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To “FD” or Not “FD,” – Politicians Puzzled

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THE SAN CARLOS, CALIFORNIA, CITY COUNCIL is considering a brainstorm presented by their City Manager Mark Weiss.  He thinks that the cash-strapped city could save $3 million to 5.5 million if they shut down the police department and the fire department and contracted other agencies to provide the emergency services.

His plan calls for contracting with the San Mateo County Sheriff’s office to patrol the streets and answer calls, and making an agreement with the California Department of Forestry and Fire Protection, or CalFire, to come in and answer fire calls.

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According to THIS ARTICLE in the San Jose Mercury-News, Weiss said he prefers the outsourcing plan because the city needs to “do something bolder” than what they have been doing for the past several years.  His alternative proposal to the “outsourcing” is to save the money by, among other tricks, closing the city’s Youth Center and discontinue televising the City Council meetings.  (We are not making this up…Ed.)  The article does not say whether Weiss has gotten any pre-approval from either the Sheriff’s Dept. or CalFire for this scheme.

Firegeezer is of the opinion that the good citizens of San Carlos are in real trouble when their city is being run by somebody who thinks that running a “youth center” is more important than running a police station.  When you think that televising the city council public meetings is more valuable than sending out a fire engine to handle an emergency, then you have completely lost touch with reality.

“If we adopt this, if we totally outsource departments, it will dramatically affect how we do business,” Weiss said.  (At least he’s got that part right….Ed.)

The San Mateo Daily Journal has MORE.
San Carlos Fire Department WEBSITE.

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IN VIGO COUNTY, INDIANA, NEVINS TOWNSHIP Trustee Carl Gregory arbitrarily shut down the town’s volunteer fire department last Monday March 1 after he became upset with some administrative shortcomings of the VFD.

Gregory donned his best coveralls for this interview with WISH-TV last week:

But the township leaders have had second-thoughts on such a drastic reaction to the lack of a few reports and rapidly called a meeting of all the involved parties to settle the dispute.  Work has commenced at the firehouse to satisfy some requirements and the volunteers are expecting to return to answering alarms in a few days.

WTHI-TV Ch. 10 filed this video update last night:

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Posted by firegeezer on March 9, 2010 • Filed under: Administration & Leadership, Fire-ology, Funding & Staffing, Videos, commentary, fire stations • Tagged: , , , , ,

Who Needs One, Anyway?

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THE CLUELESS MAYOR OF NORTH PROVIDENCE, RHODE ISLAND, continues to decimate emergency services while preserving non-essential agencies.  Recently Mayor Charles Lombardi laid off several police officers and in December he closed one of the city’s four fire stations despite strong public protests.  (See the Firegeezer video report on that action HERE.)

Now Lombardi has come up with a unique budgetary solution to preserve funds for pet projects that hasn’t been tried before.  He is refusing to fill the vacant Fire Chief’s position.  Former Chief Alfred Bertoncini resigned in December and Lombardi says that the city does not need one anymore, so a replacement will not be hired. 

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His plans call for the three battalion chiefs to share the duties of  Fire Chief and be responsible for the daily operation of the department.  Taking advantage of their mutual-aid agreements, North Providence will rely on chief officers from other towns to run major fire scenes and emergencies.  (Firegeezer wonders if he checked with the other towns first about this transfer of responsibility.)

WPRI-TV has this video report with the mayor explaining his decision:

As for turning these duties over to the battalion chiefs, Firegeezer refers you to our video report HERE from last November on Battalion Chief David Charello being hauled before the court on five felony charges.

Posted by firegeezer on February 18, 2010 • Filed under: Administration & Leadership, Fire Rescue Topics, Fire-ology, Funding & Staffing, Videos

20 Fewer FDNY Fire Companies?

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Al Baker, writing in the metro section of the New York Times, added an article this morning:

New York City’s plans to close up to 20 fire companies will require the Fire Department to undertake its most radical reorganization since the financial crisis of the 1970s, according to senior department officials.

As a result, the department is analyzing statistics, block by block and neighborhood by neighborhood, to determine how it can most safely take engines and ladder trucks out of service.

“If we have to close 20 companies, which is a 6 percent reduction in the number of companies we have, it is going to tax us,” said Salvatore J. Cassano, the newly appointed commissioner of the Fire Department of New York. “It is certainly the most challenging thing we have faced in decades.” (read entire article HERE)

DEPLOYING LIKE IT IS 1975

dropdeadOn June 26, 1975, New York City notified 40,000 city employees that they would be laid off on July 1, the first day of Fiscal Year 1976. That included 1,600 FDNY employees.

Past president of the Uniformed Fire Officers Association was a 24 year old firefighter who got his pink slip the same day his daughter was born in 1975. Frank Lombarbi, writing in the NY Daily News, profiled Battalion Chief Jack McConnell one year ago. (Article HERE) McConnell’s firehouse, Park Slope Engine 269, was closed July 1975.

Chief McConnell worked as a bus driver until he was part of a group of 700 rehired in June 1976.  The rest were rehired by December 1977.

Some of the laid off firefighters worked as temporary Housing and Urban Development contract employees. The federal program employed them to board up windows and roofs of fire-damaged buildings, preserving the urban housing stock. 

Since they were expected to immediately handle any fire damaged buildings, the delivery system was FDNY ladder companies. They took the fourth or fifth staffing position of the truck company and performed “ancilliary” duties between board-up assignments.

WHY SQUAD 1 WAS REORGANIZED AT PARK SLOPE ENGINE 269’s CLOSED QUARTERS

FDNY has used workload and hazard assessment to justify expansion and contraction of the department resources for generations. It supported the creation of second and third fire companies assigned to a fire station during the 1950’s and 1960’s and when the department lost 900 positions in July 1975.

Calderone’s Squad Company Apparatus of the New York City Fire Department picks up the story.

Analysis of workload in the mid-1950’s showed that simultaneous fires were stripping some sections of the city of engine and truck companies. Four squad companies were organized in 1955 to provide additional staffing on initial fireground activity, going back in service when the second alarm companies arrived at the scene. By 1959 there were nine squad companies. The squad companies were disbanded May 1, 1976, victim of the same municipal bankruptcy that laid off 900 firefighters ten months earlier.

Park Slope Engine 269 was one of the Brooklyn fire stations closed in 1975. The community objected to the closing, occupying the vacant fire station and eventually forcing the city to provide a fire company at 786 Union Street. A 1969 R-model Mack 1000 gpm pumper with ladder company tools and a Hi-Ex foam generator was assigned to the station as Squad 1 on December 3, 1977.

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CONSTANT EFFORT TO REDUCE ON-DUTY OVERTIME

The Uniformed Firefighters Association posted a response on December 3rd when the city reduced staffing from 5 to 4 on 49 engine companies (HERE) because of sick leave levels.

Staffing was restored on January 2, 2010, because medical leave dipped back below the 7.5% annualized rate. As a result, all 49 five-man engines that lost their 5th man in December are now restored to full manpower at the start of each tour.

