Who should run EMS systems?

[Guest alsfirefighter]

WAS, you got that right, evey private company has its ups and downs with contracts. Which for inter facility transports allows for best bang for your buck for facilities that need them. As far as 911 contracts go, I have worked part time for a couple agencies. I'll leave it at that. But as far as 911 goes, I have 3 words to solve all problems.

FIRE BASED EMS.

Well actually 4 if I threw in paid.

[x635 4,066]

WAS, you got that right, evey private company has its ups and downs with contracts.  Which for inter facility transports allows for best bang for your buck for facilities that need them.  As far as 911 contracts go, I have worked part time for a couple agencies.  I'll leave it at that.  But as far as 911 goes, I have 3 words to solve all problems.

FIRE BASED EMS.

Well actually 4 if I threw in paid.

As far as 911 goes, I have 6 words to solve most problems:

Hospital or Fire based EMS systems.

(But only when done right by FD's)

[Guest alsfirefighter]

(but only done right by FD's)

Couldn't agree more with that statement. Either do it right or don't do it at all!

[WAS967 97]

(but only done right by FD's)

Couldn't agree more with that statement. Either do it right or don't do it at all!

Actually thats not exactly what he said, but I'll let him defend his own statement. Anyhow. To say that EMS can't work right unless it's fire based is, in the words of Penn and Teller, Bullsh it. There are plenty of sucessful and effective EMS systems in the country and the world that are not fire based. And there are plenty of downright aweful EMS systems that are fire based. Thats not to say that the converse is not true.I look at systems setup by the likes of Arcadian, Pridemark, and municipal systems like New Castle and the counties in the Carolinas. Well done. Not fire based. Do they suffer from not being fire based? I don't think so. And ask anyone who works for FDNY*EMS when life was better, before or after the takeover. The answers are no mystery. Now don't get me wrong here. I have nothing wrong with fire based EMS. There are many excellent fire based EMS services out there. But to be fire based to be excellent is not a prerequisite by any means.

[x635 4,066]

WAIT WAIT WAIT Actually, let me amend my statement. I've been meaning to, but I forget. How could I foget third service systems!!!!

The ideal EMS system, and this is only my opinion, should be either a third-service municpial or regional-municipal system, or a hopsital based regional system.

As far as a Fire based system, I'm really not a huge believer in it, as it works around here....at least not yet.

Some systems do it right,and I am a beliver in it, and it's intergrated, like in LA City. Many systems, its often an ignored stepchild just used for numbers and money, like FDNY. The FDNY FF's complain they aren't paid enough, I'm not arguing that they aren't, but look at how much FDNY EMT's and Medics make, and look at their shifts. Who gets the short end of the stick in that system?

There are departments that should take on the role of EMS. EMS should not be provided by a company thats a large corportation primarily out to make money. EMS should be a system of some sort. Like Yonkers, White Plains, and possibly New Rochelle. Those cities could find the money if they tried, and the Fire or PD*ESU should pick up the role of EMS, or better, make it the third service, such as Boston EMS. The main reason for the FD or PD affiliation would be because some of the infastructure would be in place...like payroll, maitenence, etc.

My main reason for the above thoughts: Pay, benefits, pensions, and bringing EMS to the level it should be at........EMERGENCY MEDICAL services.

My reference to Fire based systems refer to those FD's that encompass everything EMS, not those that just provide first response.

[Guest alsfirefighter]

I need to defend nothing. Look again WAS bottom of his post in parenthesis (sp?) and tell me what it says.

Like I said, if your gonna do it, do it right!

In my opinion, when it comes to overall service, employee benefits and such, Fire based (when operated correctly) takes the cake. Civil service often gives you quality employees.

Yes I have seen some decent 3rd service, etc. But I would put hospital based above most.

As far as FDNY goes, in my opinion that is a 3rd service with the same name as the FD and its a system in which embarrasses true fire based EMS with cross trained personnel.

