4 Vital Minutes : Outlying communities can’t count on timely emergency service. A new assessment district may be the only solution.

The acronym is EMS.

It stands for the emergency medical service which the city provides you and your family when you phone 911. Los Angeles Fire Department paramedics arrive on the scene to help you--fast!--most of the time.

Nearly all the 104 operating fire stations in the city were positioned to serve densely populated areas. In central parts of the city, fire stations tend to be closer to one another than elsewhere. Their normal response times are within the department’s goals.

However, if you happen to live in some areas on the outskirts of Los Angeles, say Hidden Hills, Sun Valley, Tujunga or the Pacific Palisades Highlands, or if your home is located in some of the hillside areas, paramedic help cannot get to you as fast as you may need it.

It is delayed because of long distances between homes and the nearest fire station or because of miles of winding roads in the hills.

Despite best efforts, in some parts of the city paramedic help is several minutes away, longer if the team closest to you is on another call.

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For the victim of a severe heart attack, a seizure, choking, a possible drowning or electrocution--one whose breathing has stopped--unless cardiopulmonary resuscitation is administered within four minutes, the chances of survival drop precipitously.

If six more minutes elapse, recovery is virtually out of the question.

The Fire Department and the city’s newly appointed Board of Fire Commissioners are aware of this problem. Faced with a severe shortfall in revenues in the coming months, the city’s budget constraints have indefinitely postponed any plans to construct new fire stations.

One solution that has been suggested is asking residents of the few areas at risk if they want to form special assessment districts. This idea is worthy of careful consideration.

If an area approved such a district, the plan would work roughly like this: Bimonthly charges would be added on water and power bills to residents. The money would be used to build, equip and staff new fire stations in those areas. The response to both fires and medical emergencies would be speeded up.

An objection to this idea has been voiced based on the assumption that paramedics in the district could not help people who live outside it but nearby.

That should never be the case.

The sharing of fire resources (including EMS) is an overriding and well-accepted rule in this region. We see it every time an emergency arises. We saw it happen in the fall brush fires. Firefighting units arrived on the scene from hundreds of miles away--even from out of state.

When a community has an emergency, nearby communities pitch in with whatever help they can reasonably provide. Emergency help should never be denied because of boundary lines, whether they be city boundaries, state boundaries or special assessment district boundaries. That should be agreed upon before a district is formed.

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We need to make the best of a difficult situation. No person should be deprived of fast, efficient medical emergency service when needed.

Since we cannot build additional resources without more revenues, and since a general tax increase is politically out of the question, some program of direct financial assistance to the city, approved by a majority vote of those living in underserved areas, should be considered.

Why not let those people who prefer the more open spaces or mountaintop views decide for themselves? I, for one, would welcome the chance.

One more step should be considered. That is referring many of the 60,000 non-emergency calls the Fire Department receives each year to private medical care givers, as our fire chief proposed a few days ago.

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I’m talking about such things as stubbed toes and splinters. They account for three-fourths of the runs made by our EMS teams. Turning them over to the private sector would save $6 million in the first year.

The fact is, we don’t have enough money, people or equipment at enough locations to respond to every call within four minutes.

As with national health care, EMS policy making is fraught with danger. There are always misunderstandings and misplaced expectations lurking about. Clearly there are political risks inherent in making any changes in the system.

The debate becomes a process of deciding which advantages are most important to the public and which disadvantages (costs among them) the public is willing to live with.

In the meantime, lives hang in the balance. It’s a growing problem that demands a solution--now.