Bethel Island’s QRV Service Cuts Explained


By Ben Whitener

The residents of Bethel Island were treated to an explanation of the recent changes to the EMS delivery in East Contra Costa County with the loss of the Quick Response Vehicle (QRV) and the addition of a transporting ambulance on Bethel Island.

On hand at last night’s meeting were Contra Costa County EMS Director Pat Frost, American Medical Response (AMR) General Manager Leslie Mueller and East Contra Costa Fire Protection District (ECCFPD) Chief Hugh Henderson for the Bethel Island Municipal Improvement District (BIMAC) meeting.

Some background information was provided which explained how the Quick Response Vehicle started serving the community of Bethel Island, Knightsen, and at times the eastern portion of Oakley after the formation of East Contra Costa Fire Protection District in 2002.

The QRV unit would respond along with the engine company to all emergency medical calls on Bethel Island, and would respond to Knightsen and some parts of east Oakley as needed.

Prior to the merger of Bethel Island Fire with the surrounding fire districts to form ECCFPD, the Bethel Island fire engine was staffed with a Paramedic Firefighter along with either a Fire Engineer, Fire Captain or the Fire Chief 24/7, and was supported by a cadre of Paid-On-Call firefighters that would respond from home for all emergencies.

After the merge and the subsequent loss of the engine based paramedic, the QRV unit was stationed at Station 95 to maintain the level of service provided prior to the formation of ECCFPD.

Fast forward to today, now Bethel Island has not only lost its fire protection for all intents and purposes, but it has also lost its emergency medical service first responder now that the QRV is gone.  They are left with a fire engine that will respond from Oakley or farther out depending on the amount of emergency calls at the time, and an ambulance that will have the same level of response.

In a letter dated June 28, 2012 from Pat Frost to Supervisor Mary Piepho, Ms. Frost stated that “after careful review of available options within the short time frame, it was determined that, at least on a temporary basis, AMR will replace the Bethel Island QRV with a 24-hour paramedic-staffed ambulance”.

The operative term in this statement is that it could be “temporary”.

This change is being done under existing ambulance contract terms, “which allow for the elimination of one or more QRVs in exchange for provision by AMR of an equivalent dollar amount of existing substitute services.”  In reality, this change is not an enhancement of services or an improvement.  It is merely a shuffling of available resources.

Effective earlier this month AMR stopped providing QRV service on Bethel Island and replaced the unit with a transporting ambulance.

It should be noted that a statement was made in an article by the Brentwood Press on July 5th that the QRV would remain in place until mid-July, but this was untrue when it was printed.  The information provided in the Brentwood Press article was inaccurate, but The Press can only print the information they are given—the Contra Costa Times also took the bait and called it an “upgrade” was this clearly is not the case.

Let me be as clear as possible, this replacement ambulance will be a roaming unit, and its primary area of responsibility will be Bethel Island, Knightsen, and Oakley.

Depending on the number of medical emergencies in the system, this unit can be called upon to respond to any and all parts of the county as needed and could be called upon to move closer to Antioch or Pittsburg when the need to cover a large area exists due to a lack of available ambulances.

Contrary to what the Contra Costa Times and Brentwood Press printed several weeks back, it will not be committed to Bethel Island as the article and other information implied.

In addition, whenever it responds to a medical call, it will be out of service for at least 1.5 hours, but closer to 2 or more while it provides care and transports the patient to the hospital.

Leslie Mueller said during the meeting that no system “will have an unlimited number of resources”, and this is true, but Bethel Island and Knightsen are basically being left with little to no resources at all.  Fire engine and ambulance responses can, and will at times, take at least 20 minutes or more.

For someone suffering from Chronic Obstructive Pulmonary Disease (COPD), a heart attack, allergic reaction, or many other medical emergencies where early treatment makes a huge impact on patient outcome, these long response times without the initiation of any type of care can and will mean death.  Take for instance someone suffering from COPD.  When they have an exacerbation of symptoms, or an “attack”, it is like they ran a marathon and are trying to breathe through a small straw.  Without someone there to initiate care in a short amount of time, their body is quickly fatigued and they can die in a short amount of time.

The list goes on and on.

This is not meant to cast aspersions on American Medical Response management or its employees.  They are a for-profit company and are operating within the parameters of their contract with Contra Costa County.

Leslie Mueller is doing her job to the best of her abilities, and AMR has a lot of great paramedics and EMTs working for them that will provide top-notch care.  However, it would have been nice for the public to have been better informed prior to the QRV being shut down while other options should have been publically vetted.

There were two arguments that were made as to why the QRV on Bethel Island needed to shut down.

One was that they no longer had any place to house the unit with the FEMA trailer at Station 95 being taken away, and the other was patient/rescuer safety.

First of all, to address the housing situation, why couldn’t they house the unit at Station 94 in Knightsen in the interim while they looked for housing on or near Bethel Island?  In addition, quite a few residents during the meeting offered up possible housing solutions as well, but their offers were in vain.

As far as rescuer safety, it is true that responding to an emergency call solo is not the optimal choice and can be unsafe.  But, the other QRV units in Brentwood and Discovery Bay are going to be called upon to respond to emergencies on their own on a regular basis with the reductions our fire service being what they are.

When the fire engines in those areas aren’t going to be able to respond because they are on another emergency, are the QRVs in not going to respond either?  If that is the case, then maybe they should combine the other two QRV units and make one more transporting ambulance to go along with their logic.

Patient safety was also cited, but I don’t see how not having a rescuer respond would be safer for a patient than having one respond.  That argument did not hold water.

If they looked at all options like they said they did, I wonder if they considered placing interns with the QRV medics as the second person, or if they considered having law enforcement respond to medical calls with QRV units provide security (which I am sure they did, but the CoCo Sheriff’s office is short-staffed as well).  What about placing a reserve sheriff officer on the unit?  What about a police academy or fire academy cadet on the QRV unit to provide a second set of hands and provide for some added safety while providing some on the job training to the cadet?

Maybe none of these ideas would work, but it is time to think outside of the box instead of just giving up and saying something cannot be done.

All in all, the residents of Bethel Island and Knightsen are really getting the short end of the stick.  Please stay involved and informed regarding what is going on with your public safety here in East Contra Costa.

Your life or the life of a loved one may depend on it.


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