Mike “FossilMedic” Ward

Posted by fossilmedic on February 1, 2010 • Filed under: Administration & Leadership, Fire Rescue Topics, Firefighting Operations, Funding & Staffing, News • Tagged: , , , ,

Layoffs in Reno

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THE RENO, NEVADA, CITY COUNCIL DECIDED TO help make up for their budget deficit by eliminating some front-line firefighter positions.  The order went out to implement the cuts immediately and on Friday Reno Fire Chief  Tim Alameda personally delivered the bad news to 16 department employees, 2 civilian clerks, 2 fire prevention officers and 12 field firefighters.

While this type of activity is happening in more than a few FD’s these days, the Reno FD is stepping up and making sure that the taxpayers are made aware of what is happening.  Chief Alameda met with local tv news crew from KOLO-TV and explained what is occurring and the station filed this VIDEO REPORT.

Furthermore, the rank-and-file and the union Local are making sure that the taxpayers are being informed of just how the City Council’s decision is impacting their safety and response times with this aggresive informational campaign:


Subtle pressure from the grass roots (the citizens) is often the best way to get the politicians’ attention.

Posted by firegeezer on January 17, 2010 • Filed under: Funding & Staffing, Videos, labor • Tagged: ,

Pennsylvania County Abolishes VFD

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FACING A LOUD, AND SOMETIMES HOSTILE, CROWD OF CITIZENS, the Perry County, Pennsylvania (near Harrisburg), Penn Township supervisors voted Friday afternoon to abolish the Perdix Volunteer Fire Company.  Perdix was the primary fire department for the entire southern half of the township.

The supervisors then contracted with the Duncannon VFD, that currently covers the northern half of the township, to provide coverage for the entire district.  In a very unusual move, the supervisors made it a criminal act for any Perdix volunteer to respond with a penalty of jail time and/or fine.  “To a point it angers me that they would do something like this,” Chief Shade Reidlinger told WHTM-TV.  Its 20 active members have been shut out. In fact, it’s illegal for them to fight fires, or respond to crashes and medical emergencies.
“We will be arrested, placed in jail for 30 days and given a $300 fine,” Reidlinger said.

WHP-TV Ch. 21 Harrisburg filed this video report from the supervisors’ meeting Friday:

This conflict apparently stems from the Perdix department’s failure to provide proper financial statements to the supervisors.  Both departments are contracted by the township and the funds are what operated the FD’s.  The Carlisle Sentinel reports:

Officials cited several issues, including problems obtaining financial records, refusal to provide aid to township police and concerns over call responses.

“They should have been more than willing to provide that information,” Supervisor Ce Ce Novinger said about requests to both Perdix and Duncannon for monthly reports on department finances.

Duncannon provided the township with more than adequate materials, but Perdix did not, she said.

The supervisors and the two FD’s have been working for a year to try and resolve the problems, but progress was never made.  The Perdix officers were notified last month that this was going to happen.

Read the full STORY HERE.

Duncannon Fire Company WEBSITE.
Perdix Fire Company WEBSITE has been taken down.

Posted by firegeezer on January 11, 2010 • Filed under: Fire Rescue Topics, Fire-ology, Funding & Staffing • Tagged: , , ,

Firefighter “AIG” Problem

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For the second year, taxpayers are screaming about the end-of-year bonuses provided to Wall Street executives.

While the pile is money is much lower, career firefighters are encountering taxpayer anger. Let’s look at two issues:

TIME-TO-RETIRE

In the last half of the 20th century, some IAFF locals and state associations were successful in reducing the time required to qualify for a pension. Part of the argument was the punishing work conditions as a city firefighter in the 1940s and 1950s.

For example, if I was hired by Prince George’s County in the early 1970’s I could get a full pension after 20 years of service, instead of the 25 years needed to retire from Fairfax County. My ex, a civilian professional working in the fire department, always reminds me that she needs to work 32 years to get her county pension when she turns 55.

Sarasota County Fire Chief Kenneth Ellerbe

Chief Kenneth Ellerbe

Some departments have multiple retirement plans, based on when you started work. A person hired in PG today does not have the same generous retirement program enjoyed by the firefighters hired in the 1960s.

The issue with DCFD Chief Ellerbe on leave with out pay while working as the Sarasota County fire chief is an example of the nuances. When Ellerbe started with the District of Columbia fire department he needed to complete BOTH 25 years of service AND be 50 years old to start receiving a pension. Other DCFD members just need to achieve 25 years of time-in-service. Dave Statter, STATter911, provides the details HERE.

A December 26, 2009 Wall Street Journal article looked at the impact the recession has on local government. Conor Dougherty, writing in “As Slump Hits Home, Cities Downsize Their Ambitions” makes this observation:

More likely to be union members, government workers tend to be better paid and have greater job security than many of the taxpayers who pay their salaries. Benefits are often better, too. Virtually all full-time state and local workers have access to retirement benefits; in the private sector, about 76% of full-time employees had retirement benefits. Employment in local government peaked in August 2008 and has fallen by 117,000 since then, or less than 1%, compared with a 6.3% fall in private employment from its December 2007 peak. (full article HERE)

RETIREMENT BENEFITS

We posted an article about “Gilt-Edged Pensions” in response to an article published in the February 16, 2009 issue of Forbes magazine. Stephanie Fitch’s opening paragraph was designed to get your attention:

Your 401(k) isn’t doing too well, is it? But you’re footing the bill for some lucky stiffs who don’t have to worry about market crashes, medical costs or inflation.

The article featured police chief Glenn Goss. Goss retired as a Delray Beach police commander at 42 and took a job as the Highland Beach police chief. He gets a lifetime pension of $65,000 from Delray and, assuming he lives to the actuarial age of 78, represents a $2 million liability to Florida taxpayers. Fitch points out that there are “millions” of public safety employees with defined-benefit retirement programs.

Defined-benefit plans provide pension income to retired employees on the basis of a formula that accounts for a worker’s years of service at a firm and earnings. Distributions are typically made for the remainder of the employee’s life, making the plan similar to an annuity. Definition from Tax Policy Center of the Urban Center and Brookings Institution HERE

Forbes article HERE, Fossilmedic column HERE.

Sarasota’s reporting on Chief Ellerbe points out that the combination of DCFD pension and county salary approaches $250,000 a year. There is nothing illegal or improper about this situation, but generates the same anger as the federal government payout of Wall Street bonuses.

WHEN THE MONEY RUNS OUT

Forbes, The Wall Street Journal and The Economist have a pro-business, anti-labor editorial point-of-view.  Even with this bias, they make a couple of points that we cannot ignore.  A December 10, 2009 article in The Economist, makes the following observation in “Welcome to The Real World“:

Union_rates

… public-sector workers are spoiled rotten. Government employees earn 21% more than private ones and are 24% more likely to have access to health care. Only 21% of private workers enjoy a defined-benefit (DB) pension, which guarantees retirement income based on years of service and final salary. But 84% of state and local workers still receive DB plans. Article HERE

Defined benefits retirement program obligates the municipality for decades. To meet that obligation, local governments are reducing health benefits, laying off employees and reducing expenditures. It may not be enough.

The City of Vallejo filed for Chapter 9 bankruptcy on May 06, 2008 (HERE). One of the goals of filing for bankruptcy was to break existing public safety labor contracts and pension obligations.

