Firefighters to potentially take over ambulance service?

[betts]

It looks as if we're not the only ones thinking about this. I decided this is worthy of a new thread where perhaps we can discuss this without any emotion-laden rhetoric.

The decision is more than a year away, but Oklahoma City Council members are already talking about possibly asking firefighters to take over the ambulance service.

Read more: http://www.newsok.com/oklahoma-city-...#ixzz0wV4TT77D

[Bunty]

In other towns they want the ambulance service takeen from the fire fighters and given to a private company.

[BBatesokc]

I would want to see the numbers and projections from a 3rd party with no horse in the race. My fear is the firefighters union just wants more members and strength and the new firefighter paramedics would be making alot more money than the EMSA one's do now. On the flip side, it seems firefighters are already responding to medical emergencies, its just they don't have an ambulance to transport in.

[kevinpate]

The article suggests it costs way more on the front end but would save money long term. If there are unbiased numbers which support that suggestion, it ought to be a no brainer.

Deal with the front end costs the same way the city deals with MAPs style quality of life capital improvements -
an X year temp 0.00_ sales tax

or plan ahead and do a permanent bump on the dedicated PS tax and after the start up, it goes to equipment upgrades (Ambulances don't last forever, nor does the gear inside)

[Midtowner]

Or just pass a bond to be retired by the long-term cost savings?

[Mikemarsh51]

Just a couple of points for discussion. First, in all the times that Emsa has come to the city for supplemental cash, they sold or gave Emsa property to the city. Okc owns all of Emsa's facilities. No cost to buy what you already own.
Secondly Emsa is run by a "for profit" company. If you eliminate the profit, that money doesnt go to shareholders it goes back into the system.

I'm all for it!!!

[oneforone]

If I am not mistaken this would save the city a ton of money on fuel costs and maintenance. You would be able to reduce or eliminate the need for ambulances to sit idling burning fuel around the city because they would be parked at the fire stations. I would expect some to remain mobile in areas that are constantly active or during peak activity times. Not to mention the larger trucks would see less road time saving fuel and reducing wear and tear as well as the chances of the trucks being involved in accidents.

[kevinpate]

If I am not mistaken this would save the city a ton of money on fuel costs and maintenance. You would be able to reduce or eliminate the need for ambulances to sit idling burning fuel around the city because they would be parked at the fire stations. I would expect some to remain mobile in areas that are constantly active or during peak activity times. Not to mention the larger trucks would see less road time saving fuel and reducing wear and tear as well as the chances of the trucks being involved in accidents.

When I was working on the south side, an EMSA rig was often seen on standby at the 7/11 located at I-35 and SE 66th. Now, just down 66th to the west a few blocks is a firehouse. If the FD operated the ambulances, I suppose the EMSA bus could be stationed there.

Here's a Q I don't have clue one about. In this instance, is the existing firehouse large enough to take on the EMSA rig and any additional crew, if any, that would go with the rig?

[MGE1977]

KP

In that instance, probably not as the house to which you refer is already a two company house so those bays are full. Depending on how you stacked them, it might be possible, on second thought, but really it would be a measurement issue. The good news is that most stations could handle the manpower in terms of housing I should think, so really it is simply a matter of housing the apparatus.

The trouble may be that a good portion of the busiest houses in the city have full apparatus bays and moving those apparatus isn't really an option as it might conflict with the city's ISO rating.

The best news is - we are the FD baby, we can make anything work.

In the end I think that an FD centered EMS would result in the best product to the consumer and most return for the money.

[plmccordj]

I have no background on the success, failure, or financial viability in this example but I use to live in Tucson and Phoenix, Arizona and in both places it was the fire department that ran the ambulance.

[mOKCie]

Secondly Emsa is run by a "for profit" company. If you eliminate the profit, that money doesnt go to shareholders it goes back into the system.

I'm all for it!!!

How could that possibly go wrong?

[kevinpate]

KP

In that instance, probably not as the house to which you refer is already a two company house so those bays are full. Depending on how you stacked them, it might be possible, on second thought, but really it would be a measurement issue. The good news is that most stations could handle the manpower in terms of housing I should think, so really it is simply a matter of housing the apparatus.

The trouble may be that a good portion of the busiest houses in the city have full apparatus bays and moving those apparatus isn't really an option as it might conflict with the city's ISO rating.

The best news is - we are the FD baby, we can make anything work.

In the end I think that an FD centered EMS would result in the best product to the consumer and most return for the money.

As noted earlier, if it's a matter of covering the upfront expenses and then saving funds long-term, to me it's a no-brainer due to the long term savings that are touted as possible.
Any govt. entity, if service to citizens won't be harmed, ought to take the more economical approach.

[Larry OKC]

Or just pass a bond to be retired by the long-term cost savings?

Sales tax or "ambulance fee" (like we have now) is the best way to go. Bond issues are fine for long term things like buildings that are going to last for decades but for equipment etc, not best to use borrowed money. Just as you wouldn't take out a 20 year loan for a car that's only going to last for 10 years.

