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HomeMy WebLinkAbout04/21/2009 08 Firefighter/Paramedic Issue BUSINESS OF THE CITY COUNCIL YAKIMA, WASHINGTON AGENDA STATEMENT Item No. 8 For Meeting Of April 21, 2009 ITEM TITLE: Consideration of Firefighter /Paramedic Issue SUBMITTED BY: Dick Zais, City Manager Charlie Hines, Fire Chief CONTACT PERSON/TELEPHONE: Dick Zais, 575 -6040 SUMMARY EXPLANATION: Please see attached information. Resolution Ordinance Other (Specify) e l Contract Mail to (name and address): Phone: Funding Source APPROVED FOR SUBMITTAL: City Manager STAFF RECOMMENDATION: This is a council policy issue. • BOARD /COMMISSION /COMMITTEE RECOMMENDATION: COUNCIL ACTION: r' `L : ' 1 OFFICE OF THE CITY MANAGER _9 1, r 1 � 129 North Second Street ' ` � ` j CITY HALL, Yakima, Washington 98901 ® ` Phone (509) 575 -6040 • MEMORANDUM March 27, 2009 TO: The Honorable Mayor and Members of the City Council FROM: Dick Zais, City Manager RE: EMS Paramedic Issue In the aftermath of the failure of the EMS levy a number of concerns have arisen from Council members, the media and the public regarding the status of the paramedic issue within the fire department. In particular, there have been concerns raised about the direction given to the staff and approvals sought this past year with respect to the department's preparations for the submittal and potential passage of the EMS levy by the voters as well as a threshold question on whether or not there should be any form of paramedic assistance in the Fire Department in the future, within existing resources. We have researched the minutes of all of the Council Public Safety Committee meetings and Council Study Sessions on this issue. The meetings that were held provided background from the Chief and the Department on the issue. Many updates were also provided by the Chief during the course of the year on this subject. However, there was not an explicit, formal motion from 0 either the Public Safety Committee members or the Council itself which gave authorization and direction to the department or Chief to proceed with the approval and licensing process to enable the paramedic program to proceed should the levy be passed by the voters. What did occur in these meetings was a presentation from Chief Hines on the proposal and what it would take from other emergency agencies to prepare for such a program, together with a message from him that he would go forward with this process to be ready for the potential passage of the levy. In the absence of any formal direction, Chief Hines felt the Council Public Safety Committee and Council members overall were ok with him at least proceeding with the licensing /approval process, and took the initiative and acted in good faith to secure the needed Emergency Agency approvals and license to be able to start the program if the levy should pass. I supported the Chief in his efforts noted above to prepare for the passage of the levy. However, in hindsight, given the concerns and questions that have emerged, it is also clear to me that we should have asked the Council for more formal direction on the process that was pursued by Chief Hines to secure the approvals and licenses from the respective emergency agencies that govern a paramedic program. Since the levy failure, and media coverage, together with communications from Council members, the Chief has endeavored to clarify and address this issue in several memo's to the Council. Clearly the rejection of the levy has eliminated the funds for both the start -up of the paramedic program and the resources to hire additional personnel for the department. However, there are lingering questions about this issue for the future which need clear policy direction from the Council. This is the purpose of the EMS discussion at the City Council meeting on 0 April 7, 2009 and for which the attached information packet has been prepared for your review, and policy direction. Yakima heal r e 1994 Administration III Fire Suppression Fire &Life Safety .014 City of Yakima Fire Department (509)575 -6060 Division Fax 509 576 -6356 Investigation a 401 North Front Street, Yakima, WA 98901 ( ) Division t �►, Phone (509)575 -6140 (Investigation) www. yakimafire. com Training' ?, Communications 4� . S • Date: March 30, 2009 • To: Honorable Mayor, Members of City Council Cc: Dick Zais, City Manager From: Charlie L. Hines, Fire Chief Subject: MAXIMIZING YFD RESOURCES FOR EMS . • The result of the February 3, election made clear that a sufficient majority of the voters participating in that election did not support an increase the EMS levy to hire 12 firefighters and provide that up to 18 department firefighters also