Seattle's 911 Ambulance Service Faces Gaps and Changes

City routes some calls to out-of-state nurses, exempts some ambulances from wait-time limits, and uses ride-hailing services for some patients.

Mar. 19, 2026 at 8:40am

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Seattle has made changes to its 911 system in recent years, including routing some calls to nurses in Texas, exempting some ambulances from wait-time limits, and using ride-hailing services to transport some patients. These changes have raised concerns from experts and health care watchdogs, and some former city leaders say they were unaware of the full details of the new system.

Why it matters

These changes to Seattle's 911 system have the potential to impact public safety and access to emergency medical care, especially for vulnerable residents. The case of Pamela Hogan, who waited 10 hours for an ambulance and was later found dead, highlights the potential risks of the new system.

The details

In 2022, Seattle signed a contract with its ambulance provider, American Medical Response (AMR), to implement a Nurse Navigation program. This program routes some 911 calls to nurses in Texas, who then decide whether to send an ambulance or recommend alternative care options. The city also agreed to exempt ambulances ordered by the nurse line from its usual wait-time standards, meaning there is less oversight of how long these ambulance responses are taking. Additionally, AMR's nurses sometimes order Uber or Lyft rides instead of ambulances to take patients to the hospital.

  • In 2022, Seattle signed a contract with AMR to implement the Nurse Navigation program.
  • In 2022, Seattle officials agreed to exempt nurse-ordered ambulances from the city's usual wait-time standards.
  • In 2024, about 14% of 911 calls transferred from the Fire Department to the nurse line were resolved by ordering Uber or Lyft rides.

The players

American Medical Response (AMR)

Seattle's ambulance contractor that implemented the Nurse Navigation program.

Pamela Hogan

A 71-year-old Seattle resident who waited 10 hours for an ambulance after calling 911, and was later found dead.

Lisa Herbold

A former Seattle City Councilmember who supported the Nurse Navigation program in 2022 but later said she was unaware of all the details.

Tim Burgess

A former Seattle Deputy Mayor who was also unaware of the full details of the changes to the 911 system.

Katie Wilson

The current Mayor of Seattle, who has expressed interest in the 911 medical system and nurse line but has not said much publicly about it.

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What they’re saying

“Had Herbold realized the city was going to stop tracking wait times for thousands of ambulance responses, she would have objected, she said.”

— Lisa Herbold, Former Seattle City Councilmember

“Burgess, who served with then-Mayor Bruce Harrell from 2022 to 2025, was also unaware, he said last week, agreeing with Herbold that it was a mistake to stop tracking the wait times.”

— Tim Burgess, Former Seattle Deputy Mayor

What’s next

Current Councilmember Bob Kettle has promised to review the matter of Seattle's 911 medical system and nurse line in his public safety committee.

The takeaway

The changes to Seattle's 911 system, including the use of out-of-state nurses, exemptions from wait-time standards, and ride-hailing services, have raised concerns about public safety and access to emergency medical care. The case of Pamela Hogan highlights the potential risks, and city leaders are now starting to pay more attention to the issue.