There was an article during the original MAPS that due to cost over runs, they were going to issue a $10M bond. It stated that it would run for 20 years and the debt service would be $1M/year. If I am reading it correctly, suddenly the $10M doubled to at least $20M (if the debt service is only the interest then it it is triple..$10M + $20M debt service).

[mburlison]

Seems like they've been talking about this forever (firefighters taking over).

[Laramie]

The city needs to do away with EMSA operations per se as it exists today.

Purchase and place the best ambulances (not Kansas City's hand-me-downs) at local fire stations and continue to maintain a central maintenance/supply facility (Walker-near Wiley Post Park). The Skate Park is at Robinson--it wouldn't hurt to keep a vehicle on-call at that facility. Pass a 1/4 to 1/8 cent sales tax to help maintain and purchase the best equipment available; yet, continue to collect from those who pay the $3.00 plus water for those who want to be covered.

Oklahoma City is becoming of age (Big League City) and we should possess and maintain the best equipment, labor and operations available for our citizens.

We passed a 1/8 cent sales tax to cover the zoo operations and yet we can't do the same for police, fire & safety equipment? $2 - $4 million annually should help!

Where are our priorities?

Our zoo is important; then, I would think that our police, fire & safety would be just as important. Let's put this public operation to rest and find a financial solution for others (while tackling this concern) and more on...

[Larry OKC]

Laramie: Priorities aren't as far out of whack as you might think. We have a supposedly dedicated 3/4 cent tax for Public Safety in place. Lets say the $100M/year from the one cent for MAPS 3 is correct, quick and dirty math means $75M/year from the dedicated tax (plus the historic 65% of the General Fund).

As others have mentioned, OKC already owns the ambulances and firefighters get paid more than EMSA folks but are already responding to medical calls, so I am not really sure where the upfront costs the article mentioned are coming from. maybe the maintenance facility (or does OKC own that too). Where are the future cost savings it mentioned coming from? Definitely need more info on that...

[Kfire]

This is the story that has been repeated numerous times in the last 13 years. An outlying station who’s average response time from arrival from the “for profit ALS” is around 10 minutes but has been well over 30 minutes. This outlying station does have a qualified ambulance service 6 miles from the station and 3 miles from the highest population density mile section that has the most EMS calls. The “for profit service usual post is 13 miles away. This qualified ambulance service has expressed a willingness to “first Respond” (provide ALS) and still give the billing rights to the “for profit” EMS service that the city chooses to use for our city.
This unnamed station makes an OB call and has about a 12 minute response from the corporate money making service that transports for our city. This unnamed station arrives back at the station and was in service about 5 minutes. This station gets another call on a possible heart attack less than 1 mile from the station while knowing that the only “for profit” ambulance service has just sent the closest ambulance to the district a short time ago and the nearest “for profit” ambulance is likely very far away.
The comments on the incident include information like, “My husband is having a heart attack”, “My husband is dying” reporting party “screaming and crying”. The engine officer requests that the “for profit” service send the nearest qualified ambulance service if the “for profit” service does not have a unit close. Our Dispatch goes to the “for profit” service console and was told that the “for profit” service would have to check with a supervisor for approval. Mr. “for profit supervisor” denies the request for the closest the qualified ambulance service. (He was told that the unnamed station was only BLS.) At this time fire dispatch sees that the responding “for profit” service is still near downtown OKC. The on scene officer is told that the “for profit emergency service” has denied allowing another service to take their call. After all, it’s about profit on a major medical call at the expense of only one person dying.
“For profit corporate greed ambulance service had to drive 14 miles to the patient, while the qualified closest ambulance service had only 4 miles. This is not the first time that “for profit” service has defended their territory nor do I think it will be the last. I pray that it won’t be one of our own that dies while corporate greed is defendinding their territory and profits.
This in no way reflects on the paramedics working for the corporate money making company. They are doing the best that they can while seeing that profit takes first priority over patient care.

[Laramie]

LarryOKC:

Having worked in the OKC Public Schools and neighborhood observance--the firefighters are usually the first to respond. I know of a few times that EMSA made it there first. Maybe the system isn't broken?

I feel that placing the ambulances at each fire station; even if we have to add more ambulances, would provide them with being more effecient.

As far as paying them comparable salaries as firefighter(?); that's another game I'm sure the city would have to negotiate.

Thanks for the added info; I'm aware that most of the taxes we pay into the general fund coffers are earmarked for public safety.

[oneforone]

As it is many of the fire stations need renovations, I wouldn't think it would be that hard to expand/remodel the existing fire houses over the course of 2-5 years. There might be a few of them like Station 19 that are land locked. Then again, the city maybe able to do a combination of hospital and fire station based ambulances.

