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By all indications, it appears as though the fire service finds itself at an all-time high of having to defend the fact that most fire agencies provide emergency medical services. Too often, we hear debates that negatively center on the fire service and our ability to deliver, work or perform in an EMS system.
Let's look at some myths and attempt to set the record.
MYTH 1: The fire service wants to get into EMS to save jobs because there are fewer fires.
FACT: This statement refers to the fact that fire calls continue to drop throughout the U.S. as a result of stricter building codes, improved fire prevention programs and materials being made of more fire resistive. Are these statements true? Yes and no!
Yes, fires around the nation are down as a result of various programs but, no, the fire service is not responding to EMS to "save jobs." To listen to some, the fire service just got involved in EMS recently! Fire services around the country have been providing a variety of medical services for many years. As an example, the St. Louis Fire Department started running medical calls in 1915 and New York City in the 1930s. Don't forget it was fire-based systems such as Los Angeles County, Seattle, Miami, Jacksonville, FL, and Columbus, OH, that were the innovators in establishing the delivery of advanced life support (ALS) on a scene instead of in a hospital emergency room back in the late 1960s and early 1970s. The television show "Emergency," which typified these programs, debuted in 1971 and it wasn't until 1973, two years later, that the EMS Act was signed into federal law.
True, fires are down. But are total run volumes down? The answer is a definite "no," according to U.S. Fire Administration (USFA) statistics. When one considers the advent of smoke and carbon monoxide detectors, more sprinkler alarms, manual pull stations and hazardous materials incidents, it is easy to see that fires are not the only scope of the fire service. Additionally, manpower and staffing should never be based on run numbers but on geographic area of coverage, response times and risk.
I also believe the fire service is more keenly aware of EMS issues because the paramedic/firefighters of the 1970s and 1980s are now becoming the chief officers of the 1990s. These new chief officers were the same paramedics in the 1970s and '80s who felt frustration when they wanted to do more and expand the scope of the fire service even more in the medical arena and were thwarted by an old-time chief who was set in his ways.
MYTH 2: Fire departments are not as economical when it comes to delivering EMS.
FACT: This theory was put to the test last year when Seminole County, FL, put out a request for proposals (RFP) seeking bids for providing emergency medical services. Seminole County Fire & Rescue, AMR and Rural/Metro all bid on the RFP. Seminole County Fire & Rescue chose to use a full-cost allocation model developed by the International Association of Fire Chiefs (IAFC) to show the true cost of providing EMS. AMR and Rural/Metro used the Arthur Anderson template developed by the American Ambulance Association to show that private ambulance services are more economical when it comes to delivering EMS.
In a quandary as to which was the true model for determining the economies of providing EMS, the Seminole County Board of Commissioners turned to the Deloitte & Touche accounting firm. The conclusion of Deloitte & Touche was that the full-cost allocation model used by Seminole County Fire & Rescue was the truer economic model of providing EMS. This was one factor used in the decision-making process when the board of commissioners voted to give the EMS contract to Seminole County Fire & Rescue. However, even if you accept the myth that fire departments are not economical, what is wrong with the fire service becoming more productive with an already standing army of trained personnel who are statically geographically distributed in a community?