[WAS967 97]

What you quoted:

(but only done right by FD's)

What he said:

(But only when done right by FD's)

A single word can change the whole connotation of a statement.

[Guest alsfirefighter]

I was taking into account one "fire based" system, which I already explained, which becaue of its size makes many of us look bad. I was more just agreeing with any agency of either do it right or don't do it at all.

[Guest pentax02839]

I think that ems should come under the fire department.

[Guest]

The only thing that can ALMOST guarentee better employees is to offer more. (Pay, benefits, etc) This makes for more competition to get the job, therefore you can pick and choose the cream of the crop. But when you don't pay your employees well, all your left with are people who are willing to do it basically for free.

p.s. pentax, it's just not all it's cracked up to be.

[Remember585 815]

The best way for an EMS system to work is to hire quality employees, have strict SOPs, have a comprehensive and WORKING QA/QI program, training that works and more importantly, proper pay, benefits and work environments.

I belong to a Fire Dept. EMS system - and in no way do I feel it is run well, because it is the bastard child of our service.

I also belong to a VAC - and a great one at that. We have a great training program, decent personnel and the environment we are in is a welcoming one that makes us proud to be members.

But, in terms of overall service, I think EMS should be staffed 24/7 to meet the needs of the community. Volunteering is great and I love doing it and will always do it, but how often do we all hear "2nd page" or "3rd page" or even "mutual aid" for EMS calls? TOO OFTEN! If employing people to ensure full time coverage is needed - DO IT! Look beyond your tradition of volunteering - and absorb the concept that serving your public is of the utmost importance! If you can't cover your calls in a reasonable amount of time - to a certain percentage of the calls - then do something!!!!

[BFD1054 1,552]

I just have to say that i agree with Remeber585 100%! There are too many pride-driven VACs out there & unfortunately, ambulances aren't getting out in a reasonable amount of time because of it! There are however, agencies that have realized they have coverage issues & have dealt with it! If you have to pay someone (EMT or higher) to sit at your HQ to ensure calls get covered, then so be it! I like the idea of 24/7 duty crews in which members spend their duty hours at the VAC building. Unfortunately, many people aren't willing to do this, and very few VAC's are able to pull it off.

I don't know alot about FD-run EMS systems, but i do know, at the least, that career & volunteer FD-EMS are totally different. If you want (career) FD-run EMS to work, i think that ambulances should be staffed by career FF's. Theres FD's out there that will have 2 or 3 pieces of apparatus, but no ambulance at an EMS call, whats the point? Yes, its great to have a first-responder program that works, but what good is it when you have to go mutual-aid for an ambulance to transport the poor patient? I think Peekskill runs a great ALS program through the FD, they have some of the best medics i have seen! But again, if the ambulance can't get out, than theres a problem!

I don't think i'm really touching on the FD-run EMS system that alsfirefighter is trying to talk about, i just wanted to voice some opinions!

[JCESU 20]

I don't know if you guys have seen this site or not but, it is definitely worth checking out.

http://hometown.aol.com/fdemswebsite1/page1.html

http://hometown.aol.com/fdnyemswebsite/index.html

The author makes some good points. I have my own opinion which I will reserve at this time. But lets just say that I have alot of respect for EMT'S & Medics...especially those who work in the inner city tune town world.

Stay Safe guys,

Rick

[Guest SargeEMS]

Fire based EMS sucks, the only good thing about it is that the funding is there. Hospital based EMS is key because the EMTs and Paramedics are held to a much high standard being that they work for the hospital. The only reason that EMS is the bastard child is for one reason : Somebody else does it better. For example take the Fire dept, there isn't any other agency or company out there that puts out fires. The police dept, no other agency does anything like the police dept, but when it comes to EMS that is a different story. There are Doctors, PAs, Nurse Practitioners, and a whole array of people that have higher medical authority than EMS. There isn't a higher police authority than the police nor there isn't a higher fire authority than the Fire Dept. They are their own entities. ](*,)

[Guest]

Doesn't anyone really understand that Fire Based EMS will not work. The Fire dept don't want to absorb the EMS aspect of it.