[kevinpate]

As it is many of the fire stations need renovations, I wouldn't think it would be that hard to expand/remodel the existing fire houses over the course of 2-5 years. There might be a few of them like Station 19 that are land locked. Then again, the city maybe able to do a combination of hospital and fire station based ambulances.

Not to be a buzz kill, but isn't the newest under construction station, which replaces one to be closed if I recall, funded from a near on decade old bond issue?

If that memory is right, perhaps it might be fair to wonder if any expansion/remodeling would be more than a 2-5 year process.

[barnold]

I'm glad to see that the council is wanting information sooner rather than later. While it's true that the upfront costs would be more initially if the FD took over the EMS; much has changed since it was last looked at 5 and even 10 years ago and the initial startup costs have decreased significantly. As has been mentioned in previous posts the city now essentially owns all hard and durable goods that are under the guise of EMSA. In fact the only thing that EMSA currently does is serve as a middle man in brokering a contract for a personnel provider. The expendable equipment (bandaids, dressings, drugs, etc) on the ambulances along with the EMT and Paramedics hourly wage are paid for by a company called Paramedics Plus out of Texas.
I see many benefits of a single service providing EMS in our city. Duplication of efforts would be reduced. Wear and tear and maintenance on very expensive fire apparatus would be reduced. Single management tier instead of one for fire, emsa and paramedics plus. Municipal control over spending and yearly budgets which the city has Never had with EMSA. All profits collected from both the water bill and insurance collections would go straight back to the city instead of being divided out over several outstretched hands.

It will not be a simple fix and will take time to hash out details of pay, new hires, logistics of goods and services, billing, ambulance placement, etc. but it is long overdue. Marrs is actually the one who called for the study over 10 years ago when he was chief and was handed 3 separate plans. One was for a fire based EMS. One was for a 3rd party provider. The other was to remain with the status quo of EMSA. He recommended to the council (over the objections of FD staff) to push the EMSA agenda. Now he sits on the EMSA trust. Draw your own conclusions but when it becomes time to openly discuss the plans in council I expect he will be the biggest opponent of the plan. The FD staff presented numbers to then Chief Marrs showing how the city would recoup initial startup costs within 2 years and be in the black a year later. In fact the FD had the biggest price tag to it initially because of the purchase of equipment which the city now owns. The FD plan also showed the greatest stability and profit over a 10 year projection. The 3rd party service was second in initial cost but lacked any stability and also had the EMSA trust taking a very large hit if it sold all of the equipment. The great thing about a 3rd party was the city could make money from the transport service without the headaches of actually running it. The negative was that 3rd party service ambulance providers are going out of business all over the country without a moments notice and stood to leave Okc without ambulance coverage. The EMSA proposal had the lowest cost initially and the EMSA trust leaders promised city council that there would be no need to bail the ambulance trust out again. This promise lasted a little over 8 months before they came back to council asking for a little over 1.5 million or there would be no ambulance service in Okc. The EMSA proposal also promised stability to which has not materialized like the other proposals. None of the EMSA proposals have ever given the city Any profit and only succeeded in taking over 4 million dollars in the past 7 years from general funds.

To some it's all about the numbers. For me it's a little more personal. I don't like having to wait 20 min. on scene with a critical pt. because the For Profit ambulance company is at level 0 (no more ambulances available). This happens quite frequently. They do not provide adequate ambulance coverage for our city and are only in it for the dollar. Not a bad thing for a business but not so good for our citizens when we talk about public safety.

I'll have to go back to some of my archive stuff and see if I can pull out the exact proposals that were given to be 100% accurate, but what I can say is that there are several ways to provide ambulance service to the citizens of Okc and regardless of what council decides EMSA is not even remotely a good idea.

[HOT ROD]

just for prospective, in Seattle/King County area ambulance services are run in conjunction with Fire. As was mentioned, fire usually respond to service calls anyways - so why not have paramedic services available as a subcomponent of Fire while letting true firefighters respond to fires. ...

[Mikemarsh51]

I dont think the ambulances need to be housed inside. Those are cookie cutter rigs that are basically disposable. At most they could be parked under some type of carport.

[Larry OKC]

I dont think the ambulances need to be housed inside. Those are cookie cutter rigs that are basically disposable. At most they could be parked under some type of carport.

Wonder how are they stored now? Seems they are positioned in parking lots while on active duty (sort of like police). Not sure if we need to go to the expense of building structures for them if they aren't needed now? Sure it would be nice when the next hail storm comes thru (remember all of the patrol cars damaged near Portland recently), but that is what insurance is for...

[kevinpate]

Interior storage was more about the FD/operators than the rigs. Currently, the rigs are posted around town, operators inside or stretching just outside the rig. Call comes in, they roll.

With FD operators, I'm presuming, perhaps incorrectly, the rigs would be located at FD stations and the FD would not be sending part of their brotherhood out to be chained to the rigs in parking lots each and every day.

As for insurance, isn't the city self insured for their public safety rigs? Perhaps that's another faulty presumption on my part.