I am sad that 50 years of efforts to improve the working conditions of career firefighters is crumbling in the face of the 2008 recession.

Even if the economy starts to grow today, we are two to three budget cycles away from significant increases in local government revenue. Some think that we will not see a rapid return to the growth and revenue during the 1990’s.

The experts interviewed in The Economist article say it time for a fundamental restructuring of work conditions, pay and benefits.

What do you think?

Mike “FossilMedic” Ward

Posted by fossilmedic on December 31, 2009 • Filed under: Administration & Leadership, Fire Rescue Topics, Funding & Staffing, Urban Commander, labor • Tagged: , ,

The Neon Red Elephant of EMS

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I grew up riding fire-based ambulances: as a volunteer, a seasonal employee and within my municipal career.  Done part-time work with a commercial ambulance. Teaching high school EMT in rural Virginia sensitized me to the needs of all-volunteer community life-saving squads.

My first column, Walking the Fire-Based Talk, discussed the 2007 release of  “Prehospital 9-1-1 Emergency Medical Response:  The Role of the United States Fire Service in Delivery and Coordination.” This was the white paper promoting the vital role of the fire service in delivery of emergency medical services. (17 page 162 KB  HERE).

HOW THE NON FIRE SIDE THINKS

I spent the past eight years attending conferences, business meetings and hallway discussions held by non-fire ems organizations. American Ambulance Association, EMS educators, high performance systems status advocates and EMS physicians. Fire service was the neon red elephant in the room at every discussion of turf, power or politics.

Hanging out in Las Vegas with an ems expert who is grounded within commercial and third-service systems. Comparing ems conferences, he noted that the IAFF was one of the better organized venues. Provided a more diverse group of speakers: politicians, economists and highest level of regulators/ administrators. He reflected that firefighter labor was a well-resourced and politically-astute sleeping giant that could dominate ems.

Two years after that conversation the giant awakened, as one of five national fire service organizations sponsoring the fire-based ems white paper

WHY TALK ABOUT THIS NOW?

IAFF and IAFC reaffirmed their support for fire-based ems (JEMS item). On JEMSconnect a discussion question was posted that exceeded 147 posts at the time this item was published (HERE).

logo_30_rThe first Public Utility Model of EMS delivery, Kansas City MAST, is scheduled to be taken over by the fire department in May 2010, ending three decades of service. (HERE)

This is particularly heartbreaking to the high performance advocates, since the fire department does not intend to maintain an ambulance response time of 8:59 minutes to priority one calls 90% of the time.  Fire Chief Dyer points out that their implementation of fire company delivered compression-only resuscitation has almost doubled the number of patients showing a return of spontaneous circulation.

David Williams, a senior  Fitch and Associates consultant, tells Best Practices in Emergency Services “MAST is a reaccredited ACE center that does Medical Priority Dispatch and advanced systems status management, none of which the fire department has any experience with.” (HERE) Stephen Dean, PhD, provides a great PUM description (HERE).

ITS NOT ABOUT CLINICAL EXCELLENCE OR CAREGIVER DEDICATION

Delivering municipal services is a political and economic activity. The voters are not focused on the details of delivery of the service, until it becomes perceived as a problem. Two examples:

Voters failed to approve the renewal of funding for the King County/Seattle Medic One program in 1997 (HERE).

Philadelphia tolerates grossly overworked ambulances, 20 to 40 minute waits and occasional fatal outcomes. (HERE)

SOME SYSTEM DELIVERY PRACTICES MAY NOT BE IMPORTANT

Patient outcome studies are challenging ems system design assumptions, with the amazing results from uninterrupted compression-only CPR (HERE).

Last year the U.S. Metropolitan Municipalities EMS Medical Directors Consortium issued recommendations impacting six areas of clinical treatment.

  • ST-Elevation Myocardial Infarction (STEMI)
  • pulmonary edema
  • asthma
  • seizure
  • trauma
  • cardiac arrest.

Their recommendations for cardiac arrest are surprising:

Response interval of less than 5 minutes for basic CPR and automatic external defibrillators (AEDs). No response interval was specified for ALS arrival.

In justifying its cardiac arrest recommendation, the group noted that much of the clinical research used to establish acceptable ALS response time intervals was conducted prior to the widespread dissemination of AEDs and at a time in which the compression component of CPR was not emphasized as it is now.

As a result, the consensus group proposed that EMS systems not focus response time measurement on ALS ambulances, but rather pay greater attention to first response/BLS response time to measure what it called the “most important predictive elements for optimal outcome: time elapsed until initiation of basic chest compressions and time elapsed until defibrillation attempts.” (PEC article HERE)

IT IS ALL ABOUT FIREFIGHTER JOBS

General President Harold A. Schaitberger, speaking at the June 2009 EMS Conference, noted that hundreds of IAFF members lost their jobs. By June 2010 it may be thousands.

If aggressive takeover of private and third service 9-1-1 ambulance service preserves jobs, then expect to see fire departments reaching out.

Fire Service-Based EMS Advocates

Mike “FossilMedic” Ward

Edited 22:15, November 22: fixed links, changed some formatting and added Fire Service-Based EMS Advocates.

Posted by fossilmedic on November 22, 2009 • Filed under: Administration & Leadership, EMS Topics, Fire Rescue Topics, Funding & Staffing, culture • Tagged: , , , , ,

What Direction for EMS Education?

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TWO INSTITUTIONS ISSUED AN ANALYSIS OF THE EDUCATION OF A PROFESSION. They were negative and shared four criticisms:

  • Weak students
  • Inappropriately trained faculty members
  • Unintellectual curriculum
  • Poor research

Is this a more formal response to the EMS 2.0 initiative or a follow-up to a report written three years ago by the National EMS Management Curriculum Committee?

National EMS Management Curriculum Committee is a Federal Advisory Committee Act compliant group that issued a report to the National Fire Academy Board of Visitors on a proposed national undergraduate EMS Management curricula.

Part of the Fire and Emergency Services Higher Education (FESHE) process. You can access the 31 page 178 KB document HERE.

By the way, I am the chair of the committee … Draft 2.2 is as far as the report got within the bureaucracy.

STATE OF EMS MANAGEMENT EDUCATION

In 2006 we found 14 13 programs that offered a bachelor degree in emergency medical services.  Three programs provided a comprehensive approach, meaning that more than 21 semester hours covered ems management topics:

Two provided about 21 semester hours in EMS Management, as a major area of concentration within a more generalized degree:

In addition, Springfield College (MA) offers between nine and 15 semester hours of management training in their Emergency Medical Services Management bachelor’s.  That makes the EMSM program unique as it provides the clinical paramedic coursework and management courses.

The other eight seven bachelor programs offer a predominately clinical paramedic curriculum. (Lost one program since Fall 2006.)

WHAT CARNEGIE AND FORD WROUGHT IN 1959

Carter A. Daniel, director of business-communication programs at the Rutgers Business School, wrote “How Two National Reports Ruined Business Schools” in the November 13th edition of The Chronicle of Higher Education.  Fifty years ago the Carnegie Corporation and the Ford Foundation released reports assessing the state of business education in America.

