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Interpreting the Cost of Duplicated Services in Southern Nevada

When somebody reported a man possibly having a stroke at the Palazzo recently, the Clark County Fire Department sent help. So did a local ambulance company.

A rescue unit from Clark County Fire Station 18 quickly arrived, joined moments later by the ambulance. Fire Department medics hurried in, examined the patient and brought him on a gurney into the hotel driveway. They helped the ambulance crew load the sick man, and within 10 minutes of the first unit's arrival, he was on his way to a hospital, an ambulance company paramedic riding beside him and monitoring his vital signs.

Over eight hours that Saturday, paramedics and emergency medical technicians from the station rolled six more times for medical calls, including a person asleep in the UNLV library who was incorrectly reported to 911 as "unconscious," and two others in which the principal problem appeared to be excessive consumption of alcohol or recreational drugs.

In each case, the Fire Department sent at least one paramedic and one emergency medical technician. In each case, the ambulance company sent at least one paramedic and one emergency medical technician.

Sending four highly trained specialists and two vehicles to virtually every 911 call for emergency medical service provides plenty of help to the victim, agree people on both the publicly and privately funded sides of the effort. Nationally, "dual response" is a popular model, and the variation in Las Vegas is said to be especially good.

But it's so expensive that some members of a task force charged with finding ways to rein in county spending suggested outsourcing the Fire Department's part to private ambulance companies, so taxpayers could quit paying the bill and the patients' insurance companies could cough up. In the other direction, North Las Vegas Fire Chief Al Gillespie has proposed that his men take over transport for the most urgent medical emergencies and bill for the service. The Las Vegas Fire Department has studied a similar option.

Estimating the potential cost savings of a different method is difficult.

But about that expense: For weeks after the Las Vegas Review-Journal requested information about the cost of emergency medical services, or EMS, Clark County officials stalled, and they still have not answered in detail.

Scott Allison, the county Fire Department spokesman, said, "The department does not separate costs" in a manner that would allow the cost of medical calls to be extracted. "All of our fire suppression personnel respond to any and all emergency calls," which he said could include fires, swift-water rescues, vehicle extrication, hazardous materials incidents and medical calls.

Fire suppression personnel are 651 of the department's 814 total. County spokesman Dan Kulin said the total wages and benefits package for fire suppression employees was $115 million last year.

Allison said 72 percent of the 122,111 calls the department answered this past year were medical.

From that a taxpayer could calculate the cost of firefighters responding to medical calls at $82.8 million -- 72 percent of wages and benefits for those personnel -- in unincorporated Clark County alone. In 2007, the last year for which the county has provided complete payroll data to the Review-Journal, the average employee of the Fire Department was paid some $113,000. (The head of the local ambulance company said his paramedics, who must be trained to the same county-established standards as Fire Department paramedics, are paid about $60,000 a year.)

Read More, Both fire and ambulance crews answer the call in Southern Nevada

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