be trained as certified paramedics. Though much can be said about what led to the outcome of the election, given the result, the concerns which prompted the City Council to•place the EMS measure on the ballot remain unabated. • With respect to the central and most costly aspect associated with the levy proposal, that being adequate coverage through the hiring of 13 FTEs (12 firefighters and 1 dispatcher), the outcome of the election effectively eliminates additional EMS funding as a means by which the City could address the .problem. As an agency tasked in large part with providing emergency medical - services to members of our community who are in medical distress it is appropriate now to assess and consider options. Without significant additional funding to the department, addressing the coverage issue is not • possible. However on a very small scale, conditions are such that there exists an opportunity with respect to the enhancement of emergency pre - hospital care to community members in need of such services. In considering this opportunity the benefits must be weighed against any costs, even if nominal. . As you are aware, two Firefighters are also certified Paramedics. This presents us an excellent opportunity to maximize our resources. In addition, this will ensure that a Paramedic gets to the patient faster, regardless if they arrive by private ambulance, or fire engine. This is critical to the survivability of those citizens who are in acute medical distress. From a cost - standpoint, this proposal would be very cost effective; in fact all costs anticipated III with this proposal can be easily absorbed within the current EMS budget. • 110 One Time Start-up Costs • Monitor/Defibrillator, charger, extra battery, carrying case $20,000* • Equipment/Meds $5,000* • Miscellaneous (double lock safe, storage unit etc.) ...$5,000 Annual Costs for Two Firefighter/Paramedics • Replenish equipment/meds $3,000 • Skill pay (negotiated) per yr. x 2 ** ...$5,000- $7,200 * Medical Salesperson just called me this morning stating that their original quote was too high. They will be sending a revised quote (seems like they are anxious to make a deal). ** This proposal is to allow our two certified Firefighter /Paramedics to administer their life- saving skills on our citizens. There are currently no Firefighter openings in the YFD. Typically, one or two Firefighters retire per year. A recent survey indicated that no one is planning on retiring in `09 or `10. There are not sufficient funds currently in the budget to hire any additional personnel. Consequently, YFD is unable to send any Firefighters to Paramedic school. Each Firefighter /Paramedic will be assigned to an engine company on a different shift. They will share the same Paramedic equipment (similar to the way they share air packs, hose, axes etc.). All projected costs with this proposal can be absorbed within the current EMS budget. As you recall, EMS funds are restricted to EMS services, and as such are separate and apart from the city's general fund. The public benefit of utilizing the advanced life- saving skills of the two Firefighter /Paramedics on staff will be apparent at each incident to which one of these employees responds where these skills are required, particularly at events where the YFD engine is the first to arrive or multiple casualties exist. This will significantly improve the chances of survival of those residents to whom a YFD Firefighter/Paramedic responds. This is an example of increasing efficiency and delivering better results to the customer (tax payers) without increasing taxes. • With all other approvals obtained, and the question of funding from additional EMS levy revenues decided, the only issue to decide is the use of the two Firefighter/Paramedics, and within that issue there are but two alternatives: 1. Utilize and maximize all available resources by allowing our two Paramedic certified Firefighters to administer their life - saving skills on our citizens. This will significantly improve the chances of survival of those residents to whom a YFD Firefighter/Paramedic responds. OR 2. Require that the two certified Firefighter/Paramedics on staff refrain from administering life- saving paramedic skills to patients during critical emergencies and instead, wait for the ambulance to arrive. As a 33 year Fire Service professional (13 as a Paramedic) and your Fire Chief, I have a moral and ethical obligation to take advantage of all resources available to the department in providing the greatest possible benefit in terms of service to the public. I strongly recommend implementing the first alternative. • I will continue to evaluate and explore alternatives that will maximize and enhance our ability to efficiently serve the public; We are anxiously awaiting clarification and direction from the council on this important matter. 