# Report Finds that Privatizing Houston EMS would Save Money



## Fish

Report claims privatizing EMS will save money, FD claims studies show that privatizing EMS does not save money. What say you?

One thing is certain, we are talking about a lay off of 1,800 approx. Fire Fighters and if I had to guess a cut of around 80mill for EMS operations and another 80mill for payroll from the Fire Depts. budget(Once again this is just a guess looking at services a third the size of Houston's budget)

http://www.emsworld.com/news/10626279/report-houston-should-privatize-ems


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## Shishkabob

I say that it takes 2 brains cells to realize that if an agency can operate strictly off the money that comes in, and never charges a city a subsidy, it saves that city money, regardless of private, public, or fire.


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## shfd739

Wow. I bet the city wouldnt do it. 

Privatizing will save money- Id like to see how the FD is saying it wouldnt. What study is that taken from?


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## shfd739

Linuss said:


> I say that it takes 2 brains cells to realize that if an agency can operate strictly off the money that comes in, and never charges a city a subsidy, it saves that city money, regardless of private, public, or fire.



Or as Ive seen private services do is ask for a small subsidy. There is still a large savings to the city.

The city requires tight response criteria and strokes out a subsidy check that is much smaller than what the previous exspense was. Money saved and service is preserved.


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## tssemt2010

i dont see many FF getting laid off, they all rotate between the fire truck and ambulance anyways so i dont see 1800 people getting laid off, i would prefer houston to privatize its EMS anyways, most of the HFD guys i have met do not enjoy the ambulance and patient care has suffered because of that


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## Fish

tssemt2010 said:


> i dont see many FF getting laid off, they all rotate between the fire truck and ambulance anyways so i dont see 1800 people getting laid off, i would prefer houston to privatize its EMS anyways, most of the HFD guys i have met do not enjoy the ambulance and patient care has suffered because of that



The 1800 number I got from a HFD employee, there would be lay offs that is unavoidable. you cannot cut EMS completely plus a fire fighter for the truck without performing some sort of lay off


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## Fish

shfd739 said:


> Wow. I bet the city wouldnt do it.
> 
> Privatizing will save money- Id like to see how the FD is saying it wouldnt. What study is that taken from?



I have no clue, i just read in an article that the FD was claiming studies show that it doesn't save money.


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## Shishkabob

1800 laid off?!  How many do they have employed?  Holy cow.  No wonder it's a waste.


Edit:  Just saw on Wikipedia... 4,000 employed.  What the heck?  15 per station, per day... even if you take out ancillary staff, that's still like 10 per station per day, and that's being generous on the ancillary side.


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## Fish

I only have two questions, where can we find the report to read it ourselves and how will the city take the advice given in this report?


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## Fish

Linuss said:


> 1800 laid off?!  How many do they have employed?  Holy cow.  No wonder it's a waste.



No clue, but they have like 110 stations so minus 1 fire fighter from each truck off of each shift plus minus the staff for 60 ambulances and ALS vehicles and EMS supervisors and i guess that is where he got the number?


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## Shishkabob

If they can trim nearly half their department by taking people off of things that staff less than half their equipment... they clearly have too many to begin with.


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## bigbaldguy

tssemt2010 said:


> i dont see many FF getting laid off, they all rotate between the fire truck and ambulance anyways so i dont see 1800 people getting laid off, i would prefer houston to privatize its EMS anyways, most of the HFD guys i have met do not enjoy the ambulance and patient care has suffered because of that



I have to agree that to the extent I've had dealings with HFD EMT's and medics most of them act like working on the ambo is just an unpleasant task that they have to get through before they graduate to playing with hoses. Fire fighters generally don't like being medics. I don't blame them. I like working on the ambo and if I had to be a firefighter to do it I would probably be a halfhearted FF because it's not what I would want to be doing.

Bear in mind when I say most of them I'm referring to those I've had direct contact with not with HFD EMS in general but I imagine it's pretty much the same city wide.

