Across the State Most Fire Calls Are For Medical

Last year about this time, on June 17, 2011, the Vanguard reported that the Santa Clara County grand jury called “for a wholesale rethinking of fire departments and emergency responses, arguing that sending firefighters to what are now mostly medical calls is outdated and wasteful.”

The Mercury News reports, “A report by the watchdog panel found that 70 percent of fire department calls are medical emergencies, and just 4 percent are fire-related. But even so, firefighters respond as if they are heading to a fire, sending a crew of three or more on a truck or engine costing an average of $500,000 — five times the cost of an ambulance.”

This year it’s an Orange County grand jury with much the same in the way of results.

The OC Watchdog in the Orange County Register writes: “Once upon a time, fire departments were mainly in the business of putting out fires. But that was many decades ago: Less than 2 percent of the Orange County Fire Authority’s calls were to fire emergencies last year, the grand jury found.”

The vast majority of the calls, at least 70 percent, are medical, and in some departments they are as high as 80%.

“This transition from fire emergencies to medical emergencies has not generated major changes in the operation model for responding to these emergencies,” the grand jury wrote. “Each emergency call generally results in both fire trucks and ambulances being dispatched to the site of the emergency regardless of the type of emergency. The emergency response communities have discussed developing new models, but little change has been accomplished.”

“Of the 180,000 incidents reported in Orange County in 2010 by the various fire departments, approximately 134,000 (76%) were for medical emergencies and 44,000 (24%) were for fires and ‘other,’ ” the grand jury wrote. “The Orange County Fire Authority alone reported less than two percent of their 88,227 responses were for ‘Fire/Explosion.’ “

As the OC Watchdog says, “So why, in these times of tight budgets, do fire engines staffed with full crews show up when someone has a heart attack?”

The answer is not surprising: “Labor agreements with minimum staffing requirements, pretty much.”

“Most fire departments now respond to traffic collisions, hazardous materials spills, remote rescues, medical aid calls and various other emergencies,” the grand jury wrote. “The typical emergency responses include a fire truck and an ambulance. The staffing of the OCFA [Orange County Fire Authority] emergency equipment is specified by their Memorandum of Understanding that states: 1. Each single-piece engine company shall have a minimum of three (3) personnel. 2. Each paramedic engine company shall have a minimum of four (4) personnel… Each truck company or urban search and rescue vehicle shall have a minimum of four (4) personnel… 3. Each paramedic van shall have a minimum of two (2) paramedic personnel.”

“A problem that faces all of these agencies is financial,” the grand jury said. “The labor agreements adopted in good times have become financial burdens during the recent business downturn. These burdens not only affect the current but also future budgets. In most departments, the costs of the long-term benefits are not transparent to the boards of directors, city councils, and the public, consequently the challenge that the governing bodies have given to the new fire chiefs.”

Last year it was pretty much the same report.

The San Jose Mercury News reported, “Typically only one of the three arriving firefighters has medical training, the report said. That creates a ‘mismatch between service needed and service provided,’ with fire departments deploying ‘personnel who are overtrained to meet the need’ — that is, paramedics also trained as firefighters.”

“Taxpayers can no longer afford to fund the status quo,” the report said. “Using firefighter-paramedics in firefighting equipment as first responders to all non-police emergencies is unnecessarily costly when less expensive paramedics on ambulances possess the skills needed to address the 96 percent of calls that are not fire-related.”

Of course we get the defenders.

The San Jose Fire Chief, for one, “questioned whether private ambulance services can do the job faster and cheaper than firefighters. He argued that because they already are heavily staffed and widely deployed to tamp down fires, firefighters can respond more quickly, and it’s more cost-effective to give them paramedic training. An ambulance company would have to hire more medics to meet the firefighters’ response time targets, he said, and those costs would be passed on to patients and their insurers.”

“We have the personnel, and the service is compatible with advanced life support,” the fire chief said.

The relatively few fire calls is not the only similarity to Davis.

The paper continues, “The report sharply criticized politically influential firefighter unions, accusing them of stymieing efforts to ‘think outside the box’ to protect jobs. It argues that schedules allowing firefighters to live far outside the communities they serve ‘may unintentionally foster a culture of insensitivity to residents’ sentiments’ and a perception of being ‘entitlement-minded.’ “

“Unions are more interested in job preservation than in providing the right mix of capabilities at a reasonable cost, using scare tactics to influence the public,” the report said. “The result is a clear impression of firefighters as self-serving rather than community serving.”

Clearly we need to change the way we provide fire and emergency medical service to make it more cost-effective.  This is not merely a Davis problem, it is not merely a Santa Clara County problem, any more than it’s merely an Orange County problem.

Unfortunately, we have been talking about this since 2008 on this site.

Perhaps with a council that is no longer bought and paid for by the fire department, a new city manager, and a fire chief that has been on the management side of things, we will see the kind of changes that are needed.

While there is legitimate concern with the quality of service, with creativity and looking out of the box, I believe we can find a way to be safe and smart at the same time.

There is no reason we need to deploy a full fire team every time there is a medical emergency.  Our buildings are built to a high standard which means there are few fires that require building entry anyway.

Twice the city has contracted with CityGate, twice CityGate has stayed in the box.  We need to think outside the box and the city needs to appoint an ad-hoc committee that can do just that.

—David M. Greenwald reporting

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