Daniel_MBADaniel wrote MBA: The First Century, in 1998. His point-of-view:

Although generally regarded at the time as a salutary development, the reports, considered half a century later, can be more accurately described as something close to a catastrophe, with consequences felt in every school of business every day.

Daniel reported that the business schools retreated into the theoretical camp. Created more than 50 PhD business programs within a decade. In 1958 only 124 business PhDs were granted, 1,097 scholars received a business PhD in 1974.

His lament is that there is a vast separation of theory and practice, with the professional literature “… consisting almost wholly of articles written by professors for other professors.”

COMBINING THEORY AND PRACTICE

Daniel looks to medicine, engineering and law as providing a better balance between theory and practice, where the professional peer-reviewed journals are read by both academics and providers.

It is not perfect,  there remains a struggle to define what defines an academic’s professional practice. Physician-educators still see patients, how to we define the practice of a health care specialist or a public health professor?

Can I get professional practice credit by working as a per-diem paramedic or volunteering as a rescue squad chief?  Or (gasp) riding an engine company as a paramedic/firefighter!

Or, can I drop all of my paramedic certifications as an EMS oriented academic?

Mike “FossilMedic” Ward

Related earlier articles:

Posted by fossilmedic on November 9, 2009 • Filed under: Administration & Leadership, EMS Topics, Funding & Staffing, Patient Management, Training & Development • Tagged: , , , , ,

Firefighters Reinstated After “Improper” Firing

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TWO FIREFIGHTERS IN MONTGOMERY COUNTY, OHIO, have been given their jobs back after the State Employment Relations Board agreed with an administrative law judge that they had been improperly fired.

The two Butler Township firefighters, Angela Rice and Richard Nihizer were discharged in January, 2008, after being accused of “watching inappropriate material” on the fire station’s computers.  Altogether, ten firefighters were disciplined for supposedly looking at indecent websites, but Rice and Nihizer were the only full-time firefighters charged.  A third FF who was a part-time employee was also fired while four more FF’s were suspended without pay for 10 days or less.  Four more part-timers resigned prior to disciplinary hearings.

The judge agreed with Rice and Nihizer that the firings were really retaliatory actions against their union organizing activities.  The Dayton Daily News relates:

Judge Beth Jewell noted any misdeeds by the two were minor compared to others involved who were given suspensions. Jewell also took note that the firings came 10 days before the township and the union were to meet to iron out a contract. “Circumstantial evidence infers discriminatory motives and thus anti-union animus,” she wrote after reviewing testimony this summer.

“The record compels the conclusion that (Rice’s and Nihizer’s union) activities were, at a minimum, a substantial part of the (township’s) motive to discharge them,” she wrote.

In addition, the judge pointed out the township had no policy on computer use nor any prohibition against the use of employees’ personal computers while on duty.

The judge also wrote there was no evidence presented that Rice intentionally viewed any inappropriate material. The judge concluded the images seen by Nihizer, which were viewed by the judge, were not pornographic.

WDTN-TV Ch. 2 has a video report on the decision:

The Board also ordered that all back pay and benefits are to be restored to the pair.

Read the full story in the Daily News HERE.

Posted by firegeezer on November 3, 2009 • Filed under: Funding & Staffing, labor • Tagged: , , , , , , ,

Pay Me Now ….. Or Pay Me Later

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FAYETTE COUNTY, GEORGIA, DECIDED TO meet the economic downturn by not replacing three of their four 10-yr.-old ambulances.  Their original schedule had called for buying three new ambulances, one this fiscal year and two more in FY2010.  Earlier this year the County Commission approved $156,000 to purchase one vehicle, but they decided to hold off on the other three.

Those plans have now changed as the old vehicles are reaching a point of non-performance.  They are breaking down constantly and causing a drain on the fiscal resources anyway, so the commission voted 4-0 last week to solicit proposals to replace the other three.

The Fayette County News has the STORY.

Posted by firegeezer on October 26, 2009 • Filed under: EMS Topics, Funding & Staffing, ambulances • Tagged: , , ,

PG, the GM of combination fire departments

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AFTER READING DAVE STATTER’S UPDATE ABOUT VOLUNTEERS REFUSING TO STAFF AMBULANCE 821 I REALIZED … the Prince George’s County combination fire department is like General Motors and their dealers.  (HERE)

OUTDATED BUSINESS PRACTICES

Auto dealers are independent businesses that have negotiated a contract with General Motors to sell vehicles. Each of the 38 35 volunteer corporations in PG have negotiated individual staffing and resource agreements with the county fire chief.

The metrics measuring car dealers are pretty clear … the number of new cars sold and the revenue generated by the service department.  One of the goals of the post-bankruptcy GM is to increase the number of Chevrolet sales per franchise to match Toyota. 

That is quite a challenge, since Chevy averaged 208 vehicle sales/franchise  in 2008 … and Toyota sold 980 vehicles/franchise.  Cadillac averaged 73 sales/franchise and Lexus was 675/franchise. Now I understand while GM is continuing to slash it’s number of dealers.

OUTDATED VOLUNTEER EXPECTATIONS

Fellow fossils, who spent much more time in PG than I did, took me to task when I criticized Chief Finamore for not having qualified volunteer drivers at Allentown Rd 32 (HERE).  They described his years-long effort to get 24/7 county staffing increased from two to four.

They suggest his political power, as a retired county deputy fire chief and current volunteer division chief, is the reason why all of the new front-line rigs (Engines 832 and 847, Truck 832 and Rescue 847) were purchased by the county and not the corporation.  Until the start of this fiscal year, it appeared that Finamore maximized his assets to best serve his community.

In a department where each corporation has to fend for itself for county resources, it makes sense. It appeared that the resources assigned to 32 were protected. Until the start of Fiscal Year 2010, when career staff are moved out of seven of the 44 stations every day to cover vacancies.  Allentown Road 32 was without staff on July 9.

md-pg-arvfd-sign-731568

Allentown Rd 32 - courtesy STATter911

WHERE DID THE VOLUNTEERS GO?

When TriData did a report for PGFD, they showed that 1,099 volunteers took the “fit test” in 2003.   An annual assessment to use respirators and SCBA, there are just 320 volunteers listed on the  June 29, 2009 eligible list (PG ID numbers that start at 00034 and end at 18439).  A change since 2003 is the requirement that the federal ICS training and a SCBA refresher course be completed before taking the fit test.

If there are just 320 operationally qualified volunteers in the county, their ability to cover many of the July daywork and 24 hour career vacancies is impressive. Especially as the county continues a practice of ineffective communication and last minute moves. It is difficult to arrange for weekday coverage when the volunteer leadership learns about it at 10 pm the night before. Even harder at 7 am the when the county crew does not show up.

The extraordinary stress of removing county staff from up to seven fire stations every day is revealing a problem with many of the volunteer corporations.  So far we have seen that Boulevard Heights 17, Beltsville 41, Allentown 32, and Oxon Hill 21 cannot muster a weekday crew.  Chief Finamore says that 32 has no qualified drivers and former Chief Hancock says that there are just three or four active members at Oxon Hill 21.

I am still wondering how can a volunteer fire department exist with a handful of operational members.

