Hear It: Long Beach Fire Chief Mike DuRee Tells Council Why He Believes Proposed Budgeted Paramedic Staffing Change -- One Paramedic + One EMT (Instead of Current Two Paramedics) -- Will Improve Patient Care & FD Response ("Rapid Medic Deployment")
|(August 16, 2012, updated Aug. 17) -- At the August 14 City Council meeting, LB Fire Chief Mike DuRee told the LB City Council that a change in LB's paramedic staffing system -- one paramedic + one lesser trained Emergency Medical Technician instead of the current two paramedic response but with a paramedic on every engine -- included as part of the city management/Mayor proposed FY13 budget will improve patient care and response in Long Beach.
It was the first extended public description by LBFD of the proposed change, which Fire Chief DuRee (chosen for the position in early July by the City Manager) refers to as "Rapid Medic Deployment."
The LBPD management-sought change was first reported over a month earlier on July 11 by LBReport.com, when we learned that in or about April/May, LB city management (under Fire Chief Alan Patalano, who subsequently retired) had quietly approached the Los Angeles County Emergency Medical Services Agency (which coordinates emergency services countywide) about the possibility of Long Beach cutting its number of paramedics on a responding apparatus from two to one, replacing one of the paramedics with a lesser-trained Emergency Medical Technician (EMT) as a cost-saving measure.
Los Angeles, Orange and Contra Costa Counties require all cities two deliver two paramedic responses but all other CA Counties let their cities use a 1+1 system in which one paramedic and an EMT respond. Paramedics have roughly 600 hours of training, a higher level of medical knowledge with a broader scope of practice than EMTs who have about 120-160 hours of class. For decades, the L.A. County Board of Supervisors has required cities to have a two-paramedic system to participate in the countywide Advanced Life Support system, ensuring that two paramedics respond on whatever apparatus brings paramedics to a patient.
When the City of Los Angeles proposed a similar cut in paramedic staffing in roughly 1997, it created sufficient controversy to prompt L.A. City Hall to withdraw it. To date no L.A. County city has moved to test it on its residents. Long Beach is L.A. County's second largest city (behind Los Angeles).
On August 1, 2012, the proposed change was included in the management proposed budget released by Long Beach Mayor Bob Foster...and the Mayor cited it with approval among his written budget recommendations at the time: "The Fire Department has proposed a new way to deliver core services more efficiently at lower costs -- and achieve faster medical response times. I wish I could tell you it is a radically new idea; it is not. This service model is in place in Ventura, San Diego, San Bernardino and Santa Barbara counties -- and has been for years. And since 84% of all the calls for service in Long Beach are for medical response, this one change is emblematic of delivering improved service levels at a lower cost."
The proposal wasn't brought to or approved by the Long Beach City Council prior to city management appproaching the L.A. County agency on the matter. By including the item in its proposed FY13 budget, city management and the Mayor have effectively made the Council's upcoming budget vote (and any related motions due by September 15) the only Council voted actions scheduled to date on the matter.
However, the change in paramedic staffing can't be implemented in Long Beach without the County's approval. At the August 14 Council meeting, LB Fire Chief DuRee said (more than once) that his discussions with the County Emergency Medical Services Agency staff lead him to believe that the agency will ultimately approve the proposal and could do so within ten months. Under questioning by the Council, Dir. of Financial Management John Gross acknowledged that city management plans to use one time funds to maintain the current two-paramedic response system during FY13 while the City awaits the County agency's decision.
Mayor Foster and city management scheduled LBFD's budget presentation at the same 5 p.m. Council meeting as budget presentations for Police, Parks & Rec and Libraries. Management began its presentations at approximately 6:25 p.m. which ran until about 7:15 p.m.; Council questioning and management responses ran until approximately 9:15 p.m...and only then did Mayor Foster allow public testimony, limited to three minutes on all four departments.
At about 10:00 p.m., Tony Mejia, a VP in the LB Firefighters Asssociation spoke. To hear his remarks, click here.
The next day on August 15, the L.A. County Emergency Medical Services agency discussed a draft prepared by the County agency's staff on policies that would apply to any L.A. County city (obviously including LB) that requested permission to implement a 1+1 type system. (LBReport.com provided LIVE coverage of the meeting, with video now available on demand). The County agency's draft proposal drew opposition testimony from representatives of the LB Firefighters Association, as well as L.A. County and L.A. City firefighter unions.
To our knowledge, the City of Long Beach has yet to submit its plan in writing to the County agency (presumably as a "pilot" project). An L.A. County Emergency Medical Services Commission would then hear the proposal, allow public input and discuss the matter before making recommendations on the policy.
Developing...with further as we learn it on LBReport.com.
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