Calif. Dept. Expands Ambulance Service, Saves Money

Feb. 03--Fire officials say the expansion of their ambulance services program yielded faster response times in 2012 and is projected to save the city $2.1 million next fiscal year.

The program -- which began Jan. 9, 2012, with four basic life-support ambulances working around the clock -- saw paramedic response times decrease between five seconds and roughly four minutes among the Fire Department's nine engine companies. Emergency response times improved when paramedics were moved from serving on ambulances to the city's nine engine companies, Battalion Chief Greg Fish said at Tuesday's City Council meeting.

"The sooner we can get to a person that's in a cardiac arrest or having a serious problem, we can administer oxygen; we can administer pharmaceuticals for pain management or for even recovery," he said. "That's going to make a huge difference in that person's survivability."

The average response time for two paramedics to arrive at an incident improved from 5 minutes, 49 seconds under the old emergency medical service model to 4 minutes, 45 seconds with the new program, according to a city report.

The Fire Department's move to boost its ambulance transport program grew out of a need to offset the loss of 21 firefighter positions due to budget constraints.

With the program's expansion, 60 emergency medical technicians had to be hired to work 12-hour shifts to avoid incurring overtime.

Fire officials said they have been focused on reducing costs, continuing emergency medical services to residents and maintaining staffing levels on fire engines.

As a result, Fish said the department has maintained four firefighters on all engine companies as well as providing four EMTs and two paramedics per call.

"We accomplished what we wanted to accomplish when we set out to take this [Basic Life Support] program on," he added.

Meanwhile, costs to run the program dropped from $7.3 million for the 2011-12 fiscal year to $6.84 million for 2012-13. Costs were projected to further decrease to $4.48 million for 2013-14.

At the same time, billing for emergency medical services has increased because the department is handling more calls, Fish said.

Emergency service revenues jumped from $4.74 million in 2010-11 to $5.44 million for 2011-12, according to the city report. While billing revenues have dipped slightly to $5.24 million, fire officials project that figure to increase to $5.52 million for next fiscal year.

"We really feel like we have contributed to savings in the budget overall," Fish said.

The Fire Department used general funds to pay for its paramedic/firefighters.

But with the new program, the amount of funding transferred from the city's General Fund to pay for the program is expected to be reduced from $2.1 million in 2010-11 to zero in 2013-14.

Depending on billing and number of calls, the Fire Department may even see a gain of $1.04 million next fiscal year.

"The residents of Glendale are the winners in this program," Councilman Ara Najarian said.

But while the program has shaved response times and increased billing revenues, it has struggled with a high turnover rate among ambulance operators.

The hourly, part-time workers don't have medical benefits, work about 30 hours per week and are often looking to be hired on as full-time firefighters with the department, officials reported.

The Fire Department, though, hasn't hired new firefighters in three years, Fish said.

Some ambulance operators, then, find jobs elsewhere and leave their posts.

Maintaining the 12-hour-shift work schedules for the ambulance operator position has also been challenging because the department is required to hire four of them to fill a 24-hour rotation, he added.

"We are really working our brains out to try to find a way to maintain staffing levels that are appropriate so we can staff our ambulances," Fish said.

Starting in 2014, the Fire Department faces the additional expenditure of having to provide medical insurance to its hourly employees under the federal healthcare overhaul law.

Copyright 2013 - Glendale News-Press, Calif.