FD billing EMS for crash response?

[Doczilla]

Got to take this one to the quorum here.

The FD that covers part of the response area for one of my EMS agencies (government 3rd service, unaffiliated with the FD) and the city in general is a bit strapped for cash. For the past few years, the FD has made moves to try to take over EMS for their piece of the pie, believing that the revenue from billing will help some of their financial woes. They have had the support of several in the city council as well. EMS performance has been great, and part of the reason this change hasn't gone through is that the constituents are overwhelmingly happy with the EMS agency (95% satisfied in recent survey). In fact, when they tried to push through the change, the council hall was packed with angry voters. The council and manager see this as a way to reduce spending.

At present, the FD does not do first response on medical calls, and does not require EMT certification for their firefighters. They used to do first response, but the chief decided that this was not a FD function, and ceased the practice. The relationship between line personnel is very good, and many of our employees are also firefighters for the FD. Recently the FD has stopped going to MVCs that don't involve some kind of rescue function or fire. The city manager and one city council member have argued that trucking out a large fire truck just to block traffic on the interstate is not a FD function. They have proposed that every time they do that, the EMS agency should be billed by the fire department.

I personally believe that having the fire truck there serves more function than blocking traffic, and I've stated as much to the interested parties.

I want to steer clear of the whole fire-based EMS debate here, as I think that is a separate issue. The questions I have are these:

1) Does anyone else work at an EMS agency that gets billed by the FD for responding?

2) Is there legal precedent or IAFF policy recommendations that state that crash response is a FD function?

'zilla

[spenac]

Wow. The council needs to realize that often times it is unknown whether extrication or other is needed so fire should be called. If they want to charge establish a charge to the owners of the cars involved in the wreck. Establish rates for just showing up, traffic control, extrication, putting wet stuff on hot stuff, etc.... and then bill the car owners and or their insurance. I can just see the lawsuit when a person burns to death when fire is sitting at the station because initial call did not mention fire.

[Richard B the EMT]

I have posited that it is always easier to stop responses than to start them in the first place.

[reaper]

If I was the EMS dept. I would find the funds to buy and stock 2 brush trucks. Train people in extrication and do my own rescue on scenes. Then tell the FD they are not allowed on scenes, unless it is a fully involved car fire.

Once the tax payers see that they are paying for a big FD, that does nothing. I could see the layoffs and cutbacks coming quick!

[spenac]

If I was the EMS dept. I would find the funds to buy and stock 2 brush trucks. Train people in extrication and do my own rescue on scenes. Then tell the FD they are not allowed on scenes, unless it is a fully involved car fire.

Once the tax payers see that they are paying for a big FD, that does nothing. I could see the layoffs and cutbacks coming quick!

Remember Doc asked for no EMS vs Fire. Thanks. Play nice.

[WolfmanHarris]

I can't confirm this one for sure as it's the product of the EMS rumour mill, but recently one of the town's in Durham region approached country council wanting to be paid for responding to EMS calls. Durham Region EMS (3rd service Regional Municipality) told them thank-you but in that case your presence will no longer be required at anything other than VSA's and MVC's. So far FD is apparently happy with the arrangement, but budget time hasn't come around yet and their decreased call volume hasn't been an issue.

I do not know of any area within my part of Ontario where FD is paid for their first responding by EMS. The cost comes out of their annual budget, which like any municipality, there's no bonus for having a surplus of at the end of the year.

[UMSTUDENT]

Got to take this one to the quorum here.

The FD that covers part of the response area for one of my EMS agencies (government 3rd service, unaffiliated with the FD) and the city in general is a bit strapped for cash. For the past few years, the FD has made moves to try to take over EMS for their piece of the pie, believing that the revenue from billing will help some of their financial woes. They have had the support of several in the city council as well. EMS performance has been great, and part of the reason this change hasn't gone through is that the constituents are overwhelmingly happy with the EMS agency (95% satisfied in recent survey). In fact, when they tried to push through the change, the council hall was packed with angry voters. The council and manager see this as a way to reduce spending.

At present, the FD does not do first response on medical calls, and does not require EMT certification for their firefighters. They used to do first response, but the chief decided that this was not a FD function, and ceased the practice. The relationship between line personnel is very good, and many of our employees are also firefighters for the FD. Recently the FD has stopped going to MVCs that don't involve some kind of rescue function or fire. The city manager and one city council member have argued that trucking out a large fire truck just to block traffic on the interstate is not a FD function. They have proposed that every time they do that, the EMS agency should be billed by the fire department.

I personally believe that having the fire truck there serves more function than blocking traffic, and I've stated as much to the interested parties.

I want to steer clear of the whole fire-based EMS debate here, as I think that is a separate issue. The questions I have are these:

1) Does anyone else work at an EMS agency that gets billed by the FD for responding?

2) Is there legal precedent or IAFF policy recommendations that state that crash response is a FD function?

'zilla

Doc,

Hopefully I can provide some answers and potential solutions to take to your local elect-tards.

1) I work for one service that is 3rd service, private not-for-profit that works in cooperation with several volunteer fire departments and one large municipal service. At my other job I work for the fire monkeys...

While I have never encountered a fire department that bills EMS for service, there is a potential solution to take to your local council. Fire departments can bill auto insurance companies for crash response and clean-up. Additionally, if they respond to a call on Interstate or Federal highways and perform extrication functions, they may receive reimbursement from the DOT. MVCs are probably the most lucrative types of calls for EMS and fire. Most plans provide anywhere from $500 or more right-off the bat to be provided to fire companies that respond to these types of calls. EMS organizations almost always receive 100% reimbursement under the patient's PIP (personal injury protection/policy).

2) There is no IAFF recommendation, since they're just a union. The NFPA (National Fire Protection Association) sets consensus standards for most types of fire response. Depending on where you live, your state's Occupational Health and Safety agency may be what is called a "NFPA state." Some states, instead of spending the millions of dollars necessary to develop their own administrative laws regarding fire response, may simply elect to follow, word-for-word, all NFPA standards. This essentially makes these consensus standards administrative law. I'm not sure if they have a guideline specifically related to MVC response, but it wouldn't surprise me. I'd look into this if I were you.

Irregardless of all of the above, it is 100% a recognized "good idea" to have fire departments respond on all forms of MVC. At the very least, simple accidents require an engine to respond for fire suppression (in case the car flashes over, or blows up with personnel inside). Most jurisdictions require that a "Class A" (large, structural firefighting engine) engine respond on calls found on major roadways (Interstate, major state routes) simply to block traffic. Fire engines provides tons and tons of steel between a 50 MPH car and working crews.

This whole situation is stupid and irresponsible. I can't imagine even the most redneck fire department around here EVER wanting to give-up their response to a motor vehicle collision.

[WolfmanHarris]

Not to mention on a roadway I want that engine as a blocker vehicle for me and everyone else on scene.

[Richard B the EMT]

An engine (pumper) company for road blockade? Not the (Ladder) truck company?

I guess it depends on what jurisdiction the incident being responded to is in.

[UMSTUDENT]

An engine (pumper) company for road blockade? Not the (Ladder) truck company?

I guess it depends on what jurisdiction the incident being responded to is in.

Yeah, around here the standard dispatch goes something like this:

1 Ambulance

1 Medic Unit (If Chase Car System)

1 Engine

1 Rescue Squad or Rescue Engine

In the metro systems you'll find ladder trucks or quints responding to MVCs, especially if they're equipped with basic extrication equipment.