The Los Angeles Fire Department unveiled an ambitious five-year plan Tuesday to correct severe staffing and equipment shortages in paramedic services, a proposal sharply questioned by Mayor Richard Riordan's office.
The main thrust of the proposal calls for the department to train 500 paramedics during the next five years and staff 40 additional rescue ambulances. The goal, said Chief William R. Bamattre, is to have at least one highly trained rescuer and an ambulance at each of the city's 103 fire stations.
Currently, 17 firehouses have no paramedics and 29 have no ambulances.
The plan, which is estimated to cost $11 million over the next 18 months, was approved Tuesday by a special task force of the mayor-appointed Fire Commission.
The infusion of resources is intended to help resuscitate an emergency medical service system that city officials say is in a state of crisis, with soaring burnout rates among paramedics and persistent problems with dispatching. It also is a frank acknowledgment that the Fire Department's primary role has become emergency medical care, not battling blazes.
Fire Commission President David Fleming called the plan costly but essential at a time when 80% of the agency calls for help are medical emergencies. Beefing up paramedic service, he said, "is an area we have to give particular attention to and preference to."
There would be about a 45% net gain in paramedics and ambulances. A total price has not been estimated but is expected to be tens of millions of dollars. Funding could be an uphill battle at a time when the city has already agreed to shell out more than $30 million in legal payouts stemming from the Rampart police scandal.
During the meeting, Bamattre's proposal was sharply questioned by the mayor's budget director, Steve Rubin, a member of the task force.
The need for 500 paramedics, Rubin said, was "somewhat confusing" and not based on clear goals. He said the public is more concerned about response times, not the number of paramedics and ambulances.
"When they're having a heart attack they want to make sure the resource gets there within an appropriate period of time," Rubin said. "I don't think they care if a particular fire station up the street has an ambulance or not."
The department, he said, should first analyze what it would take to get paramedics on scene faster before deciding how many to train.
But Bamattre and others, including the department's medical director, said response times were just one part of the equation.
"It's a very complex system that can't just focus on one measure," said Capt. Robert Linnell, who represents paramedics on the task force. He said it is just as important to have enough ambulances and crews to cover holes when call loads peak or when major emergencies develop, which can tie up ambulances at hospitals.
"There's not one person in the city of Los Angeles who's going to complain there are too many paramedic resources in their neighborhood," said Capt. Ken Buzzell, head of the firefighters union.
The exchanges between Rubin and department members reflected an ongoing tension at City Hall.
Many in the department, and some City Council members, say Riordan has focused the brunt of his safety policies on beefing up police. In their view, that has contributed to the deterioration of the emergency medical service system.
Rubin's questioning Tuesday did little to dispel those perceptions. After the meeting, Rubin said the mayor has been a staunch advocate for the Fire Department, increasing its budget over several years.
"The mayor is very supportive of improving and enhancing paramedic services," he said. He noted that the mayor this year backed the hiring of 100 temporary paramedics. The first 50 are now training, but they are only temporary employees, working eight-month assignments to fill vacancies.
Rubin said that the give and take between the mayor's office and the Fire Department is part of the budget process. He said Riordan has not made any decisions yet on Bamattre's proposal or other pending requests for funding, including an additional 75 paramedic positions and 10 more ambulances in next year's budget.
Other parts of the proposal range from nearly tripling the amount of paramedic captains who supervise field crews to seeking national certification for the agency's troubled dispatch center downtown.
The plan also calls for quarterly progress reports.