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-leaders-eye-plan-for-firefighter-ambulance-service/article/3484691?custom_click=headlines_widget#ixzz0wV4TT77 D

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

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.

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)

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

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!!!

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.

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?

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.

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.

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?

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.

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).

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

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...

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...

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.

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.

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.

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.

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.

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. ...

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.

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...

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.

While I have disagreed with public safety employees re: funding issues, this is one area I support, the firefighters are dedicated to the citizens and as always, would provide excellant service.

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. ...
This is not necessarily true. The ambulances COULD be parked at the fire stations now. They are located at various intersections, convenience stores, etc., based on some very sophisticated mapping software that uses past call patterns to determine where demand is most likely to exist.
Another thing to keep in mind with this thread is that the council always does this evaluation at the end of each EMSA contract. It's felt - I think by all sides of the fire union debate - that this council is far less politically beholden or swayed by the fire union than past councils. So it may stand to reason this council is even less likely to go this route than others - UNLESS - Tulsa bails out of EMSA. And if that happens, all bets are off the table and ANYTHING can happen.

Steve,
Some stations could handle indoor parking of an ambulance and some cannot. But overall Yes, apparatus could be moved around the city to ensure enough ambulances are positioned to provide adequate coverage. The "sophisticated mapping software" you speak of is neither sophisticated or new. It's called system status management and was developed by Jack Stout when AMCARE was going out of business. It was a quick fix of how to reduce the total number of ambulances and personnel on the street. The things that this simple spreadsheet cannot predict are variances each day caused by little things like heat waves, snow storms, traffic problems such as car accidents on a major highway, special events like Basketball games, concerts, etc. It's an OLD antiquated system that has proven to fail time and time again, which is why EMSA is at Level 0 so many times everyday.

As to the council and their opinions, I think you hit the nail on the head. They will follow whatever direction the Mayor and CM take and probably see this as "more political power for local" rather than what it truly would be- a major improvement in patient care for the citizens of Okc. Tulsa is closer than Okc has ever been to bailing out of the EMSA merry go round and as you said all bets are off if that happens. EMSA cannot survive without both Tulsa and Okc. I'm happy to say that if this happens, Okc FD is in a much better position and has been doing the preemptive work for the past 10+ years more so than Tulsa. It would be a much better transition if plans were made rather than having everything dumped with little warning like the potential EMSA walkout that nearly happened a few years ago.

Never meant to say it's new software. It's been around at least since the mid-1990s. But yes, now that you mention it, considering the advancement of GPS technology, what struck me as sophisticated when I saw it a decade ago probably wouldn't be so impressive to those in the field today. I stand corrected.
Here's one twist that may be interesting to follow - what if the council decides to go a third way and pursue a creation of a medical public safety agency that address mental health needs and ambulance service separately from police, county sheriff or fire?

That idea was also suggested in lieu of a 3rd party service several years ago, but was never pursued per council and CM direction. It has merit but would also have some issues that would need to be worked out like any other plan. As in the past, all the players will come with their latest and greatest suggestions; but reading between the lines and becoming a fortune teller will be once again on the council's back. I just hope that they look at the last 10 years history with EMSA, models that have proven to work in other similar sized cities and gatherer information from all sides before moving in any direction.

That sounds like a goal I doubt any sane person could argue with. Gosh - this thread is becoming reasonable and intelligent. Which means, of course, it will die.

What's the current reason for sending both fire and EMSA to a call? Is it just in case they need the extra equipment and personal or is this just an excuss? If this is the case they would still need to send two trucks to a call. Obviously, you would need the firefighters on scene for a bad car crash.

The Fire Department can usually be on scene with in 3-5 minutes. EMSA is usually there within 5-7 minutes. Depending on activity it can be as long as ten minutes. The firefighters can usually stablize the patient until EMSA arrives. Most cities that have seperate services use this model because the fire department can be there faster and they have the tools on their trucks in situations where people need to be rescued from a car,building or remote location. They also have the muscle to move large patients. I work in a local hosptial. Many of the paramedic crews I have seen are teeny tiny people that barely weigh 200 pounds between the two of them.

This is not necessarily true. The ambulances COULD be parked at the fire stations now.
That is how it is done here in Austin, Austin/Travis County EMS (not private like EMSA) posts at fire stations in whatever area they are located, sometimes Austin or sometimes in the other communities/fire districts like Westlake. A few of them have indoor parking for the ambulance but most park outside and the crew can wait for calls inside the firehouse.

