October 5, 2016

Chief Christopher Heiser

City of San Diego

EMS Deputy Chief

1010 Second Ave Suite 300

San Diego, CA 92101

Re: FY2017 Quarter 1 Notice of Ambulance ReSponse Time

Dear Chief Heiser,

Thank you for your letter regarding FY2017 Quarter 1 ambulance response

times. American Medical Response (AMR) is committed to providing the City of San
Diego a world?class EMS system. AMR has been consistently meeting compliance over
the course of its contract since it assumed the Rural Metro contract October 28, 2015.
That said, although AMR is meeting its response time compliance citywide, we have
experienced challenges in multiple zones within the City of San Diego since July 2016.

The challenges are largely due to a staffing shortage which is reverberating throughout
the State as well as the nation within the EMS community. Our top priority has always
been -- and continues to be to provide excellent service and patient care to the
citizens of San Diego. To that end, AMR immediately created an

aggressive mitigation plan to improve staffing and contractual compliance within the City
of San Diego.

AMR enhancements and EMS system modifications include:

1. AMR is standardizing our staffing models throughout the county to a one?
paramedic one?EMT system, which will allow AMR to direct all paramedic
applicants from existing service areas into the City of San Diego EMS
system, which could be up to 18 additional paramedics by the end of the year.

2. AMR continues its robust recruitment, training and hiring program of new EMT's
and Paramedics including the offering of a $3,000 sign-on bonus for those who
qualify for paramedic employment. Since June, AMR has hired 16 new
Paramedics, in addition to 4 who are expected to onboard as paramedics
beginning as soon as November 2016.

3. scholarship program, which currently funds our EMT employees to attend
school for paramedic training, has exceeded expectations. Currently there are

 

23 AMR-sponsored EMTs in paramedic training at Southwestern College,
EMSTA College and Palomar College. Upon graduation, AMR expects to
immediately onboard these new paramedics into the City of San Diego system.

We greatly value our partnership with the City and the San Diego Fire-Rescue
Department. AMR is confident that our plan and modifications will help mitigate the
current staffing shortages within the City of San Diego and address compliance matters.
Moving forward, we will be providing updates on our onboarding of paramedics.

Should you have any questions or need additional information, please feel free to
contact me utilizing the contact information listed below.

Regards,



Mike Rice

Director of Operations, AMR
8808 Balboa Ave

San Diego CA 92123
858?492?3738

Cc: Scott Chadwick, COO

Brian Fennessy, Fire Chief

Colin Stowell, Assistant Fire Chief
Alyssa Ross, EMS Program Manager
Noah Brazier, Deputy City Attorney