[E64PCFD2044 1]

Listen...Firefighters are Firefighters. Why hold up an Engine for an EMS call when the PD is there and the bus is there and a medic is there... Why deprive the municipality of fire protection?? EMS should not be a part of the fire department unless it gets the paid guys up and out doing something better than watching TV all day. Port Chester VAC is now Port Chester EMS. There's people there all the time and they do a hell of a job!! I think that if EMS was run solely by the PD where your property tax just covers it or something than everything would be run better... The EMS personnel work for the 'town', they slack off and make money..it's all good..and they're doing their job. Does anyone complain about police not getting to a call?? Not where I live. Most of the time the desk sarg. calls one car and three show up..why can't EMS be run like this? Too many times I hear (NOT BASHING...JUST MAKING AN EXAMPLE) KEC625 Somers, an EMT for the ambulance and a driver is still needed for E183 to respond...or 60-Control to Hawthorn 3rd and final dispatch...I know when I call for an ambulace, the people are there and ready to respond and not holding any other agency up. Port Chester, Rye, & Rye Brook all use one EMS provider and for the extremely high volume of calls, the bus always gets there on time...dispathced by PD. Remember this is only my opinion.

[DOC22 1]

In my District we simply back up the NSVAC. We respond to most EMS calls and work very well with them. We have almost 30 members who are EMTs so if they are short we almost always have an EMT who can and will ride with NSVAC. It's a good system and works well for us. Many compliments have been made by police agencies on the professionalism and great working relationship we enjoy.

[WAS967 97]

Port Chester, Rye, & Rye Brook all use one EMS provider and for the extremely high volume of calls, the bus always gets there on time...dispathced by PD.

I have to wonder if that trend will continue once United closes it's doors.

[Pudge3311 5]

Excellent point WAS967.

Anyone know if PC EMS is planning on adding another ambulance due to their soon to be longer transport and turn around times?

[Guest alsfirefighter]

Maybe some of your FD's are so closed minded they wouldnt want to perform EMS. Keep in mind that I am talking a career based FD EMS system. Some of the best in the country are fire based. I'll take most FD based EMS systems over a private anywhere and certainly volunteer where you don't know if it will be 2 or 20 mins. No bash but facts are facts gang. FDNY EMS sucks, it wasn't handled properly and isnt' run properly. That system isn't the role model for fire based EMS is the poster child of what not to be.

E64: News flash. Firefighters are what leadership and training mold them into. Set a standard above what they expect and they will respond. If an engine is being held up while everyone else is on scene, then that's a leadership problem. If they are needed for the hands then they stay, if not they are available from the scene. I'm not as closed minded as you so I won't even touch the paid guy watching TV comment, but EMS does have its ups.

1. It gives you access to occupancies you normally may not. Try paying attention to the big picture. Construction type, challenges, etc.

2. Gives some types of fire service personnel the ability to whine about wearing out a truck so you can order another custom engine at nearly the cost of what a commercial ladder could be purchased for. Just think of how many more trophies you could win.

3. More professional image. Then again this could be rough when some "professionals" show up in torn jeans, and t-shirts with budweiser or some other stupid saying on them like "coed naked firefighting." That has always impressed me.

4. Revenue can be produce supplementing the cost. Tax dollars will not cover the cost of running EMS. If you do it with career FD the salaries are already accounted for in the budget and once the billing gets off supplements it and the possibility for the need of more providers or equipment.

[mikeinet 37]

E64: To be honest... i'm not opposed to having a fire apparatus going to the scene of an EMS Call... maybe that's just because i'm used to how it works in Syracuse.

