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OREGON CITY, Or. – The Clackamas County Board of Commissioners on Thursday adopted a new performance-based contract with American Medical Response Northwest, Inc. (AMR) to provide ambulance services to the Clackamas ambulance service area. The contract will remain in effect until June 30, 2035 unless it is terminated or extended.
With this performance-based contract, AMR will be held accountable for meeting specific standards, including response times and quality of care. While previous contracts imposed penalties for missed response times, the new contract also offers incentives for strong clinical performance. This new approach encourages continuous improvement and offers greater flexibility in addressing challenges.
“When someone in our community needs an ambulance, it’s so important that it arrives quickly and that they receive quality care,” said Clackamas County Chair Craig Roberts. “Ambulance response times have been a region-wide struggle over the past few years, but I am pleased that recently here in Clackamas County we have been seeing positive trends. This new contract with AMR will help ensure that those positive trends continue and that AMR meets clinical performance metrics in addition to response time requirements. Innovative programs like nurse navigation also help ensure that residents get the quality care they need.”
Notable additions to the contract include:
- Clinical performance metrics with built-in incentives
- Updated response time requirements (with rewards and penalties)
- Nurse navigation (launched in 2024) and secure transport services
- Data dashboards, electronic charting and upgraded technology
- Enhanced compliance and performance improvement processes
- Option to allow Basic Life Support (BLS) ambulances
- Increased transparency and accountability
Due to the rising cost of health care, patient rates are increasing. As part of the new contract, AMR agreed to continue providing their Compassionate Care Program, which provides assistance to those experiencing financial hardship.
In 2023, AMR was placed on a performance improvement plan at the direction of the Clackamas County Board of Commissioners for failing to meet performance requirements. At the time, emergency medical services across the region were facing challenges with ambulance response times, primarily due to staffing shortages.
AMR has made significant investments in its workforce over the past two years, including scholarships and work-study programs to attract and support new emergency medical technicians (EMTs) and paramedics. Currently, AMR in Clackamas County is fully staffed and has consistently met the required response time standards for the past five months.
The previous contract expired on April 30, 2025, triggering provisions that required AMR to continue services for up to 90 days or until a new agreement was in place. That contract was a one-year extension of a contract that was set to expire on May 1, 2024. The extension was granted to enable AMR to overhaul its operations in order to comply with response time requirements.
“Getting this contract to the finish line has taken a lot of hard work, and I want to thank everyone at Clackamas County and everyone at AMR who made it happen,” said Clackamas County Health, Housing and Human Services Deputy Director Philip Mason-Joyner.