FAST OPERATIONAL BANKRUPTCY FOR PGFD?

The 39 day “fast bankruptcy” that the federal government engineered for General Motors accomplished what the corporation could not do by itself. The  new “Government Motors” has far fewer employees, will have far fewer dealerships and jettisoned many of the legacy obligations incurred by the 100 year old corporation that lead to it’s demise. 

Acting Chief Eugene Jones has his confirmation hearing today. PGFD is a combination fire department with fewer county employees and operational volunteers. The TRIM admendment and outlawing of the “Las Vegas-style” fundraisers have resulted in 15 years of increasingly threadbare operations.

Maybe it is time for an operational reorganization.

Mike “FossilMedic” Ward

Posted by fossilmedic on July 14, 2009 • Filed under: Firefighting Operations, Funding & Staffing, commentary

It is ALWAYS Political

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A COMMON WHINE FROM FIRE OFFICER CANDIDATES IS THAT FIREFIGHTERS ARE NOT POLITICIANS. A “real” firefighter is good of heart, focused on saving those endangered by fire and righteous in suppression skills. That is all that is needed.

Only in the movies …

A STARK CONTRAST

Dave Statter posted a video showing Engine 848 (West Lanham Hills #2) arriving at a well-involved garage fire (HERE) in Prince George’s County, Maryland. His comments in a later post are worth considering today:

It also illustrates what has long been a problem in the county: staffing. The first engine arrived with just an officer and driver. As we have pointed out many times in the past, PGFD is the only fire department inside the (Washington DC) Beltway that allows front line suppression units to respond with just two. Even with that built-in handicap, PGFD is also the only Beltway department to suffer major cuts in career staffing at its fire stations due to the current economic crisis

If the fire occured 20 miles west, in Arlington County, Virginia, all of the arriving crews would be staffed with an officer and three firefighters. Both are urban counties with career and volunteer elements. There are significant differences in county funding practices and the evolution of the fire departments.

But why, in “liberal, labor friendly” Maryland the majority of the PGFD engine companies operate with a crew of two, while in “conservative, right-to-work” Virginia, Arlington has a minimum of four on every front-line suppression company?

KITCHEN POLITICS

We love to argue and fight among ourselves: Career versus volunteer, EMS versus suppression, Majority versus protected class, Rural versus urban. Each of us have hot-button issues and ownership of a concept that we spend a tremendous amount of time and energy to protect and promote. I can imagine how some firehouse kitchen conversations went after the Supreme Court ruling on the New Haven reverse discrimination appeal.

The problem is that all of that energy, heat and effort is squandered at the fire station kitchen table. It has the same effect an on-line petition has to change a policy or restore a favorite program …. NOTHING.

Our fight for independence from Britian was not won after a rousing discussion at the fire hall.

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REAL SUCCESS REQURIES REAL HEROS

My heros are the men and women who spend the time making a real difference for their brother and sister firefighters. They have mapped out the turf and figured out how power works in their community, region or state.

They are engaged in the messy, unglamorous process of participative democracy by working with legislatures and political leaders in order to promote and protect what firefighters need. They are not well compensated for this effort. They spend hours in committee meetings. They ghostwrite studies and propose legislation. Back at the fire station get grief from those whose only action is to sit in the kitchen and complain.

Thanks to these heros, we have federal grant programs like SAFER and AFG, and state cancer presumption legislation. That same process of participative democracy also brings criticism like The Heritage Foundation analysis of the impact of federal grants (HERE) and the National League of Cities funding an analysis of cancer presumptive legislation (HERE).

This is real life. We need to protect, and often carve out, our chunk of turf and power. From the neighborhood to the nation.

PRO BOWL QUARTERBACK WITH COLLEGE SKILLS

Malcolm Gladwell used this image when describing the challenge in finding the right type of educator in the December 15, 2008 edition of New Yorker. (HERE) Dan Shonka describes the dramatic difference in NFL working conditions, meaning that the best college quarterbacks are not assured success in the pros.

There is the same level of difference between a one or two station volunteer fire department and an urban fire agency with more than 500 employees. I spent nine months living in the College Park fire station as an undergraduate.  My master’s degree from the University of Maryland focused on State and Local Government. I started writing about the two-hatter issue in 1999. Made a 2007 case study on the Kentland ambulance battle. It is clear to me that many of the players act as if they were still in a mom-and-pop fire company,

I wonder what PGFD would look like if more of the players would have spent their time and energy developing pro-bowl political and administrative skills for the greater good, rather than to embarass, bury or destroy their fire service colleagues. There are smart, capable and dedicated PGFD members doing great work, but so much energy is wasted fighting with each other.

Mike “FossilMedic” Ward

(8:20 pm: edited next to last paragraph for clarity and corrected typos)

Posted by fossilmedic on July 1, 2009 • Filed under: Administration & Leadership, Fire Rescue Topics, Funding & Staffing, Urban Commander, commentary, labor • Tagged: , , ,

Advanced Practice Paramedics 2.0

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About 15 years ago the buzz in ems academia was the prospect of advanced-practice paramedics (APP) doing patient assessment and treatment that went beyond the Paramedic National Standard Curriculum. Demonstration projects were set up in remote areas with few medical resources.

While one of the demonstration projects suffered from operational issues, there were larger problems. Medicare and health insurance would not pay for services. The Advanced Practice Paramedic competes with the Nurse Practitioner and the Physician Assistant in delivering delegated advanced care.

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THE PARAMEDIC PARADOX

Wake County EMS Director J. Brent Meyers, MD, MPH, wanted to improve agency response to low-frequency/high-risk “red zone” patients that needed an experienced paramedic. He also looked at patients that could avert a 9-1-1 trip to the hospital if they were assessed sooner. He described this “paramedic paradox” at the 2009  Metropolitan Municipalities EMS Medical Directors “State of the Science” conference.

Within community health, Meyers wanted experienced paramedics to perform Well Person Checks. Tasks included monitoring of patients with diabetes, hypertension and congestive heart failure. Arrange direct admission of patients to an alcohol treatment center, an idea adopted from a Memphis Fire initiative.

APPs would also perform ems pre-plans for nursing homes and home health facilities. They would develop fall prevention programs for their patients. All of these activities would reduce the number of 9-1-1 calls for EMS.  Unlike the 1994 experiment, Wake County APPs are reducing operating expenses by reducing the transport unit workload through at-home assessment and treatment of chronically ill patients. 

SEVEN WEEK ADVANCED PRACTICE ACADEMY

Experienced paramedics were required to read 20 peer-reviewed medical journal articles and pass a written exam, interview and scenario.  The didactic covered critical encounters, public health and alternative destinations.  Clinical rotations in OB/GYN, infectious disease, cardiac cath, ED, ATC, behavioral health, RN follow-up, pediatrics, 9-1-1 center and Wake EMS PI. 

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FIRST FIVE WEEKS

Five single APP “Medic” units went into service January 6, 2009.  They had their first cardiac arrest save less than four hours later.  At the end of five weeks the APP units handled 2309 incidents, including 99 cardiac arrest responses. The top five 9-1-1 responses were for unconscious, chest pain, seizure, fall and motor vehicle crash.

