Fire & EMS mergers, any advice?

[Reddfrogg]

I work for a third service EMS company in western Colorado. Recently the local fire district (mostly volunteer) has been interested in taking over EMS operations. The EMS company is a paid service, with some per-diem staff, and some full time medics and EMTs. Does anyone have any experience with merging an EMS service into the fire service?

I'm thinking at this point the structure of the EMS company would pretty much stay the same, but fall under the umbrella of the fire district. Presently the EMS company is funded by grants, fund raisers, and billing.

Any information or stories (good or bad) would be appreciated.

Thanks for your input.

[paramedicmike]

There are examples nationwide of the massive failures associated with fire taking over EMS. From the NYC*EMS/FDNY debacle to San Francisco and beyond. Some searching here in these forums as well as your friend Google will provide a whole bunch of information as to why the proposed merger is such a bad idea.

Do the residents of your community a favor and don't let this happen. You all will be much better off in the long run.

-be safe

[spenac]

What usually based on experience happens is fire also claims the EMS runs in order to pad their numbers, thus getting more money for fire. EMS then ends up getting less funds to operate. Sorry I am not trying to start a fire vs EMS fight. It is clear that these are to separate fields and combining does not benefit the patients that are EMS's priority.

[reaper]

If EMS is paid and Fire is volly, then why doesn't EMS take over the Fire Dept.? Would work out better that way!

[FormerEMSLT297]

DO NOT DO IT UNDER ANY CIRCUMSTANCES..... to quote Jay fitch an EMS system consultant who did a comprehensive review of the NYC-EMS system in the late 80's or early 90's ,,,, and he said this to me directly in a meeting when i asked about FDNY taking over EMS.... "Very few Fire Deptartments run a quality EMS system."

He went on to say in part that with the exception of Seattle, and he named a few others that i forgot, MOST FD's, are forced into EMS, and do not do it very well...

My personal experience with a "merger" I use the term HOSTILE TAKEOVER, is that it does not work ...

When FDNY took over and NYC-EMS DIED on March 16, 1996, the firefighters did not WANT to do EMS, but were forced into it, I was a 10 year Paramedic Lieutenant, on the Captains Promotional list, and i was told, "this will bew good for you, you can take to "promotional" exam for Firefighter."..... I was a boss, and a medic for 10 years, and Probationary FF was a "promotion" I DONT THINK SO......

Ask most FF's in any combo dept. and EMS is either a burden, annoyance, or punishment, no one wants to ride the medic unit, "we were paid to fight fires"......

Didnt work in NY, San Fran, DC, and there are tons of other depts that are having major problems with it.

[CBEMT]

I'm trying to figure out why a volunteer department is the one trying to make the takeover. Do they think that suddenly they'll have paid firefighter jobs?

[Just Plain Ruff]

I'm trying to figure out why a volunteer department is the one trying to make the takeover. Do they think that suddenly they'll have paid firefighter jobs?

I would bet that is exactly what they are thinking plus they can add the ems numbers to their volume and qualify for some nice new fire trucks, turnout gear and WMD preparedness stuff. GRANT MONEY BABY!!!

Your service needs to be the one incorporating Fire into the mix not the other way around. There will more than likely be new positions opening up soon, and not on the fire department.

[medic_texas]

Do you want your boss being a Fireman who has no interest, desire, or experience in EMS? What kind of leader would they be? Who would he side with if an issue came up? Who would he favor and promote when positions came up?

You, the EMS professional, would be a step-child of the fire department. You run more calls and bring in the money. The fire department will use that to boost their money coming in for new equipment, add personnel, and for grants. And what will EMS get out of it?

Nothing.. Especially if you're boss is a "fireman".

Worst idea ever.

[firedoc5]

I've seen it work well, Seattle comes to mind first, and I've seen it work with a lot of problems that eventually worked themselves out, and I've seen it fail miserably. So I'm not pro or con. Still haven't decided.

Luckily I worked on a Dept. that it worked out very well. In the late '70's there was only a private ambulance service, who I started out with in '84, and a Fire Dept. that ran rescue alongside of the ambulance service. It was when they started in advancing into EMT-I's and Paramedics, both agencies at the same time, that the Fire Dept. started to provide EMS for the city with the ambulance service doing the transport, sort of like the Johnny and Roy thingy. The ambulance service provided EMS to the county with Rural Fire doing rescue and back up.

It has been brought up from time to time for the Fire Dept. to start to transport by having a separate agency as a branch of the Fire Dept., but that would always get canned.

[emTpromises]

Reddfrogg, I don't have any experience regarding an actual merger, but I work in a fire-based EMS system. Large numbers of people wanting to become firefighters here become paramedics in order to get hired with the department; however, these are people who want to be firefighters, not medics.

Of course, there are some older medics in the system who are phenomenal and I love running calls with them and learning from them. Unfortunately, the majority of medics are just biding their time until they can get a spot on the engine. Their treatment is affected by this attitude.

We have issues with medics BLSing ALS patients because they just don't care. For example, protocol states that systolic blood pressure over 200 and/or diastolic bp over 100 is ALS--can't tell you how many times I've gotten a reading like this and had the medic or another firefighter redo the bp and claim that I was wrong. Later, show up at the hospital, take vitals again and have a nurse upset that we just brought a patient in BLS with a bp of 210/120.

Not sure how it will be in your area, but our ambulance company is contracted by fire, so it's in everyone's best interest to keep them happy. We are generally told not to question a medic's decisions; we are literally "gurney-jockies" here. If the dept. is unhappy with us, they can simply renew the ambulance contract with a different company. In order to win the contract, our company must also keep expenses low, which is why we work 24 hour shifts here at $8.00/hour.

Bottom line: I don't recommend it.