I think privatizing Houston EMS is probably a pipe dream. If it did happen I imagine that with the exception of those being laid off the rest of HFD wouldn't be to sad about losing EMS.


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## socalmedic

@linuss, according to the HFD website they have 104 stations (1-105 with 1 closed) and 4 shifts. 4000 / 104 / 4 is approximately 10 per station per day including overhead. it appears that the majority of their stations are multi resource stations so that makes sense.

I cant see 1800 loosing their jobs if this proposed plan goes through. a few hundred tops if anyone gets laid off. I am sure there are already hundreds of vacancy's, my citys FD has 23 stations and 76 vacancy. in addition to the retirements that are to come. and i am sure this will be a "tiered" roll out meaning that ems will go first, then the extra guy on the truck, then the extra guy on the engine. if they do it right they could cover all the lost positions with retirement incentives.


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## Shishkabob

Maybe going from 24/72 to 24/48 with the resulting cut in staffing could solve a big chunk of their issues...


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## medicsb

I was under the belief that HFD paramedics, though cross-trained, generally only did EMS, and that it wasn't until relatively recently that some of them could rotate onto fire apparatus.  Also, what is so bad about HFD EMS?   There's been a decent quantity of research done within the Houston EMS system, and Dr. Ken Mattox (world renowned trauma surgeon for those who don't know who he is) has referred to them positively in regards to trauma.

Just curious.


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## Fish

I do not know a lot about them clinically, so maybe someone else can answer that for you. I was mainly concerned with everyones opinions on whether or not this would be a money saving change and although we all know the Union would fight it, will them or the City prevail if the city decides to privatize EMS?


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## Fish

medicsb said:


> I was under the belief that HFD paramedics, though cross-trained, generally only did EMS, and that it wasn't until relatively recently that some of them could rotate onto fire apparatus.  Also, what is so bad about HFD EMS?   There's been a decent quantity of research done within the Houston EMS system, and Dr. Ken Mattox (world renowned trauma surgeon for those who don't know who he is) has referred to them positively in regards to trauma.
> 
> Just curious.



As a side not, i would be more impressed with a Cardiologist referring to them positively or some sort of National EMS committee or Agency, Trauma is the easiest thing a Paramedic does and is rather hard to mess up and Houston gets a lot of it, so they are experienced in it.


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## shfd739

Fish said:


> As a side not, i would be more impressed with a Cardiologist referring to them positively or some sort of National EMS committee or Agency, Trauma is the easiest thing a Paramedic does and is rather hard to mess up and Houston gets a lot of it, so they are experienced in it.



Even though this is harsh it's the truth. Trauma is simple. What is their current cardiac arrest survivial rate? How are the protocols and equipment?

Privatizing would be a potential positive thing for the citizens. By having people on the ambulance that want to be there the quality of service will improve. 

Im afraid the union will squash anything that requires a reduction in manpower or giving up EMS. Even though a private can do it better.


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## bigbaldguy

shfd739 said:


> Even though this is harsh it's the truth. Trauma is simple.



Really? I dare you to walk up to a trauma surgeon in a bar and say that.


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## Fish

I am not for anyone losing their Jobs, I know these HFD fellas have got families to take care of and no one wants to wish unemployment on another. But, Fire Depts. to it to themselves by not running lean Departments. And I know this comment will draw flack but, I am Anti-Union....... Why should the Union's opinion in this ever matter ever overide/trump what the Mayor/City Council and its Citizens want(a balanced budget) not just in this particular matter but ever!


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## Fish

bigbaldguy said:


> Really? I dare you to walk up to a trauma surgeon in a bar and say that.



He doesn't mean at their level, he means at the EMS level it is simple. And that I will say to a Trauma Surgeon at a Bar.

What an EMT or Medic does for Traumatic Patients is Peanuts compared to a Trauma Doc and an OR suite.


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## bigbaldguy

Fish said:


> He doesn't mean at their level, he means at the EMS level it is simple. And that I will say to a Trauma Surgeon at a Bar.
> 
> What an EMT or Medic does for Traumatic Patients is Peanuts compared to a Trauma Doc and an OR suite.