They also completed 54 well-person checks and are compiling case reports showing the impact of well-person checks and direct alternative transportation on ambulance transport workload.

HEMI-POWERED MEDIA ATTENTION

The mainstream and trade media fixated on the shiny new police-package Dodge Chargers … no different than the NC State Trooper vehicles.  The real power is in the appropriate utilization of experienced paramedics with additional training.  This may be the first example of what the Scope of Practice will bring to out-of-hospital care.

Dr. Meyer’s February 2009 Eagles Presentation (HERE)

JEMS discussion with Skip Kirkwood January 15 (HERE)

JEMS Editor A. J. Heightman January 2009 column (HERE)

Wake County EMS (HERE)

Mike “FossilMedic” Ward

Posted by fossilmedic on March 14, 2009 • Filed under: Administration & Leadership, EMS Topics, Funding & Staffing, Patient Management, Training & Development, Vehicle Operation & Ambulances, commentary • Tagged: , , , , ,

It has nothing to do with Mrs. Smith …

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. . . and everything to do with local political power

A guaranteed groaner when teaching a fire officer course is to talk about “Mrs. Smith” or The Phoenix Way.  Firefighters are quick to point out that they are not in a retail trade. Users of 9-1-1 are called victims or patients, not customers.

With Fire Chiefs Clack and Rubin embracing Brunacini customer service, a brief search on TheWatchDesk will provide vigorous and emotional responses from city firefighters:  Baltimore example, Washington example.

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DCFEMS Community Service Unit – Go HERE to read Vito Maggiolo’s dcfd.com article

The Phoenix Way does not travel well outside the Valley of the Sun.  It makes no difference if the plan was lifted from the PFD website out-of-context or implemented by a retired Phoenix command officer at a new fire department.

But in the city where it started, it is protecting firefighter jobs.  There were two significant pressures in Phoenix that provide an example of carbon transformed into a diamond.

PRO-BUSINESS WITH A BULLET

Phoenix public safety unions won the right to collective bargaining in the early 1980s. One result of this political activism was a firefighter-initiated referendum to replace the at-large city council system with single member district elections. This eroded the ability of business leaders to influence city operations.

Phoenix is lead by old-school Republican conservatives. It is the home of two senators who were presidential candidates, Barry Goldwater and John McCain. In the 1980s and 1990s the police chief functioned as a political operative, using his law enforcement authority to investigate and harass political foes. (HERE)

Just before the 1982 single-member district referendum vote occured, more than a dozen firefighters, including the union president, were arrested on cocaine charges. Duane Pell, a former city council member and IAFF Local 493 leader, talked about this incident in a 1993 Phoenix New Times article.

“The headlines were firefighters involved in major drug trafficking, a system of drug trafficking that, because of the convenient location of fire stations throughout the city, made perfect locations for firefighters to distribute cocaine,” says Pell, describing the allegations. Most of the firefighters were cleared of criminal charges and no major drug ring was ever found.

This arrest started a decade of intimidation and harassment of the union president. Eleven years after the unfounded cocaine arrest, IAFF Local 493 President Pat Cantelme filed a $1 million lawsuit accusing the police chief, county attorney and others of violating his civil rights.  (HERE)

WE COULD ALWAYS CONTRACT WITH RURAL-METRO

During this time Scottsdale-based Rural-Metro was a successful for-profit contract fire protection corporation.  Imagine working every day in a city that is hostile to organized labor and points to a neighboring private corporation when things get dificult.  For the metro Washington readers, it would be as if McLean/Tysons, Bethesda/Chevy-Chase, Inner Harbor or Georgetown/West End were protected by a for-profit fire department.

APPLYING NATIONAL LABOR RELATIONS BOARD (NLRB) TECHNIQUES

Phoenix started the Labor/Management effort in 1984 using a NLRB Relationship By Objectives (RBO) procedure . RBO is recommended when labor and management are at an impasse. The RBO process created The Phoenix Way, The Big Five and “Be Nice.”

Be Nice covers both the internal (firefighter) and external (Mrs. Smith) customer. Within the department there was a tremendous effort to encourage, reinforce and reward nice behavior.  It was a recurrent feature within their internal publications and videos, retelling customer service stories and celebrating random acts of kindness.

During a discussion of organizational structure, a PFD captain identified a senior staffer as “the Deputy Chief for Being Nice.” For a municipality involved in hard-ball politics, each positive firefighter/civilian encounter increased citizen support of the department.

BE NICE PRODUCES VOTER SUPPORT

Voters passed Proposition 1 in a September 11, 2007 election.  Proposition 1 hikes the sales tax 0.2 percent, which will be used to hire 500 new police officers and 100 new firefighters within the next two years. (source – Goldwater Institute)

During an October 2008 budget work session, the Associated Press reported “… a majority of the City Council expressed support for increasing the public-safety budget by $10 million, or about 1.3 percent, while cutting the other departments by 25 percent to 45 percent.”

PROPOSED FY 2010 BUDGET

With a budget deficit approaching $270 million – a 22% reduction in projected revenue - city agencies were directed to provide budgets reflecting a 30% reduction of expenditures. Public safety was directed to provide a 15% reduction.  Courts, police and fire account for 68% of the city expenditures.

The proposed FY2010 budget released last week calls for elimination of 1,300 of the exising 14,000 city jobs.  (HERE)  This reduction is on top of a $90 million budget cut in early 2008.

NONE of the 1,588 firefighter postions were eliminated in the proposed city budget. The department will be losing some of their 350 civilian employees and will run no recruit schools in 2009.  The fire department will reduce it’s FY10 budget by 7.5%. (HERE),

“Seventy percent of our general fund goes to first responders,” said Councilman Michael Nowakowski. “You can’t cut from police and fire because it’s a need. Our city is growing and we need officers on the street and firefighters and paramedics out there to protect our families.”

This is a far cry from the city council sentiments in the 1990s, when candidates ran against public safety labor and their featherbedded jobs.  Maybe being nice is not just a warm and fuzzy sentiment.

Mike “Fossilmedic” Ward
Diamond or Dust budget series

Lacey, M. (1992, December 30). The Pursuit of Pat Cantelme. Phoenix New Times.
Pasztor, D. (1993, February 3). Arizona’s Own J. Edgar Hoover. Phoenix New Times.
Pasztor, D. (1993, March 3). Firefighter Fires Back: Union Chief Alleges Abuse of Power by Ortega, Romley, others. Phoenix New Times.
Wong, S. (2008, December 26) Phoenix’s budget gap grows bigger The Arizona Republic.
Berry, J. (2009, January 01) Phoenix unveils $270 million in cuts. The Arizona Republic
Ferraresi, M. (2009, January 01) Phoenix police, fire asked to cut costs. The Arizona Republic.

Posted by fossilmedic on January 5, 2009 • Filed under: Administration & Leadership, Command & Leadership, Funding & Staffing, Urban Commander, commentary • Tagged: , , , , , , , , , , , ,

How do you spread thin resources?