Syracuse Fire Dept is an ISO 1 rated dept, and run all engine calls with a engine and a "mini" (mini = literally just a pickup truck with an amount of hose on it to hit the hydrant and run it to the engine) - but the mini also carries a trama bag/AED/etc/etc and is staffed by an EMT Basic (hmm, maybe all SFD are basics? not sure)

Syracuse runs w/ the opticom system... and only fire apparatus have it, so they have full right of way at every intersection...

A mini gets dispatched to "vital" ems calls (unconcious/possible CVA/heart attacks/etc) and 99% of the time are there before the ambulance (private owned, Rural/Metro) which has a lot lower number of rigs on the road, thus taking it a longer time to get to the scene. This way, care is started, then transfered to the EMS crew once they've arrived.

That's just an example of SFD/RuralMetro and how they run... i'm pretty sure most fire depts in onondaga county run ems style calls like SFD.

Dispatch is all centralized for the county - 911 goes to a central call location, Syracuse Police, Onondaga County Sheriff, SFD, Vol. Depts, Vol. EMS all get dispatched at that location. Only exception is Rural/Metro who dispatches themselves (private company) - but they don't actually call take, they just get the info sent to them from 911 and dispatch the ambulances.

Fire / EMS *can* work together, if set up properly and proper SOP's are in place.

happy new year everyone.

[E64PCFD2044 1]

mike- everyone's got their own view on stuff and where ever you go things are done differently...that was just my opinion..i was a little ticked off when iI wrote that anyways..needed a place to vent

[E64PCFD2044 1]

als - im not bashing anyone or their system, i'm just saying how I feel about it. and the tv comment is because of a little situation around here from what i'm told. again, i'm just saying how I feel.

[Guest alsfirefighter]

E64: That's cool, hey even I have to vent, which I also did in my last post. I just didn't appreciate the comment. I understand there are problems everywhere caused by both sides. However, if your not part of a solution you become part of the problem. If I stated everything I felt on here, instead of trying to make good, professional, knowledgable posts, I'd probably wouldn't be allowed on this site. Sometimes some things are better left unsaid.

Either way I appreciate your professionalism to allow me to respond to your post without any back and forth.

[E64PCFD2044 1]

als - I thought I pissed you off or something. the reason for my post was to just say that I personally feel safer that if I need a bus at 3AM PC EMS is already there in their quarters...maybe thats just what I'm used to..who knows. Thanks for the constructive critism.

BTW, i'm not saying the fire based EMS do a bad job!!! anyone in these fields are to be looked up to, I think.

[Oswegowind 17]

well I will return to yonkers when it is either run by the pd, fd, or is a third party service...not including empress obviously...and if the fd takes it over and we still have to sit on post who cares...i used to hate sitting around the station...driving around is way better...see more chicks that way...right 901

[JCESU 20]

The FD in my City wanted to take over medical calls (from the P.D.) as first responders a few years back. The Union and the upper echelon of the FD felt it would be a great way to improve community relations and would justify adding more manpower via more runs tallyed at the end of the year. The PD had handled them without incident and quite effectively for decades. Well after a few months having to go out in the middle of the night (people here use EMS as a taxi) the FD decided they should given additional Vacation/comp days for their trouble. A CBA battle ensued. The FD lost.Since then, and on a daily basis, whichever agency the call taker sends the call to respponds.

After taking over the F/R calls the FD decided that they wanted to go into the EMS buisness. Somehow FF's making 80K a year sitting in an ambulance is alot less attractive to the taxpayer when the Jersey City Medical Ctr pays their EMT's 12-14 pr hr. They still lobby to take over EMS with a straight face. The EMS we have in place is outstanding and the vast majority of them are extremely angry with the FD. I have seen it first hand these guys won't lift a finger to help EMS at a scene. Not even so much as carry a clipboard.

My question to you gentlemen is.....why would the FD's want to take over EMS and deal with all the headaches associated with it? You guys have made some great points and I'd like to hear you opinions.

JCESU