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California Paramedics, EMTs Frustrated Over Staffing Change

LONG BEACH - It was a typical busy night in Long Beach.

At one end of the city, a woman got into an argument in a 7-Eleven on Long Beach Boulevard, and firefighters were called to assess her health.

Before fire fighters from Station 3 returned to the firehouse, they were dispatched to a location blocks away, on Earl Avenue, where a woman was threatening to kill herself. A paramedic and emergency medical technician duo examined her, put her on a stretcher and took her to a hospital.

Firefighters say such calls illustrate how sworn firefighter paramedics are being tied up with non-life-threatening situations that could be handled by civilian EMTs under an experimental new staffing model. The Long Beach Firefighters Association says the change could potentially lead to slower response times for more critical calls requiring a highly trained medic.

A system called Rapid Medic Deployment, the culmination of 2 1/2 years of discussions, is the first of its kind in Los Angeles County. The Long Beach Fire Department put the two-year pilot program into effect July 10 in the hopes of saving $1.4 million.

Other area agencies, many of which, like Long Beach, have faced tough budget decisions in recent years, are closely watching to see if the new model is an effective way to trim costs while delivering residents the same level of service.

Just one month in, the system is being criticized by paramedics and EMTs.

The firefighters association says its chief concern is that when an ambulance is called out to a critical situation, a paramedic will arrive with a civilian EMT, who is less expensive but also receives less training.

"Our guys feel nobody cares," said Long Beach Firefighters' Association President Rex Pritchard.

"They feel the only ones that care about the service is us."

At the same time, EMTs say the department's increasing reliance on them is putting them into life-threatening situations for which they have neither the proper training nor equipment, and the union representing them has filed a grievance with the state Public Employment Relations Board.

Fire Chief Mike DuRee says Long Beach residents are, in fact, receiving better service under the Rapid Medic Deployment system. DuRee said the average response time to an emergency has dropped, and the most urgent calls are seeing the first paramedic on scene a minute faster on average compared with last year.

Paramedics typically spend 22 minutes in hospitals, no different than in the past, DuRee said.

The average response time to a 911 call is 4 minutes and 51 seconds, and for critical medical calls, the first paramedic arrives in 5 minutes, DuRee said.

While there may be some anomalous hiccups as the system is rolled out, it's too soon to determine the system's effectiveness, he said.

"The point we're trying to make is, it's a pilot program," DuRee said.

"It's basically created on a hypothesis. Could we engage in an alternative staffing model in this city that is equal to or more effective than the one we had before?

"So far, what we're seeing with the data is that it is equal to, and in some cases more effective than, the program we had before - and at the same time we're saving money."

The new model is a hybrid staffing model with one sworn paramedic and one civilian EMT responding together to a variety of calls. Previously, two paramedics would respond to the most urgent calls, and civilian EMTs would respond to less pressing matters.

DuRee said the new model frees a sworn paramedic on a fire engine to respond to the next emergency instead of having two sworn paramedics take someone to the hospital.

EMTs cost less but have less training and in-the-field experience than paramedics.

"The thought was, 'Why do I need (a paramedic) to drive the ambulance to the hospital when I can place him on a fire engine so that he can run another call for someone who may have a critical need, and I can replace the driver of the ambulance with a lower cost EMT ambulance operator," DuRee said.

The vast majority of the department's calls are for medical issues, not fires, according to LBFD statistics.

But in its grievance filed with labor baord, the EMTs' union says their employees are being asked to do more than what is in their normal scope of work.

The union says EMTs are being put in the same perilous situations that firefighters face without protective gear or training.

"Under this plan, on any kind of a fire scene, they are on the fire ground (in the area of a fire) assigned to the battalion chief. They are now in a life-threatening situation that they wouldn't normally have been involved with," said International Association of Machinists and Aerospace Workers business representative Dave Sterling.

"It's like taking a private security officer who is trained to observe and report and putting them in a black and white (police) car with blue and red lights ... without the tactical equipment to handle that job."

They also don't receive the same benefits firefighters have; should they suffer an injury, they wouldn't have the financial protections granted to firefighters, Sterling said.

DuRee said civilian EMTs are not asked in emergencies to do anything they wouldn't normally do.

"We don't want them to function outside their scope," he said.

"We want to be very clear they're not to function in an (immediately dangerous to life or health) environment."

Deputy Chief Dave Segura said having EMTs on the scene of a fire creates added structure at the scene away from danger.

"There is a benefit to having these folks medically ready," Segura said. "I don't want you engaging in any fire fighting activity. I want you to stand by, medically ready, for either the civilian or firefighter that gets hurt."

Although the department and firefighters are at odds over the new program, both sides say it isn't affecting the responders' ability to work together.

"I want the people in the community to understand that the men and women who go to work everyday and put on the badge of firefighter in Long Beach are consummate professionals," DuRee said.

"When the bells go off they respond quickly. They deliver their service in the same world-class way we always have."



562-243-3419 or lwilliams@lbregister.com



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