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Tonight, Philadelphia Mayor Michael Nutter announced cuts that the city is making to cover a billion dollar revenue deficit. HERE

He is laying off 200 city employees and leaving 600 jobs vacant, including 200 police officer positions. No firefighters will be laid off, but he is closing five engine companies and two ladder companies. Members from those units will be reassigned to significantly reduce fire department operations overtime.

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Yesterday, New York City Mayor Michael Bloomberg announced that they are laying off 500 employees and allowing another 2,500 jobs remain unfilled when the current employee leaves the position.  Read story HERE.

Bloomberg is not starting a 1000 officer police academy in January.  He proposes closing five engines in dual (engine + ladder) houses in the evening hours.  The FDNY academy school will be reduced from 23 weeks to 18 weeks.

IT IS ALL ABOUT THE CASH FLOW

Municipalities are trying to reduce “cash” expenditures, the direct outlaying of funds.   In the Washington DC area, Prince George’s County instituted an eight day furlough affecting 6000 county employees … with disasterous results when applied to the paper-thin fire department operations staff.

Dave Statter has been on top of it since the beginning, including this bad outcome event during the first week of furloughs. HERE

Fairfax County will be furloughing all but public safety employees on January 2nd.

HARD CHOICES FOR PUBLIC SAFETY

Consider four engine companies, each staffed with a minimum of an officer, an apparatus operator and two firefighters. That represents 16 on-duty employees … actually you will need 20 employees to assure that 16 positions are filled.

You are told that there will only be eight available positions to staff the four engines starting next week.

  • Do you staff two four-person engine companies?
  • Do you staff three engines, two with a crew of three and one with a crew of two?
  • Do you staff four two-person engine companies?

It is day three of this reduced staffing, and one of the eight remaining employees goes home sick. No overtime is available and there is no one left to fill the position.

If you decided to run two four-person engine companies, now will you:

  • Run one three-person engine and two two-person engines?
  • Run one four-person engine and one three person engine?
  • Run one seven-person engine company?

I used these type of questions when teaching Fire Officer III, now most of us are living in a cruel economic reality.

I do not think there is a fire chief or budget officer that can beat this Kobayashi Maru scenario.  As trekkies know, James T. Kirk cheated when he beat the scenario on his third attempt at the academy.

Earlier blog entries:

Mike “FossilMedic” Ward

Posted by fossilmedic on November 6, 2008 • Filed under: Administration & Leadership, Funding & Staffing, labor • Tagged: , , ,

Fiscal Forecast – Mostly Cloudy

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IF THEY ONLY KNEW …

A common lament heard around the fire station kitchen is that if the public only knew what the budget cuts were doing to the fire department, they would put a stop to it. Last week we looked at the impact of recessions in Fiscal Years 1982, 1983, 2002 and 2009. This week we will take a longer look.

FORD TO CITY: DROP DEAD

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New York City laid off more than 40,000 employees at the start of Fiscal Year 1976. This included 1,600 FDNY firefighters. While the city hired back 700 firefighters within three days, 900 others lost their permanent firefighter jobs. It would take two years before the city could rehire all the laid off firefighters who reapplied to FDNY.

Some of them were temporary employees working on a federal Housing and Urban Development grant that paid their salary because they would board up roofs and windows of fire-damaged buildings, preserving the city housing stock. FDNY assigned them to ladder companies as the fourth or fifth position. All of the HUD funded temporary employees were laid-off FDNY firefighters.

WHY ST. LOUIS AND RICHMOND WENT TO QUINTS

When Neil Svetanics was appointed the Fire Chief of Saint Louis in 1986, the mayor required a significant reduction of the firefighter workforce. Svetanics established the Total Quint Concept because of the mayor’s mandate. 30 quints replaced 30 engine companies and 12 truck companies.

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St. Louis Quint Co. 1 by Keith Belk

When Jack McElfish became the Richmond, Virginia, fire chief in 1996 he was facing a department that, like many big cities, suffered a steady decline in firefighting resources. Jake Rixner describe the situation in his 2001 Fire Engineering article “To Buy (or Not to Buy) a Quint.”

In 1971 the Richmond Fire Bureau (RFB) had 25 two-piece engine companies, nine aerials and two tactical squads. Eleven years later the department shrunk to seven two-piece engine companies, 13 single rig engine companies, nine aerials and one tactical squad. Minimum daily staffing was 150 firefighters.

By 1996 the department was shrunk to 20 single rig engines and six aerials. Much of the apparatus was worn out, many made by fire apparatus vendors long out of business like Maxim and Hahn. Chief McElfish proposed a Total Quint Concept, establishing 20 quints and three heavy rescue companies. Minimum daily staffing was reduced 100 firefighters.

Rixner described “Christmas in March” when the new rigs arrived. The new rigs included features that were common in the fire service but never seen in the city, like instant-on tire chains.

His article went on to describe his concerns about firefighter safety and operational issues when operating in an all-quint system with four firefighter staffing. Responding to the article, John Mittendorf (retired Los Angeles City battalion chief) pointed out that Austin (Texas) was staffing their quints with six to eight firefighters.

RFB operational information here: http://www.ci.richmond.va.us/departments/fire/operations/quint.aspx

IT JUST TAKES A COUPLE OF BIG FIRES … OR NOT … SAN DIEGO COUNTY

Sitting at the firehouse kitchen, we would speculate the impact of a couple of large loss fires to get the community’s support. Unfortunately, we now know what will happen. San Diego County suffered devastating wildfires in 2003 and 2007. Almost a million acres were burned, destroying almost 6000 structures and killing 38 civilians and one firefighter.

I remember hearing a presentation from a deputy chief describing a situation where he was trying to defend a community with one county pumper and the nearest help hours away. California was burning, as it is doing now. Closest help was Phoenix, Arizona, but they are not part of the CalFire system.

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San Diego, 2007

California uses a grand jury system to analyze and report on municipal issues. On May 29, 2008, “The Fire Next Time – Will We Be Ready?” was filed. The twenty page report makes eleven recommendations. http://www.co.san-diego.ca.us/grandjury/reports/2007_2008/Firereport.pdf

John Becknell, publisher of the Best Practices in Emergency Services newsletter and a San Diego County resident, reflects on this issue in his July ruminations:

… the citizenry continues to reject more support for essential fire services, despite dire consequences. The loss of thousands of homes from two devastating fires in the last five years have not been enough to change minds, prompting a recent San Diego County Grand Jury report to call the county “woefully unprepared,” and an academic expert to declare San Diegans “serial non-learners when it comes to fire preparation.”

We have to recognize that what is best or ideal may have a changing meaning. Saving lives or property is no guarantee of funding. People take more risks during hard times. With 78 million baby boomers bearing down on retirement, gas prices soaring, the housing crisis continuing, the economic slump deepening, many local governments are near default and many states are slashing education budgets, releasing prisoners early and putting off infrastructure repairs in an effort to stay afloat.

http://www.emergencybestpractices.com
Hmm, this could be a rocky Fiscal Year 2009, and 2010, and 2011.

Mike “FossilMedic” Ward

Posted by fossilmedic on July 15, 2008 • Filed under: Administration & Leadership, Funding & Staffing, commentary • Tagged: , , , , , , , , ,

Death By Design

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Deborah Payne, a 55 year old northeast Philadelphia resident, called 9-1-1 because she had trouble breathing at 2:39 am on January 1, 2008. There were no city ambulances available. Engine 36 arrived within four minutes and started oxygen therapy. Ladder 20 brought more oxygen to the scene.

