Proposal Would Give Firefighters More Duties : Ventura: Plan would give department a chance to make money by taking over business from Pruner Health Services.
Ventura firefighters will unveil a proposal to the City Council Monday to take over paramedic services and private ambulance transportation.
Assuming paramedic duties and transporting patients would be a logical extension of the first aid they already administer and would be a way for the department to make some money, fire officials said.
But the move would siphon business from the private ambulance company Pruner Health Services, whose executives argue that firefighters need to worry about fighting fires, and that the proposal could cost taxpayers money and expose the city to more lawsuits.
“It’s questionable,” said Steve Murphy, chief administrative officer for Pruner. “We have a system that works very well, at no cost to the taxpayers. It’s all funded through insurance companies and users.”
If the proposal is approved, Ventura would be the first city in the county to enter the ambulance business.
A majority of the council members said they have not made up their minds about the issue but are open to the idea of generating revenue for the city.
Councilman Jim Monahan, who received political support from the firefighters’ union in his last reelection bid, said he is enthusiastic about the proposal. “If we’re the first people responding, we might as well get paid for it,” Monahan said.
Firefighters say they arrive first at 90% of medical calls. If responding firefighters were trained as paramedics, they say, patients would not have to wait for Pruner.
The department also wants to take over transporting patients to hospitals and get some of the money that residents currently pay the Thousand Oaks-based Pruner. Pruner officials say they charge base rates of about $300 for non-emergency transportation and about $530 for emergency transportation.
“We’re looking at it as a possible way of generating revenue, at equal or better service, and possibly at lower costs to residents,” Assistant Fire Chief Ken Hess said.
If the council endorses the Fire Department’s proposal, it may have to be approved later this year by county health officials and the Ventura County Board of Supervisors, who regulate emergency care in the county. City officials say it is unclear whether the proposal will have to go to the county for approval.
Hess estimated that the changeover would occur in July, 1995, if approved. Start-up costs, which have not been estimated, would include buying ambulances and hiring paramedics.
Pruner officials said firefighters endorse the idea only because paramedic-firefighters get paid more.
“There is not a medical need to change the system,” said Murphy. “We have a long track record of providing very good service. I’m dubious about government coming in and saying they can do this service cheaper and better.”
He said losing contracts to Ventura would be “a substantial financial blow” to his company, which serves most of Ventura County.
Under the current system, a resident who calls 911 for medical help will receive visits from both the Fire Department and Pruner paramedics. Most of the time, the Fire Department arrives first because it has six stations throughout the city, compared to Pruner’s three.
Firefighters administer first aid, including supplying oxygen and providing defibrillation treatment. A paramedic has more medical training and is authorized to dispense medication and can work directly with doctors.
After paramedics arrive, they take over the patient’s care and transport him or her to the hospital. Pruner bills the patient for service, and the firefighters’ services now are provided free.
County health officials said that from a medical point of view, the most important issue is initial response time.
“The thing to worry about is how quickly you will have medical personnel on the scene,” said Dr. Nat Baumer, who heads the emergency room at Ventura County Medical Center.
Dr. David Chase, the county’s director for emergency medical services, declined to speculate on whether firefighters or Pruner paramedics would be more effective because county officials may have to decide the issue later this year.
Chase said county officials probably will weigh such factors as response times, training, equipment, cost and personnel turnover.
“I think they both do a good job the majority of the time,” Chase said. “No matter who does it, it’s not going to be free.”
The Fire Department’s motivation in backing the proposal stems from the fact that the 75-member department is anticipating budget cuts this year, and fire officials say they are looking for ways to raise money for their department to avoid layoffs. Three firefighters are scheduled to be laid off in the next 18 months.
Fire officials said they do not know yet how much they would charge residents, but contend they could do as good a job.
David Hilty, president of the firefighters’ union, said firefighters frequently become frustrated waiting for paramedics to arrive. Only five firefighters in the department are paramedics, and fire engines are not equipped to transport patients to hospitals.
For the month of August, 1993, county health records show that the response time on 50% of Pruner’s calls was longer than eight minutes, Hilty said. Response time on three calls was 25 minutes, Hilty said.
“You’re doing CPR on someone for 25 minutes, and the family is screaming about when the ambulance is going to come,” Hilty said. “We’re already the first responders. Why don’t we just go in there and do the whole enchilada? They travel and they get the profits.”
Murphy said average response time in Ventura by Pruner paramedics is 5.36 minutes, and he said if Ventura firefighters got involved in being paramedics, it would tie up their time and distract them from fighting fires and responding to hazardous waste spills.
“Our people only have one mission,” Murphy said, “and we have a 30-year track record in the county.”
In addition, he said, the city may find that it is more expensive to hire and train additional paramedics than it expects.
The ambulance company has fought for years with the Ventura County Fire Department about whether the county should hire paramedics. County fire officials have frequently complained that response time and training of Pruner paramedics is inadequate.
Despite many public battles with firefighters, Pruner has maintained its hold on paramedic services in Ventura County. The company has a contract with the county to provide ambulance service to all areas except Oxnard and Ojai, which use different ambulance companies. Pruner’s contract will be up for review by the county supervisors this summer.