However the non-elected Commission put off until its next meeting -- scheduled for July 17 -- a decision on whether to approve the first such requested change in the County -- being sought by Long Beach City Hall management -- which seeks to let one paramedic and a lesser trained emergency medical technician (EMT) respond on different arriving vehicles but with one paramedic assured on every fire engine, instead of the current Countywide requirement of two paramedics arriving on one vehicle.

Long Beach city management seeks a two year pilot program test of what it calls a "rapid deployment model" in which one paramedic plus an EMT respond on separate vehicles (with arrivals promised within three minutes of each other) and -- for the first time -- a paramedic assured on every fire engine. Long Beach Fire Chief Chief Mike DuRee has acknowledged that the proposal has a budgetary component (that he says would avoid the possibility of shifting from four to three firefighter crews, a move he opposes) and says the new paramedic system will be better on its merits and improve patient care.

The Long Beach Firefighters Association and a number of other firefighter associations in L.A. County oppose the proposed change, saying it will produce worsened patient care and outcomes and create operational problems. They have been joined by some hospital workers who say it will increase emergency room delays and create other bottlenecks. Two advisory Committees to the non-elected County Commission have reviewed the proposed rule; one recommended that it be rejected, another advanced it for Commission action on a split vote.

At the Commission meeting, Chief DuRee indicated that Long Beach sought to become the only L.A. County city to test the pilot program. Critics said this limitation would prevent comparison review and testing of Long Beach City Hall's claims by other cities. The rule as ultimately adopted by the Commission lets a small number of cities Countywide (including Long Beach) test pilot projects for a year, not two years sought by Long Beach City Hall. Prior to its split vote approving the rule change, the Commission voted down a motion that included a provision for analysis of the data by an independent third party.

A contingent from the Long Beach Firefighters Ass'n attended the meeting at the Commission's Santa Fe Springs headquarters, with three LBFFA representatives speaking in opposition to the rule change. LBFFA President Rex Pritchard told the Commission that the data points that would be used in the rule to measure the pilot program's effectiveness or ineffectiveness are flawed and won't adequately show the results for patients.

Among those speaking against the proposal was a representative of emergency room workers, who said the proposal would worsen "wall time" [time spent by paramedics waiting in ERs instead of being available for service on the street].

After voting to adopt the rule applicable Countywide, the Commission initially indicated it would take up the specific Long Beach proposal...but on returning from a quick break noted that the meeting had already extended beyond its scheduled 3:00 p.m. end time...and voted to adjourn before discussing the Long Beach city management proposal.

The net result is that Long Beach city management's proposal now isn't scheduled to reach the Commission for discussion and approval or disapproval until July 17. Chief DuRee indicated during the meeting that if the Long Beach proposal is approved, the City won't simply "flip a switch" and implement it overnight; it would be phased in over a period of time.

In August 2012, Long Beach city management and Mayor Bob Foster proposed the paramedic staffing change as part of their proposed FY13 budget, noting that similar paramedic staffing was currently used by most CA counties (although not in L.A. or OC). A Long Beach City Council majority approved a FY13 budget with sums to allow a transition to the pilot program with cost savings assumed from implementing the not-yet-approved proposal.

The City Council (motion by Councilman Austin) has subsequently voted to take a separate up-or-down vote on whether to actually implement the pilot paramedic change in Long Beach if the County agency approves city management's request to allow it.

LBREPORT.com webcast the County Commission meeting LIVE and now provides on-demand video below. Ambient audio was usable (floor loudspeakers) but less than optimal (requiring careful listening; you may wish to turn your computer volume up).

Developing with further to follow on LBREPORT.com.