Medic 43B, an emt-staffed ambulance, arrived at 3:42 am. It failed to start after loading Payne into the unit. When the second fire department ambulance arrived, at 4:20 am, Payne was dead.

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Unfortunately, this situation was not an anomaly. While the first four hours of the New Year may be one of the busiest times for ems, the under-resourcing of Philadelphia Fire Department’s EMS section has received extensive documentation during the past few years. It was an item in my first column here, Walking the Fire-Based EMS Talk : http://firegeezer.com/2007/07/24/walking-the-fire-based-ems-talk/

Need at least 20 more ambulances

On December 20, 2007, City Controller Alan Butkovitz released an audit report “Emergency Medical Services: Strained Resources Creating Major Impediments to Quick Response Time.” You can download a copy of the 54 page, 2,133 KB Adobe Acrobat report by clicking here: http://www.philadelphiacontroller.org/page.asp?id=242 .

This report validated the statements made in earlier reports by the media and IAFF. The transport workload has risen significantly in the past five years, even as the city population shrank. PFD ambulances handle up to 8000 responses a year, with 20% of the ambulances running above 100% capacity. To translate that statement, it means they are responding to a call every 45 minutes.

Where can PFD get the money?

While the audit report is powerful, it has no teeth. The city controller has no ability to change city budget priorities or change city policy. Incoming Mayor Michael Nutter pledged to make tax cuts. This is one of a series of audit reports issued by Butkovitz pointing out “gaping holes in service” in many of the city agencies. The city controller is advocating the fixing of city services before making tax cuts.

The fire department attempted to disband four engine and four truck companies in order to establish eight additional 12-hour paramedic ambulances in 2004. That effort was stopped by an injunction obtained by Local 22. The injunction expired March 30, 2006. See this earlier column about Baltimore’s similar effort of fire-rescue roulette: http://firegeezer.com/2007/08/07/fire-medic-roulette/ .

EMS mutual aid?

Imagine a report of a structure fire in Philadelphia and there are no city engine companies available. There would be a call for mutual aid to get an “outside” engine company to respond to the fire. On the other hand, the city has refused to allow for-profit ambulance companies to cover the excessive 9-1-1 calls. Locals mention that the largest private service, American Medical Response, was run out of town. It took about two hours for Payne to die waiting for a fire department ambulance to transport her to a hospital. How long would she have waited if there was a back-up plan using private ambulance companies?

Mike “FossilMedic” Ward

Posted by fossilmedic on January 8, 2008 • Filed under: Administration & Leadership, EMS Topics, Funding & Staffing, Patient Management, commentary • Tagged: , , , ,

Nursing Is A Profession, Firefighting Is A Hobby and Paramedics Are Caught In The Middle

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He was a thirty-something probationary firefighter and I asked what his first career was. Turns out it was firefighting. He spent over a decade as a career firefighter in a large west coast fire department, rising to the rank of captain. Ailing parents brought him and his wife back to the east, where he spent almost four years getting to this point in his Virginia firefighting career.

He applied for a job at every fire department from Richmond to Baltimore. Over a year went by before he was hired by a moderate sized county fire department, where he spent a dozen weeks in recruit school. He finally was hired by the largest northern Virginia fire department where, two years after graduating from one Virginia recruit school, he is starting a second recruit school … that will lead to the same Virginia certifications he already earned.

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Meanwhile, his wife had no problem obtaining immediate employment as a registered nurse at a hospital. It is this staggering lack of career mobility that leads me to label firefighting as a hobby. One of the speakers at last week’s National Association of EMS Educators reminded me of this “recruit.”

The speaker started as a registered nurse from a diploma school in Los Angeles. Hospitals and health departments ran vocational registered nurse training thirty years ago. He also became a National Registry EMT-Paramedic. Because his ambulance agency worked in both Ventura and Los Angeles, he had to maintain paramedic certification from both counties. Moving to another state, he had no problem with his registered nursing credentials, but needed to take a “paramedic refresher course” and sit for a state paramedic exam, even though he already held a national registry EMT-P certification.

Nursing, firefighting and ems have moved forward since the 1960s, but with significantly different outcomes. Since 1996 the vocational registered nursing diploma programs were edged out by community college associate degree programs. Nursing leaders are advocating replacement of the associate degree with the bachelor’s of science as the minimum academic level for a registered nurse. Regardless of how you earned your registered nursing credentials, RNs are able to move throughout the country without needing to re-qualify because of a geographic change. The same is true for most professions.

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Since the 1966 Wingspread conference, the fire service has talked a lot about professionalizing the career. Some notable accomplishments are the NFPA 1000 Professional Qualification standards, Degree-at-a-Distance undergraduate program, expansion of the American Council of Education accreditation of selected programs, Chief Fire Officer Designation [http://publicsafetyexcellence.org/ ]and the Fire and Emergency Services Higher Education model curriculums [http://www.usfa.dhs.gov/nfa/higher_ed//feshe_direction.shtm ].

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Unfortunately, entry to fire department employment remains restricted to the bottom and top of the organization chart. It is telling that both of the Harvard University three-week summer programs provide no academic credit, either for fire chiefs or union leaders. The $11,000 programs provide an intense and valuable experience for the attendees, taught by Harvard University faculty. The university has not provided a mechanism to award academic credit for these programs.

EMS started as a Department of Transportation vocational training program thirty years ago. By 2009 it will reflect the nursing model, moving into the scope of practice model. We are about two-thirds through this change, with the release of the second draft of the National Emergency Medical Services Scope of Practice Educational Standards draft next month.

There will be four levels of ems provider: Emergency Medical Responder, Emergency Medical Technician, Advanced Emergency Medical Technician and Paramedic. Deb Cason, an EMS program director for the University of Texas Southwest Medical Center, is the project leader. This link takes you to a 13 page, 1.2 Megabyte .pdf handout of a presentation Professor Cason made about the program and process: http://www.dshs.state.tx.us/emstraumasystems/Cason_DevEduStandards.pdf

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The comment period for the second draft will close January 2008. Go to http://www.nemses.org/ to review the standards and provide feedback. There will be a stakeholder’s meeting in February 2008 in Washington DC. The NHTSA contact calls for the submission of the final EMS Scope of Practice by August 2008.

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One of the challenges with the incoming EMS educational standards is the requirement that the person in charge of a paramedic training program have a bachelor’s degree. I was surprised to learn that some directors of the 400+ paramedic training programs have yet to achieve an associate degree, much less a bachelor or graduate degree.

The EMS Scope of Practice provides an opportunity for 50,000 practicing paramedics to have the same professional mobility enjoyed by 2.7 million registered nurses. A pity is that the fire service is farther along the professional path, yet may never provide the same type of professional mobility to the 350,000 people who make firefighting their career.

Mike “FossilMedic” Ward

Posted by fossilmedic on September 25, 2007 • Filed under: Administration & Leadership, EMS Topics, Funding & Staffing, Training & Development, commentary, culture, education