Such optimism. If it follows past threads you may be right.

The FD's goal is an average response time of 4 min. and 30 seconds to all calls; which has been met (give or take a few seconds) for the past 10+ years. EMSA goal is to maintain an average response time of 8 min. and 59 seconds, which has been met sporadically over the past 10 years. When EMSA does not meet their quarterly goal, the provider (paramedics plus) is fined. To keep this from happening EMSA watches the numbers very closely and Paramedics plus will put up extra trucks at the end of the quarter if they are falling behind in compliance. So if they have had good quarter no extra trucks and it's a crap shoot on how long you will wait for transport service. With the recent heat wave over the past couple of weeks we've routinely waited 15-20 minutes for a transport to arrive. It's not the ambulance crews fault; its the way the system was designed and just one of the flaws with system status management. With the FD you will always have 35 fire stations to respond-unless they cut more manning and put rigs out of service as they recently did. (but that's a topic for another thread)
The ALS FD rigs have paramedics on them (in some cases two) and carry all the same equipment as an ambulance for Basic to critical calls. They stabilize and make the pt. ready for transport until the ambulance arrives and turn the pt. over to the EMSA crew unless it's a critical call. If it's critical pt. then FD rides along to assist with pt. care until they get to the hospital. A single provider for all EMS in Okc would merge all players (somehow) into providing some of the best pt. care in the country. IMO

That sounds like a goal I doubt any sane person could argue with. Gosh - this thread is becoming reasonable and intelligent. Which means, of course, it will die.

Steve

Has it been 2 weeks already? How was Vienna? Welcome back.

I like the idea of ambulance service being provided by the fire department. I've been the recipient of the OKC fire department's services and I cannot speak highly enough of them. I know that if me or a loved one is in need of emergency care we can depend on the OKCFD.

I wish we would bring up again Mick's attempt to bring county-wide service for reconsideration. It'd make more sense if we could consolodate city-wide if some of our surrounding suburbs like Bethany,Warr-Acres, The Village would give up their pride. It'd save us all money and make a more efficient system.

week and a half... still not blogging. Still not doing any writing or reporting. Just messing with you guys! Didn't go to Vienna. But went to a place that was pretty darn nice!

I wish we would bring up again Mick's attempt to bring county-wide service for reconsideration. It'd make more sense if we could consolodate city-wide if some of our surrounding suburbs like Bethany,Warr-Acres, The Village would give up their pride. It'd save us all money and make a more efficient system.

Vaguely recall that and seemed like a good idea. If different people are in power now, may be worth another shot.

Emergency functions

OKC leaders consider revamping the current arrangement for emergency medical services.

http://www.okgazette.com/oklahoma/article-12460-emergency-functions.html

This has been done to death ever since EMSA came about (which was a huge mistake). It's not going to get resolved now either. Unless the city takes ownership of all assets, the city can't afford to leave EMSA. So we'll keep pumping money into the system to make it survive.

Problems are coming from the federal level though as well, which will happen whether the city or EMSA runs the service. The decline in Medicare and Medicaid pay outs is contributing to a huge downfall in income levels in healthcare. Not to mention that the unemployment rate has caused so many people to lose insurance coverage. Then they can't afford their medical bills and default on them. So EMSA is just a mircocasm of the larger picture of problems in healthcare. One problem is the overinflated cost of it. Things like an MRI cost such different amounts for the same machine from one hospital to another...and even the cheaper one is higher than it should be. That's why price structure was going to be part of the new healthcare plan...but didn't make it. Or take prescriptions...they aren't cheaper in Canada or Ghana because it's a different pill, the profit margin is just reduced to an acceptable level for the consumer (or subsidized in Ghana's case).

But anyway, currently, the fire facilities aren't able to absorb the workers anyway. Not to mention adding everyone to city payroll...training them as FF's, then adding them to the retirement plan. And then there's the question of manpower, dispatch, etc. There are millions of issues at play here that aren't seen on the surface in articles. EMSA would flat out have to go bankrupt before the city will force its hand.

Would patient choice of hospital still be in effect? Meaning that if a patient in Surey Hills wanted to be transported to Norman Hospital and the time would not adversely afect the medical situation,the OCFD ambulance would be mandated to make the transport. This is one of about 10,000 concerns I have is this. I am totally agaisnt the service not honoring patient choice first and foremost. Also how would the dissolution of EMSA effect the surrounding communities?