1111 r I Dc a+- {`as/0 9 Mee- Yakima City Council Meeting, April 21, 2009 Public Meeting — Item #8: Consideration of Firefighter/EMS issues Subject matter — Consideration of Firefighter/EMS issues NEEDS vs. WANTS NEED: Up to 12 more Firefighter/EMT's: There is no doubt that due to annexation our city has outgrown the present size of our fire departments personnel and that there is a definite need additional firefighter/EMT's. NEED: What to do with two (2) presently trained Firefighter/Paramedic's It is my recommendation that you find a way to keep both of the trained Firefighter/Paramedic's on staff and utilize their skills and training to better serve the citizens of Yakima. This, as our Fire Chief has already stated, he can do within his existing budget. NEED: A strong policy language that the City "SHALL NOT" vs. "WILL NOT" transport patients now or in the future without presenting it to the general public for input and/or vote. This is something that should be discussed with all parties prior to any policy writing. WANT: To have a Firefighter/Paramedic on every fire truck to give the citizens of Yakima the best possible emergency care when needed. This is a very good idea, but during these economic times is not feasible. It also needs to be discussed in more depth, given more time to digest, and a working relationship between our fire department and the private sector ambulance companies developed regarding paramedics, paramedic -in- charge (PIC) and transportation. I am in favor of the paramedic program, but it needs to be phased in. RECOIVIlVIENDATION: It is therefore my recommendation to the City Council that a- joint meeting between the City Council Public Safety Committee representatives, Fire Chief, and the two (2) private sector ambulance company representatives meet together to discuss /resolve these issues and report back to the City Council with a recommendation for final resolution. Discussion of facts presented... During many of the meetings held by the City Council I have heard the fact presented that the Fire Department is first on scene 50% of the time and that this merits consideration to train the fire department personnel in order to have a paramedic on every fire truck to better serve the citizens of Yakima., The 50% fact might be true, but I believe it to be only part of the facts. What seems to be missing are answers to the questions about delay. If either the fire department or the ambulance is first on scene, what is the amount of time before the other shows up? What about dispatch ? Does all or most of the emergency calls go through the 911 center and if so, who gets dispatched first? This can also have an impact on who has the advantage to be first. The Fire Chief is correct when he stated that the location of the equipment, fire truck or ambulance, plays a part in the response. So therefore, the 50% argument for or against might or might not have a play in resolving this part of the discussion. HISTORY: Basic First Aid training to EMT's to Paramedics Prior to 1972 the only requirements to be an ambulance driver /attendant was to be Basic First Aid trained. In 1972 the two ambulance companies, Sun Valley Ambulance and Yakima Ambulance together upgraded their staff to EMT's. This was done through their staff volunteering their time to train and study and by a request to the physicians and specialists volunteer their time and expertise to train us. Two of the physicians were heart specialist and surgeon Dr. Twist and Gynecologist Dr. Harrington, Sr. Arrangements were made with YVCC for a classroom and our training began. There were two ambulance companies and also a few firefighters that took this training. I was one of those first trained EMT's with Sun Valley Ambulance service and received my certification on May 9, 1972. Following that training, a few personnel continued to train and became the first paramedics in Yakima somewhere between the end of 1972 and the beginning of 1973. Since then, it seems that our fire department has trained all of its firefighters as EMT's and worked well the two ambulance companies in Yakima, who now have maintained paramedics on their ambulances. • The future for Yakima is in fact to have a paramedic on each truck and that needs to be done as resources allot themselves to attain this goal. It took over 30 years to get here today, it should not take another 30 years, but it also cannot be done immediately. Thank you, • William R (Bill) Duerr 3206 W Yakima Ave Yakima, WA 98902 -2765