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LBFD Data Shows Reduced-Cost Paramedic System Didn't Deliver Second Promised/Required Paramedic 95% of Time From Outset (July / August) As County Test Requires; County Agency Has Sought Improvement Plan; LBFD Mgm't Has Provided This Response


(Nov. 14, 2014, 10:45 a.m.) -- LBREPORT.com has learned that the Los Angeles County Emergency Medical Services Agency, which let the City of Long Beach test a less costly paramedic response system (in which two paramedics arrive on two vehicles instead on one) says LBFD's own data show the City Council-budgeted "Rapid Medic Deployment" system didn't meet the County-required test standard of a second arriving paramedic within three minutes of the first unit 95% of the time basically from its July inception through August.

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An exchange of correspondence, visible on the County agency's publicly available website for its Nov. 19 Commission meeting agenda, the County agency cites LBFD's own CAD system data which show that while the County test requires a second unit (carrying a second paramedic) to arrive within three minutes of the first unit 95% of the time, this only happened 80% of the time in July and 83% in August. The second unit (carrying the second paramedic) arrived between 3-10 minutes after the first unit 19% of the time in July and 16% of the time in August. In both months, the second unit arrived more than 10 minutes after the first unit 1% of the time.

In September, correspondence from the County agency indicates it met with LBFD Chief Mike Duree and his senior management to discuss the matter, and ultimately requested a written improvement plan for implementation no later than Oct. 1, 2014. When that plan didn't arrive, the agency sent an October 22 letter seeking an improvement plan with an implementation date no later than November 15.

LBFD Chief Duree responded with an Oct. 28 letter in which he said that under RMD system, the first Advanced Life Support units have arrived 50 seconds faster; Paramedic Assessment Units have increased 9-17. Chief DuRee's letter says the 95% arrival time for a second paramedic isn't required for any L.A. County agency...and argued that a better metric for assessing the RMD system is to compare how quickly two paramedics arrive now compared to before RMD. Measured by that metric, Chief DuRee said arrival time for two paramedics has improved on average by 1:04 seconds.

In his Oct. 28 letter to the County agency, Chief Duree says that as a plan for improvement, LBFD has added two peak load Basic Life Support [simple transportation ambulances], plans to add a third peak load BLS unit, is more closely monitoring dispatch data and has added a "Firestat" program enabling a more proactive approach to tracking response times.

"With the additional BLS units and Firestat reporting, we expect to se a better performance profile in the future," Chief Duree's letter to the County agency says. Chief DuRee cc'd his letter to City Manager Pat West. [It's not immediately clear if city management informed Councilmembers of the issue as it emerged in September and LBFD management's response to it in late October.]

Below are salient items from the exchange of correspondence. [We regret that graphs included in the correspondence reproduced poorly, a shortcoming we're working to correct.]

Correspondence b/w L.A. County Emergency Medical Services Agency and Long Beach re Paramedic system

Under Mayors Foster and Garcia, Council majorities approved testing the RMD system on LB residents and visitors as a cost-saving budget matter [avoiding an explicit recorded policy vote on the paramedic change.] The Council acted after holding a "study session" at which city management was allowed to speak at length in support of the RMD test while the LB Firefighters Association -- which objected to the plan from its inception and predicted it create unintended negative patient consequences -- had three minutes per speaker to respond.

As previously reported by LBREPORT.com, in brief remarks at the July 17 meeting of 3rd district neighborhood groups held by newly elected Councilwoman Suzie Price, Chief DuRee spoke extemporaneously and briefly and told the audience:

[The changed paramedic system has] been in place a week. We've had no issues whatsoever. The system is running seamlessly and across the board citywide, we're getting a paramedic to the scene of an emergency on an average over a minute and a half faster than we were before. [applause]

So, it's one week worth of data, folks...some laughter) We anticipate this trend continuing. We're consistently refining the program., It's only going to get better.

I just wanted you to know that rest assured, the Long Beach Fire Department is in good hands. We're still responding to calls. It's not a degradation of service in any way and it's moving just fine.

Chief DuRee has previously acknowledged the system is less costly but said it is a re-examination of an old L.A. Countywide model that hasn't been seriously re-examined for years and will be an improvement on its merits. The LB Firefighters Ass'n leadership has said the RMD test wasn't advanced to seek better patient care on the merits but for management/Mayor/Council budget reasons.

The L.A. County Emergency Medical Services Agency has allowed Long Beach to test the new system for two years but on terms adopted by the agency after considerable discussion and some controversy.

Further to follow on LBREPORT.com.




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