BomberMWC, you are highly misinformed about this situation. All these years of adding subsidies to Emsa, the city did require something in exchange for the cash. The city of Okc owns all property in the west division of Emsa. Buildings, ambulances and the like. Secondly if you go to the agenda for the council meeting on the cities website you can find the OCFD proposal. The city is to hire 88 paramedics and 88 EMT's. They will be city employees not firefighters. The basic premise is to move the current system as it is with minor changes under the OCFD. It will be a division of the dept. Not a for profit company out of Texas. All monies could be put back into the system, not paid out to shareholders.

BomberMWC, you are highly misinformed about this situation. All these years of adding subsidies to Emsa, the city did require something in exchange for the cash. The city of Okc owns all property in the west division of Emsa. Buildings, ambulances and the like. Secondly if you go to the agenda for the council meeting on the cities website you can find the OCFD proposal. The city is to hire 88 paramedics and 88 EMT's. They will be city employees not firefighters. The basic premise is to move the current system as it is with minor changes under the OCFD. It will be a division of the dept. Not a for profit company out of Texas. All monies could be put back into the system, not paid out to shareholders.


Hopefully this will happen, should have been done years ago.

The basic premise is to move the current system as it is with minor changes under the OCFD.

Please specify and delineate exactly each and every "minor" change that would be involved. Thanks.

if it is a stand alone, not part of FD, department being proposed, why would it be under the direction of the FD? Seems like that could eventually result in FD funds helping to run it instead of growing the FD

MustangGT, I appreciate your interest. I don't believe all minute details have been released. From scuttlebutt I have heard at our union meetings. I get the idea that the most cost effective way to do this is to move it into the fire dept. Leaving the system almost exactly as is, changing small details in the upper management. Placing ambulances in 14 fire stations, using old station 4 as a supervisor station with extra ambulances. All this information is in the proposal. Look I will let the cat out of the bag here! The proposal the fire chief presented was based on a proposal the International Association of Fire Fighters tailored for Oklahoma City. Obviously with most of the larger 200 fire departments running the ambulance services already, the IAFF has great resources of how to operate this type of system. Bottom line is this plan provides greater service at less cost!

Kevinpate, if you look at the proposal you see some strong phrases like "gives the city more control". To me it would make sense to put any profit right back into the system. The city has some unusual accounting practices. As an example if somebody crashes into a city vehicle and the insurance company pays for it, that money goes into the general fund and the vehicles are repaired out of that departments budget. I would be sorely disappointed if any revenues created by the city ambulance service went right back into the genereal fund. That to me seems like the main idea. Paramedics Plus is a for profit company based in Texas, I believe the name is the East Texas Hospital Corp. They make money. There is a lot of money in this. I have heard these medics talk about the bonuses they are given when manpower is low. A bonus and time and a half just to man the ambulances. I know there will be OT to be made, that is the nature of the business. But it will not be 100% stand alone. It will be intergrated with the fire dept., no competition between the services, there is definitely a competitive edge on Emsa's side. They need to prove they are needed just as it is. Just think about the amount of money that is being spent right now to influence the powers that be to keep the system as it is.

Contrary to Marshe - they would be part of the FD...not standalone. That's always been something he's been against beacuse it means dual training and he feels the city wouldn't compensate the person for that properly. You can't make both arguements man, you have to pick one.

As for the assets, no the city does NOT own them all. In fact if you read anything at all, it expressly says how the city does NOT own them all and that should the city leave the agreement, such things would be decided in court. Read with your eyes, not your ears.

You'll see an elimination of dual services for a paramedic being in the engine AND an ambulance at the same call. You won't see both parties responding to calls either. Right now you might see an engine with a medic respond to say a house call. You'll see only the party needed...which should result in cost savings from reduced fuel expenses (which is big right now). When you find the synergies between the groups and REALLY integrate them, it works out much better. There are countless cities out there with combined services that are hugely successful. And what we have now, is not at all.

Bomber I appreciate you speaking for me! Not really. I have a hard time believing you have any idea what I think. I could give a crap less about a city employee employed as a paramedic being cross trained as a fire fighter. If the want to be a paramedic turn in your application, if you want to be a fire fighter turn in that one. Regardless of what you think or feel. I want the best system possible. We don't have that now, not with a for profit company squeezing money out of the system.

