If residents haven’t seen as many fire trucks on the streets responding to every medical emergency phone call, that’s because changes occurred last month to which emergency medical services calls firefighters now respond.
The issue came up publicly earlier this month when retired firefighter Randy Elliott told aldermen a recent reduction to the list of EMS calls firefighters go on, to save wear and tear on the trucks and equipment, is not meeting the mission of the fire department.
Elliott again spoke before the city council Tuesday night saying he was initially “disappointed” with the changes and now was “aggravated” about the issue.
Mayor Scott Eisenhauer sent information to aldermen and the media about the fire department changes after Elliott spoke Nov. 6 about the fire department’s response now for various calls.
In his e-mailed statement, Eisenhauer said Elliott’s suggestion is untrue that recent changes to the fire division response to EMS calls had been reduced to an unsafe level and that protection of the public is in jeopardy.
He said Elliott’s comments are based “far more on fear than on fact.”
Public Safety Director Larry Thomason said a list of possible response calls was pared down to 13.
Firefighters still will respond to heart problems and other life-threatening EMS calls, but for more minor calls, such as twice responding to a call for transportation for a pregnancy, won’t be happening any more, Thomason said.
Medix Ambulance Service remains the primary medical call responder.
Elliott said Tuesday night that he knows a policy is a policy, but he wasn’t speaking from fear, but facts.
He cited a Centers for Disease Control and Prevention survey about the leading cause of death being heart disease and the No. 1 symptom being chest pains. The fire department now will not respond to non-traumatic chest pains.
Elliott said the policy change will affect individuals’ lives.
If someone lives farther away from Medix than a fire station, firefighters could help the ill person if they would get there first, Elliott said.
Some firefighters are or have been paramedics and they also have Emergency Medical Technician training, he said.
Firefighters can save a life, Elliott said.
Elliott also said it doesn’t make sense for the fire department not to respond to unconscious persons or people with diabetic problems. These can be life-threatening issues, he said.
Thomason said he, with the fire command staff, analyzed which responses were appropriate for the fire division to respond, and based on training and resources, which responses the fire department could effectively provide medical assistance.
The new response call list went into effect on Oct. 1.
In reviewing the list, firefighters still respond to life-threatening medical calls, and continue to support Medix in providing life-saving assistance. According to Thomason, the recent changes in EMS dispatching for fire were discussed with the firefighters.
Dispatching a fire apparatus to all EMS calls was instituted in the city years ago to show activity in the fire service, according to Thomason.
“The intent, while well meaning, did not take into consideration advances in fire suppression training/requirements or the ultimate impact it could have on fire personnel physically,” Thomason said in a memo about the issue to firefighters.
He said after consultation with fire command, he made the changes in EMS dispatching for three important reasons: personnel safety, public safety and equipment preservation.
When an engine company responds in full emergency, the potential is there for an accident to occur and the public usually is involved, Thomason said.
Equipment also is getting older and while city officials continue to identify funding sources for upgrades, the city must maintain the current fleet for the purposes it was intended: the primary function of the fire service, fire suppression, Thomason said.
He said some of the fire calls people have heard are funny and can leave them scratching their heads.
A call in the early morning hours, a pregnancy, and an emergency response. On arrival, the caller is waiting at the curb with bags in hand. She called only for a ride to the hospital.
The original EMS dispatching list, which was prepared in 2010 by former Assistant Fire Chief Don Hanetho, was reviewed by command, Thomason reiterated.
Not all EMS dispatches were canceled, nor will they be, Thomason said. The current list addresses what are true medical-needs responses where fire could be a first-on-scene to stabilize. Also considered in the final list was the fact that once Medix is on scene, the patient is turned over to them.
Further, Thomason said there were no objections raised by Medix.
“Additionally you are aware of the status change to rescue. At a recent meeting with the regional coordinator, I and Assistant Chief (Larry) Jaggers learned for the first time the requirements attached to a licensed transport vehicle. Prompt declassification to non-transport was the only approach. To that end, the decision to man or not man the rig was one additional problem an incident commander will not have to deal with, especially during an alarm event.
“The most basic purpose of any fire department is to prevent loss of life and property related to fire incidents. Fire services are further responsible for enforcing building codes, promoting fire safety and conducting safety inspections. With these additional tasks and combined with larger amounts of training, interruptions for non-medical calls need to be eliminated,” Thomason said.
“We are now, and shall continue to be, at a stable level of personnel for fire suppression that can adequately staff each station house and equipment to perform the basic function,” he added.
Thomason said he believes the reduction of EMS responses will benefit each fire division member, will provide an additional safeguard to their well being and help maintain the fleet to the extent members and equipment are used for their intended purpose — fire suppression.
With the built-in monitoring by the assistant chiefs and duty captains to override any response potential, and always with the caveat for dispatchers that “when in doubt — dispatch,” the services by the division will be delivered in a timely, professional manner.
It was almost a year ago that the city council approved a Public Safety Revenue Committee recommendation to requesting proposals for fire division billing services for non-residents
Eisenhauer had said the city is capable of doing the billing itself, but nothing proceeded.
Thomason said there are insurance issues.It would have involved outsource billing for fire department recovery billing for emergency medical services and incidents to which the fire department responds that don’t involve city residents.
Thomason voiced objections to this proposal. Thomason favored the city’s finance department overseeing any billing of public safety services, not an outside company. A billing company would essentially be a collection agency and likely would use aggressive tactics to seek payments, he said.
He said the department could then have a bad image.