Kern County Grand Jury • 2022-2023

Report: County of Kern Department of Public Health

Published: April 17, 2023 23 pages
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Findings and Recommendations 15 findings

F1
The public is unaware and/or unknowledgeable regarding the appropriate use of the 911 Call System. Many calls made to 911 are not priority and may be handled more efficiently with a visit to their physician's office or to a local urgent care facility.
Related Recommendations (1)
R4
The EMS should advertise and inform the public of the importance of the 911 Call system as to when to use it and when to transport oneself to medical care. The first public announcement should be completed by September 1, 2023. (Findings 1 and 8) 142 NOTES: • The Kern County Board of Supervisors and the Public Health Department should post a copy of this report where it will be available for public review. • Persons wishing to receive an email notification of newly released reports may sign up at the Kern County Grand Jury website. • Present and past Kern County Grand Jury Final Reports and Responses can be accessed on the Kern County Grand Jury website. RESPONSE DEADLINES: • REQUIRED WITHIN 90 DAYS FROM: Kern County Board of Supervisors O • REQUESTED RESPONSE WITHIN 90 DAYS: Progressive Ambulance Inc. O  Liberty Ambulance Service Hall Ambulance Service Inc. o Kern County Fire Department o • RESPONSES ARE REQUIRED PURSUANT TO PENAL CODE §§933(c) AND 933.05 WITHIN 90 DAYS TO: • PRESIDING JUDGE KERN COUNTY SUPERIOR COURT 1415 TRUXTUN AVENUE, SUITE 212 BAKERSFIELD, CA 93301 • TRUXTUN AVENUE, SUITE 600 BAKERSFIELD, CA 93301 Reports issued by the Grand Jury do not identify individuals interviewed. Cal. Penal Code §929 requires that reports of the Grand Jury not contain the name of any person or facts leading to the identity of any person who provides information to the Grand Jury. 143
F2
The COVID-19 pandemic continues to have a major effect on the emergency care and first responders in Kern County. Ambulance response times were stressed due to the units waiting to offload patients at hospitals and the increase in call volumes have created a shortage of available units to respond to calls.
No recommendations for this finding
F3
The National, State, and County EMT and paramedic shortage has placed a burden on the emergency medical system, with not enough ambulance units available, less paramedics in the field, and delayed Ambulance Patient Offload Times, which results in slower response times.
Related Recommendations (2)
R1
The Emergency Medical Services Program of the Kern County Public Health Department should organize and coordinate a countywide job and information fair to recruit new paramedics and EMTs to fill the void in the emergency response teams. Coordination should include the ambulance providers, KCFD, community and vocational schools in the area. The first job and information fair should be completed by September 1, 2023. (Findings 3, 6, and 7)
R3
The EMS should coordinate with Harvey L. Hall EMS Academy, Kern County Fire Department, and Bakersfield College to recruit more candidates in the paramedic profession. This should be completed by September 1, 2023. (Findings 3, 6, and 7)
F4
The APOT has tied up many ambulance units and personnel in long waiting lines. The hours waiting at the hospital could be used for other responses.
No recommendations for this finding
F5
Stacking patients was used during critical times to free up units and crews to respond to the next emergency. This happens when one ambulance crew provides care for two to five patients at the same time at the same hospital (extra ambulance cots are stored at hospitals), allowing the other ambulance units to respond to other calls.
No recommendations for this finding
F6
The Harvey L. Hall EMS Academy offers three EMT academies per year and one paramedic academy per year. EMT training and certification can be completed in about 90 days, Taft College offers an EMT course each semester. Paramedic training, licensing, and certification is completed over 18 months with a partnership 140 with Bakersfield College. More programs are needed to fill the 7,000 position shortages statewide.
No recommendations for this finding
F7
The lack of certified paramedics and EMTs within the County has caused a severe shortage for both ambulance providers and the KCFD. Sign-on bonuses of $20,000 and starting salaries of $70,000 are being offered. Traveler paramedics are recruited to fill in on a short-term basis.
No recommendations for this finding
F8
Of the ten approved acute care hospitals with emergency departments, two are approved for trauma level care; it is very important that the patient chooses the correct hospital for care, as this may not be the closest hospital at the scene of the emergency.
No recommendations for this finding
F9
The BOS approved and authorized the retroactive Agreement with Ridgecrest Regional Hospital to extend the term for designation as a Level IV Trauma Receiving Center through May 3, 2023. Residents of East Kern County are better served with an approved trauma emergency department.
No recommendations for this finding
F10
The Board of Supervisors has an agreement with Mercy Air to provide medical transport services from July 1, 2022, to June 30, 2027. This agreement will ensure that the County will have air support medical transportation along with ground service for the next four years.
No recommendations for this finding
F11
The use of Tele911™ medical system saves time in transportation, allows units to respond to other calls, and provides the patient with immediate access to an emergency department physician. Currently, reimbursements are not readily available to the ambulance providers unless there is transportation to a hospital.
Related Recommendations (1)
R2
The EMS should continue to expand the Tele911™ System, so the public and first responders are more comfortable with its use. The EMS in conjunction with the ambulance companies and Tele911™ should negotiate with insurance providers to allow for compensation for its use when transportation is not necessary. The first negotiation session should be completed by September 1, 2023. (Findings 11 and 15)
F12
The Kern County 911 Emergency Response System works with all EMS providers and dispatches through one system. The use of one dispatcher, Global Positioning System (GPS), black box, on-board computers, and a common radio frequency now provides real time locations of all first responders’ units, thus ensuring the correct unit is responding to the emergency which makes the EMS system more efficient.
No recommendations for this finding
F13
All emergency calls in Kern County for the ambulance providers are directed by the same dispatcher, and use the same radio frequency, allowing for better communications between the providers.
No recommendations for this finding
F14
Using mutual aid agreements, Hall contracted with Liberty, Pro Safety & Rescue, and many out of the County ambulance companies to cover the required responses within the contracted EOAs.
No recommendations for this finding
F15
The reimbursements rates from Medi-Cal and Medicare have not changed in 20 years and do not cover the current costs of ambulance transportation. COMMENTS: The Grand Jury thanks the Kern County Emergency Medical Services personnel for their cooperation and information provided. Thanks to the Kern County Fire Department and the two ambulance companies for providing pertinent information to complete this report.
No recommendations for this finding

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