City Pushes to Hire 100 Paramedics

Hoping to halt the decline of Los Angeles’ medical rescue system, Mayor Richard Riordan and other top officials Wednesday called for the emergency hiring of 100 new paramedics by cutting through a long-standing series of recruiting and training bottlenecks.

The move is designed to bring a rapid infusion of highly trained paramedics into a rescue network that the Fire Department’s medical advisor has described as “barely afloat.”

“When Angelenos call for emergency medical services, they must have the confidence that our paramedics will be there to respond, treat them and rush them to hospitals when necessary,” Riordan told reporters at a news conference in front of a downtown fire station.

Riordan said that while his administration has long supported the Fire Department’s emergency efforts, “we always must do more.”

In recent weeks, the department’s emergency care system has come under broad criticism--and sweeping inquiries by the Fire Commission and county regulators. There have been disclosures of improper dispatches tied to at least five cases of patient deaths since February. Paramedics have spoken emotionally about the stress and burnout that is depleting their ranks, forcing them sometimes to be on duty up to 100 consecutive hours. A recent department analysis found paramedic attrition is at its highest level in nearly 20 years.

The gravity of the problems surrounding the paramedic operation was underscored by the array of city officials joining the mayor for the unveiling of his initiative. They included Fire Chief William R. Bamattre, Fire Commission President David Fleming and two of the City Council’s most influential members, Cindy Miscikowski and Michael Feuer.

Bamattre, noting the breadth of political backing, said afterward that he hopes to put the new paramedics on the street beginning in mid-December. “I think what you’re seeing now is everybody lining up,” he said.

The mayor’s recruitment plan--which the federal government must sanction because of restrictions over past hiring practices--may bring short-term relief. But it is unlikely to address deeper-rooted issues that many paramedics and city officials say are at the heart of the problems.

The agency is steeped in a history and culture that values firefighting more than paramedic service. Over the years, improvements in fire prevention and building codes have resulted in dramatic reductions in structure fires. At the same time, calls for medical aid have soared, now accounting for 80% of the department’s workload.

In a frank acknowledgment of the agency’s changing role, commission President Fleming said Wednesday: “In truth and in fact, we are not a fire department as much as we are a medical emergency department . . . that occasionally puts out fires.”

Among other things, his panel is considering long-term reorganization of the department to reflect those changing realities. Another in a series of commission hearings on paramedic issues will be convened today at Los Angeles Valley College.

The package announced by the mayor Wednesday includes some proposals already pushed by the chief and City Council members. They include intensified training for Fire Department dispatchers and an upgraded computer system that forces dispatchers to more closely follow scripted medical questions intended to assess the urgency of an emergency medical call.

The Times recently reported that internal department studies have found that inappropriate dispatches have been made because firefighters have regularly strayed from the standardized questions, dispatching inadequate resources to emergency situations.

One Riordan proposal, endorsed last week by key council members, would eliminate a requirement that all applicants for firefighting and paramedic jobs live in the city. That edict was part of a 1974 civil rights settlement with the U.S. Justice Department intended to draw more diverse applicants.

To overcome that obstacle, Riordan asked U.S. Atty. Gen. Janet Reno in a letter on Wednesday to lift the residency requirement so that the city can “quickly bring on board qualified paramedics during this time of critical need.”

Los Angeles’ paramedic shortage, the mayor wrote, is causing “ a strain on the Fire Department and an acute ‘burnout’ syndrome.”

Justice Department officials in Washington could not be reached for comment.

The mayor also told reporters he wants to move paramedics onto the street more quickly by dropping a requirement that they undergo 18 months of firefighter training before working full-time on ambulances.

Together, officials say, the proposed changes will clear the way to hire experienced paramedics from other agencies.

Although welcoming the mayor’s proposal, critics within the department are asking why it took him so long to recognize the severity of the problems, which have been festering for years.

“The mayor got elected on the basis of holding people accountable,” said Capt. Ken Buzzell, head of the city firefighters union. “I’d like to know who he’s going to hold accountable for ignoring this problem for three years and letting it get to crisis stage,”

Buzzell and others in the department have voiced concerns in recent years that Riordan has focused his public safety efforts on beefing up the Los Angeles Police Department at the expense of the Fire Department.

Riordan said his support of the Fire Department through his tenure has been steadfast. “We have increased wages, salaries and resources consistently during my administration,” he said.

Deputy Mayor Jennifer Roth, who supervises financial and budgetary matters for the mayor, said Riordan has tried to ease the paramedic shortage in several ways. The mayor’s most recent budget, Roth said, doubled the money available for hiring new Fire Department employees,including paramedics, from 135 in the previous year to 270 this year.

Paramedic positions have been difficult to fill because of the heavy workload and a culture within the agency that has, in the words of the department’s medical director, treated paramedics as “second-class” workers.

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Times staff writer Jim Newton contributed to this report.