple as reminding the caller to take their prescribed medication, or “have difficulty breathing, but haven’t used their inhaler in days.”

“Or the inhaler is empty,” Surface continued. “And the doctor is able to get the pharmacy to deliver their inhaler.”

In November and December last year, the county also conducted a trial period where paramedics rode separately from the ambulance and would only answer calls deemed necessary. Upon arriving, the paramedic would only stay with the patient if it was necessary. Otherwise, they gave instructions to the EMTs and went to the next call.

“The Fly Car trial proved successful in getting the paramedic back available in the system 64 percent faster,” Carrigan said, explaining that is a difference of 25 minutes compared to an hour and 11 minutes.