MustangGT, I appreciate your interest. I don't believe all minute details have been released. From scuttlebutt I have heard at our union meetings. I get the idea that the most cost effective way to do this is to move it into the fire dept. Leaving the system almost exactly as is, changing small details in the upper management. Placing ambulances in 14 fire stations, using old station 4 as a supervisor station with extra ambulances. All this information is in the proposal. Look I will let the cat out of the bag here! The proposal the fire chief presented was based on a proposal the International Association of Fire Fighters tailored for Oklahoma City. Obviously with most of the larger 200 fire departments running the ambulance services already, the IAFF has great resources of how to operate this type of system. Bottom line is this plan provides greater service at less cost!

Thanks. I would like to see more stations utilized say 20-25. As long as they can get anywhere in the city at least as quick, but no slower, than the current system. Also the level of care needs to by vastly upgraded. In other cities even small "surgical" procedures are carried out in the field. For a really good exxample the IAFF should look to the militaries TCCC system and go up from there. Thanks for replying

If the FD takes over ambulance service and they do as well as do their current job it can't help but be an improvement. I'm impressed with our FD. My dad falls out of his wheelchair every couple of months and mom calls the FD. They're always there within 5 minutes with smiles. They get dad up, ask about his collection of WW2 memorabilia which dad loves to talk about, and they're on their way.

MustangGT, I'm sure you will find that 14 ambulances is way more than we have on the streets now. We made a drowning call a couple of weeks ago on a Tuesday night at 7:00pm. Not rush hour and not a weekend. It took an ALS ambulance 11 minutes after we arrived to get to get to the scene. If younput service in front of profit I thinkmyou will find we will have a better service!

I agree. My question is if there is a major crash and you have 3 or more FD ambulances on scene will units be shifted to compensate for breaks in coverage. Also when you get several units tied up on calls it is AUTOMATIC that the folks in those districts with a 10-6 ambulance have there response times rise. I am not so interested in the total number just that once a time standard is set it is NEVER violated like it is now. Once the FD takes over the service I will have little to no sympathy if things do not get DRAMATICALLY better.

I live in OKC FD STA 34's district and when they are out of the house and STA 3 is also on a run the nearest help is at least 10 minutes away.

You forgetting station 32, which is about 5 miles from station 34. Also remember the amount of ALS engines. Our original plan was for all engines to be ALS. I think all but 10 are ALS now.

This would be an opportunity for the FD to put some new software in place for managing such things. There are countless packages out there to help re-distribute the fleet for coverage and route medics to hospitals dependant on bed availablility...our company sells a crap ton of these out of our software division, not to mention the in-ambulance electronic charting..blah blah blah. You name it we make it. And in fact in some recent disasters, our software has come to light as extremely helpful to multi-municipality interactions to reduce reaction time and increase coordination of everything from response to recovery.

So many packages don't interact with each other so one group has one piece and another has another piece and they don't talk to each other....remember the radio problems on May 3rd...now it's software that's the culprit. Dispatch is still the slowest portion of the call for OKC and that's where the software can make up the lag. GOOD software packages can help tell you things before you know them. A GOOD package will automatically suggest coverage changes based on the calls it has in the system so the dispatch time later is reduce for calls in the other areas. So when you've got 5 ambulance out, not only do you coordinate with the others in your own fleet, but you coordinate with the MWC's and the Norman's so they can assist when needed...automatically rather than having to make the call and take even longer. We see coordination today, we just see it on a slower pace.

So Mike, while i may not be an actual Firefighter or Paramedic, my entire business life is centered around the emergency response world. And not just one piece of it. I try to keep the larger picture in mind because I see every day how things operate all over the country...and the "we've always done it this way" stuff never flies. Just beacuse OC currently operates in a particular way, doesn't mean it's the best way to do it. I'm not saying they are doing things bad by any means, but you've always got to plan for making improvement and not be stagnant. Stagnation creates irrelevancy.

True Mike I did, however in the instance I named they must have been out of the house also. The time delay was still there.What is the criteria for backfilling when you have a big response. During grassfire season the resonse time will inevitabley rise as much response is put into grassfires. Also wilkl ALS engines be given a pass on grassfire response inorder to maintain EMS response time? If not why not?

