Californians STILL Take E.M.S. For Granted
(After All, What’s One Minute in an Emergency?)
Public comment submitted to Contra Costa County EMS in response to the Fitch & Assoc. Emergency Medical Services Report.
Originally submitted on May 2, 2014. Edited and posted on May 5, 2014. Author’s postscript includes excerpts from a discussion with Contra Costa’s EMS Director. NOTE: If you’re interested, the public comment period ends on 6 May 2014.
Lieutenant Governor Gavin Newsom once told me (I interviewed him when he was Mayor of San Francisco) that “Smart people can disagree.” Such inclusive words gave me permission to be a centrist, but I draw the line at skewering fire and police departments, or our nation’s emergency medical responders. They don’t ask a patient’s party affiliation before running into the house to save his or her soul from flames, heart attacks, strokes, Black Widows, falls in the shower, or—in my wife’s case—things going bump in the dark.
In Contra Costa County (where I work) and nationwide, Americans take emergency responders for granted. We treat cops, firefighters and medics as if they bleed less than molten titanium: these men and women risk everything for us yet we repay them with a kick in the mouth. As a local small business owner, I understand not wanting to pay more taxes; I can find great use for every dollar hiring people or paying my colleagues what they deserve. Measure Q’s failure was irresponsible and reckless, but that’s a debate for another time.
What taxpayers should not abide is a consultancy from Missouri being hired to write a report for our county [at a cost of roughly $200,000, including travel and expenses] — despite there being several EMS consultancies in our backyard—without disclosing its biases. In this document, published on March 24 and discussed at a town hall on April 10, Fitch & Associates recommends changes that could benefit a Colorado-based EMS agency (the largest in the U.S.) to the detriment of county services like the fire department, while potentially putting the public at risk.
American Medical Response, the county’s ambulance contractor, does wonderful work, and some among the company’s leadership have mentored my career. Still, it’s a for-profit public firm, so its profits comprise monies paid by county citizens (or their insurers) that are then sent out-of-state, away from our county and fire service despite the fact that Contra Costa could benefit from jobs and funds kept in-house, if only to stave off fire station closures during the worst drought of the 21st century (so far).
One troubling statement in the Fitch report comes on page 67: “Extending the response time requirements by 60 seconds would result in $1.1 million in annual savings for the System’s emergency ambulance service providers.” They suggest authorizing longer response times to the scene of a crisis in order to benefit the county’s “emergency ambulance service providers”—which is American Medical Response…? Whose drum is Fitch banging, exactly?
Scandal alarms rang when the Los Angeles (City) Fire Department found that “average response times for turnout and travel of Emergency Medical Services (EMS) incidents have increased by 12 seconds citywide: from 4 minutes, 45 seconds to 4 minutes, 57 seconds.” (SOURCE: Los Angeles Times, 18 May 2012 and City of Los Angeles, Office of the Controller) Yet Fitch thinks a private firm offering emergency medical services to our county should extend its response times by a full minute in order to save a million-plus dollars.
I fail to understand why our county should be concerned with any private firm’s profit margins unless it also demands that the company cut the amount it charges us—especially when those profits are not destined to be returned to the county, and the same county’s fire department is so strapped for cash that Measure Q’s failure sentenced 10 of 28 stations to the guillotine.
Author’s Postscript: In a much-appreciated gesture, within one business day of receiving my public comment, Patricia Frost, Director of Contra Costa County’s EMS, personally contacted me to be sure that I knew the Fitch & Associates report is still a “draft” until June 3rd, 2014. (On that date it will be submitted with recommendations to the Contra Costa County Board of Supervisors.) The following are key excerpts from my ~20-minute discussion with Ms. Frost, who stated that she knew I would be publishing this op/ed:
- “Any savings from improving efficiencies are designed to be reinvested [in the county’s emergency services system].”
- “The important thing to understand that we’re [Contra Costa County] working with Fire first response, Law Enforcement first response—including bystander first response—until the ambulance gets there. Those people [Fire, Law Enforcement and bystanders] typically get there faster [than ambulances]. The ambulance is typically deployed at the same time, with fire getting there a few minutes ahead of time, hopefully, and [the] ambulance shortly behind — that’s basically the bridge…you could build a system when you would have very quick ambulance response but then fire wouldn’t have anything to do, but that’s not a good situation because that reduces your fire capability.”
Clarification / Augmentation (5/6/2014): Ms. Frost contacted me to request that her statement be clarified as follows, to better align with her intent: in light of the short time periods associated with emergency activation, “Fire would have [a] limited period of time to fulfill its important role as a first medical responder.”
Jonathon S. Feit, MBA, MA, is Co-Founder & Chief Executive Officer of Beyond Lucid Technologies, Inc, the Concord, CA-based developer of MEDIVIEW™ — the most robust electronic patient care record platform and Prehospital Health Info Exchange for Fire & E.M.S. agencies nationwide. He is also a member of the National Press Club. The opinions expressed are solely those of the author. They may not — and should not be taken to—represent the views of Beyond Lucid Technologies, its employees, directors, clients, or partners.
