California City Becomes First In County To Consider Private EMS - News - @

California City Becomes First In County To Consider Private EMS

Costa Mesa will try to become the first in O.C. to bring in private paramedics and to reduce the number of medics on each call.


FRANK MICKADEIT, Orange County Register | | Monday, February 28, 2011

Has the political outrage over public-employee unions and the desire to cut the cost to taxpayers reached the tipping point?

Events of the last week suggest it has - at the national, state and local levels. It's almost impossible to keep up: In Wisconsin, you have Democrats so afraid, they're willing to winter in Illinois. In Sacramento, a flurry of bills (albeit by conservative lawmakers) would severely curtail union bargaining power in this state.

And in Orange County, if there was ever any doubt that the tip of the spear was Costa Mesa, that can be erased with this tidbit Councilman Jim Righeimer gave me on Wednesday: The city will try to become the first in O.C. to bring in private paramedics and to reduce the number of medics on each call.

This comes a day after our Jon Cassidy reported that Costa Mesa firefighters paid for a study that shows fiscal justification for dissolving the city Fire Department and contracting with the Orange County Fire Authority.

Union leader Tim Vasin told me firefighters commissioned the study because the city had asked how it could cut costs and the union wanted to see how the public could best be served. Vasin was "a little surprised" that the study showed the city could save up to $3.7 million a year going to the OCFA.

I asked whether the union paid for the study - after the city declined to - because it fears the City Council will play hardball when their contract expires in 2014, and would rather flee into the relatively benign arms of the fire authority now. Vasin said, "No, I don't look at political issues 31/2 years down the road."

The paramedic move might change his thinking.

County Emergency Medical Services authorizes only 13 public fire departments to provide paramedic services in O.C. Private firms can staff ambulances, but they don't carry medics. The medics - and two must go to each call - are union firefighters and must arrive on city firetrucks and engines, which are driven by a non-medic union firefighter accompanied by at least one other non-medic firefighter.

Thus, in Costa Mesa, Righeimer says, at least four firefighters in a lumbering, expensive piece of fire apparatus, must respond to every medical call, even while private ambulance drivers are responding to the same call. It gets crazier, says John Moorlach aide Kathy Moran, who has studied this issue. Sometimes, the medics in a given city are at different stations when a call comes in. When that happens, two firetrucks and at least eight firefighters roll out.

If a victim has to be taken to the hospital, a medic then rides in the private ambulance, and colleagues in the fire engine follow and wait for the medic to complete the handoff at the ER. "It is a huge, huge expense," Moran says. She said the city of Orange is asking the same questions as Costa Mesa.

According to the county, nothing legally prohibits cities from hiring private medics who are fully certified. It simply has never been done. The two-medic rule, however, is policy and would have to be changed by the Board of Supervisors, Moran said. Then, a medic and a less-expensive EMT could go on calls.

The public-only, two-medic practice is apparently an Orange County anomaly.

"Fifty-seven other (California) counties have figured out how to do it, and we have to find out," Righeimer said.

The current city Fire Department contract doesn't allow the city to eliminate firefighters who are paramedics, but if the city can get the county rule relaxed, the city could bring in some private paramedics now and have the firefighter-paramedics do other tasks.

"The point to have the private ones in now is to get them into the system," Righeimer told me.

When I told all this to Vasin on Wednesday, it was the first he'd heard of it. His immediate reaction was that Costa Mesa residents aren't going to like it.

The city currently bills for paramedic services but if the patient doesn't have insurance or is a hardship case, the city doesn't try to collect. Private companies aren't so forgiving, Vasin said.

Righeimer responded that any contract with a private company would have to include the same policy.

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