I and many others want the FD to have the service however we also are going to pretty much demand a ZERO DEFECT product. Whatever the FD claims it can do to get the service I will hold them to that standard 24/7 no matter what else is going on. Even if half the cities outlying areas are on fire when I call for an EMS response the time to deleivery of that servicce must be the same no matter if all companies are in the house asleep or half the companies are 10-6.

I have never been a guy who endorsed any of our methods because we have always done it that way. One of the bottom line issues is manpower. Many of our responses are highly manpower intensive. I can only believe that if we are reinvest every dollar back into this system that we will increase service quality. With 35 ALS engines responding to patient care and 14-20 ambulances to transport, I know this is better than what we have now. I had to think what 10-6 was, we quit using 10 codes over 10 years ago.

Ok wheres some more information. Like Rc said we would elliminate duplication of efforts. This would start in dispatch. If the information they got was lets say a 17 yof with a headache, awake and breathing then probably just the ambulance would go. If they got a call of a person with chest pain or unresponsive then both an ambulance and fire rig would go. Now you ask if there was a big wreck and 3 ambulances are tied up. Well luckily in our system our firefighter.paramedics are trained and held to the same protocols as the transport medics. So even though and ambulance may be a little ways out, the pt will still have access to a Paramedic fire engine providing Advacned life support. VERY MCUH like what happens now. I know on a full arrest EMSA took so long i asked my officer to have our rescue ladder to come help out. After i looked at the presentation i did notice one BIG change. it is prooposed that we take some stations that are ALS now and put them BLS but have a paramedic ambulance stationed there. With that being said, we would make outlying stations such as stations 2, 27, 4, 36, 28 all paramedic stations so that the response time of a paramedic getting to the patient is dropped considerably I also see that there would be a reserve ambulance at some of those stations. So the Fire Paramedic and another firefighter would staff the ambulance ONLY on medical calls so that we dont have to send an ambulance from the city all the way out of town and back. AS for grass fires go that is a whole different animal. When it does come to that time of year and those big grass fires are buring it probably wont change much than now. The AMBULANCES wont go as they are not firefighters. One may go for rehab andbe in stagging but you wont lose all of them in that area. As fire operates now if there is a 3 alarm or big fire then we do relocate our fire rigs to where the hole is so that we can continue to proved service to the citizens in a timely manner.
RC i am glad to see you are supportive of this. BTW EMSA is projected to get $7,000,000 in 2014 from that $3.95 extra charge on the water bills. AND they get a subsidy. Im not sure how the budgets will be divided with there being a Chief over the EMS side so i cannt comment nor rebuttle anything said about that. I do believe there are great advatanges. One of the biggest is teamwork. The crews would train togther and get to know each other better. I also believe moral would go up so becuase instead of sitting in a truck with poor ac they can come inside a firestation and relax, wash their faces in a clean bathroom, get out of the truck mingle. There is potential that depending on what uniforms they have and if they are given a lightweight protective gear for pt care in during an auto extrication also may allow them to work out at fire stations like the firefighters do now, which would improve employee health and possibly reduce OJI.
I have lots of friends at EMSA as i used to work there and they think they ambulances will be staffer 24 hour crews. Dr goodloe whom is the medical director now and has said he will stay if fire takes over, is against 24 ambulance crews so they will be 12 hour shifts. The staffing will be a lot like it is now. the biggest changes.... New Uniform, NEW paint job, New pay check. Plus bette benefits as it sounds they will be Unifromed Civilian personal so like the other city workers. It beats their health Savings account as their only insurance option now. I did my paramedic school in Utah where fire transports. Such as Provo, Orem, Sandy, Salt lake city, and Salt lake county. It is all over the nation and it works well if doen the right way. I know a lot of haters talk about KCFD and when they took over MASt and how that is a mess. That is the only foot they can stand on. Even then we have talked to them and we learn from their mistakes. As far as the equipoment goes, i did hear that if Tulsa AND OCK gets rid of EMSA then the equipment is released to teh city, but if one or the other keeps them, then all the resources will go to that city.
Also. I saw on news channel 4 that Frank Gresh was interviewed saying that EMSA is second to non on cardiac saves. He made it sound that EMSA did it alone. But it really is a team effort and together we get that rating as a city in whole, not as a service.
So... Taking over has a great potential of offering the citizens a great response with EMSA medics having better bed side manner as their moral iimproves and can also have medics stay longer than 2 years which is seen now, giving the systme lots of experienced medics.