Currently, every L.A. County city (likewise in Orange County) must provide two paramedics on a single responding unit...although most CA Counties don't require this. As previously reported by LBREPORT.com, a rule change adopted by the non-elected L.A. County agency in May lets other L.A. County cities apply to conduct similar pilot tests, spurred by Long Beach city management's desire to do so.

In Long Beach, the change would for the first time put a trained paramedic aboard responding fire engines while producing a cost saving but cutting the number of available ambulances citywide from 13 to 11.

LBFD Chief Mike DuRee acknowledges that the new system, labelled a "Rapid Deployment Model," will save money but says that on the merits it will provide improved patient care in addition to for the first time assuring a trained paramedic on every Long Beach Fire Engine.

The Long Beach Firefighters Association has strongly opposed the change and says it will degrade the current level of patient care. The group's president, LBFD Engineer Rex Pritchard, told LBREPORT.com that he believes the new system will create serious problems and due to lack of resources will fail to perform as predicted. Pritchard says when that happens, the public shouldn't hold Chief DuRee responsible but rather Long Beach Councilmembers who invited the consequences by treating the public safety issue as a budget matter.

To date, the City Council, the city's policysetting body, hasn't taken an up-or-down vote specifically on implementing the paramedic change. Instead, the change has proceeded as a city management driven budget matter.

In July-August 2012, city management and Mayor Bob Foster included the proposed paramedic change in their proposed FY13 budget. In his budget recommendations at the time, Mayor Foster wrote: "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 Council approved the proposed budget -- with the paramedic change savings included -- in Sept. 2012 on 6-2 vote (Austin and Neal dissenting, Andrews absent). The Council's action followed a study session at which LBFD management presented at length (with Power Point) its rationale for changing the paramedic system while LB Firefighter representatives were given three minutes per speaker to respond at the public speakers podium.

However after an agendized March 12, 2013 update on the paramedic plan, the City Council voted 7-0 (motion by Austin and Neal, with Lowenthal and Andrews absent) to direct city management to bring the issue back to the Council before implementing the parademic change.

Following the County agency's July 16 vote, City Manager Pat West sent Long Beach elected officials a memo stating that the Councy agency had voted "to approve the Long Beach Rapid Medic Deployment plan in accordance with their previously approved policy" and "formally approved the Long Beach Plan" meaning LBFD "will begin working on the specific implementation plan with the EMS Agency and will bring the item before the Mayor and City Council for an update prior to implementation."

LBFFA President Pritchard says that's not quite so, since paperwork submitted by Long Beach several months ago varies in some respects from what the County agency has allowed, meaning revised papers must be submitted. Among other things, Long Beach city management sought a two-year trial but the County is allowing only a one-year trial. And the County agency included a proviso requiring cities seeking a pilot test to show that they have budget sums identified so that if the County agency withdraws its approval, money is available to reinstate the previous service level (to return to the two-paramedic system.) In addition, other protocols require revision, Pritchard said.

Aren't these remaining items relatively small? President Pritchard replied that the whole change will be a major one, and since the County requires that the city money have money put aside to reinstate the existing system, why not just keep the existing system, which isn't broken?

Long Beach Fire Chief DuRee, appointed in 2012 by City Manager Pat West, says L.A. County's current system has been in place without serious reexamination for decades...and notes that most California Counties already allow one paramedic plus an EMT -- without the assurance of a second arriving paramedic that Long Beach proposes. Chief DuRee has also said that without budget savings from the paramedic change, he would be forced to consider measures including reducing Fire Engine staffing from four to three firefighters, an action he does not favor.

The "Rapid Deployment Model" will increase the number of paramedic ambulances with advanced life support capabilities from 8 to 11 while reducing ambulances from 13 to 11 and reduce ambulance staffing from two paramedics to one paramedic + one ambulance operator Emergency Medical Technician. At the same time, a second paramedic trained firefighter would arrive on every fire engine, meaning two paramedics would be present at every medical response although they'd arrive separately. Fire Chief DuRee acknowledges the change would save money but has said it will mean better patient care at less cost on the merits.

The Long Beach Firefighters Association has consistently opposed the change and says it will mean degraded responses, worsened patient care and is very unwise in urbanized Los Angeles County. Following the County Agency's July 16 vote, LBFFA President Pritchard told LBREPORT.com:

"This is a big deal for us. We know there aren't enough units to sustain the proposed system. We'll be going from 13 ambulances to 11 with an increasing call load, so the Chief is going to have to say that they need more units to make the system sustainable, otherwise it isn't going to work."

Pritchard noted that while city management forecast a $2 million deficit for FY13 if the paramedic change wasn't implemented, City Hall is now completing FY13 with a balanced budget without the paramedic change. Meanwhile, city management is forecasting a surplus for FY14 but plans to cut 21 firefighters and 2 ambulances under the paramedic change.

So...what will the LBFFA do now?

"We'll urge the Council not to implement the paramedic change. Our position hasn't changed. We've been against this from the beginning."

And what will the LBFFA's political action committee do in the upcoming election cycle (Mayor and Council)? "We've never been a single issue organization. We take a whole system approach, but this issue is very important to us. It's a big one."