Previous statement redacted due to false assumptions caused by skimming between commercials.

 I read your comment on the cardiologist thing then his and thought they were part of the same chain of thought from same poster my bad.


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## DrParasite

Fish said:


> Report claims privatizing EMS will save money, FD claims studies show that privatizing EMS does not save money. What say you?
> 
> One thing is certain, we are talking about a lay off of 1,800 approx. Fire Fighters and if I had to guess a cut of around 80mill for EMS operations and another 80mill for payroll from the Fire Depts. budget(Once again this is just a guess looking at services a third the size of Houston's budget)
> 
> http://www.emsworld.com/news/10626279/report-houston-should-privatize-ems


it's probably right.  40,000-80,000 for a FF/EMT or Medic, vs $9-$12 an hour for a private EMT or medic.  benefits are more for public employee, vs cheap poor benefits for private.  privates run as cheap as possible (SSM, postings, ambulances equipped to the minimum guidelines, poor trucks in excess of 200,000 miles), vs top of the line equipment, stations, and training in down time for HFD.

Will it save money? sure..... will the quality of patient care, employee, and support system decrease? sure.....


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## systemet

If the guys doing EMS are fully trained firefighters, I'd bet there won't be that many jobs lost.  9/11 ensured a future for most fire departments in the US for a few decades.  No one's going to want to be the politician that has to run for re-election against an opponent showing images of angry/sad firefighters.

If there's an administrative separation between fire and EMS, and the only thing "fire" about the EMS side is the word "Fire department" on the ambulance, and the firefighters are only there to get OT, then I can see them pushing through larger lay offs.


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## Veneficus

Fish said:


> He doesn't mean at their level, he means at the EMS level it is simple. And that I will say to a Trauma Surgeon at a Bar.
> 
> What an EMT or Medic does for Traumatic Patients is Peanuts compared to a Trauma Doc and an OR suite.



Anyone doubting the complexity of a trauma patient and the impact EMS treatment have on them is welcome to take me to the bar and I will explain it to them in detail that will likely result in first hand experience when they start drinking heavily enough to fall off the bar stool.


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## Fish

Veneficus said:


> Anyone doubting the complexity of a trauma patient and the impact EMS treatment have on them is welcome to take me to the bar and I will explain it to them in detail that will likely result in first hand experience when they start drinking heavily enough to fall off the bar stool.



Never said they were not complex, never said that at all. What I said is the treatment that an American Paramedic provides in the field for one is not complex, there is not much we do for Traumatic patients compared to Medical. Thus making the Trauma call less "challenging" and easier to run, because our treatment options are very limited....... Most of what a Medic caries is for Medical Patients. That doesn't mean we do not have an impact on the patients outcome.


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## Veneficus

Fish said:


> Never said they were not complex, never said that at all. What I said is the treatment that an American Paramedic provides in the field for one is not complex, there is not much we do for Traumatic patients compared to Medical. Thus making the Trauma call less "challenging" and easier to run, because our treatment options are very limited....... Most of what a Medic caries is for Medical Patients. That doesn't mean we do not have an impact on the patients outcome.



I got it.

I was just trying to get somebody to take me to the bar and buy drinks.


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## Fish

Veneficus said:


> I got it.
> 
> I was just trying to get somebody to take me to the bar and buy drinks.



Well since the big bald guy decided to flurry everyones taste buds by talking about drinks, I think he is buying first round.


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## usalsfyre

DrParasite said:


> Will it save money? sure..... will the quality of patient care, employee, and support system decrease? sure.....



From what I've seen of HFD's EMS system (they were the original push behind TEEX 10 week medic program) it'd be hard for care to suffer that much. 

DrParasite, I know you love to hate privates but I know of several who provide far better benefits and work environments than many FDs I've been involved with.


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## 46Young

Linuss said:


> 1800 laid off?!  How many do they have employed?  Holy cow.  No wonder it's a waste.
> 
> 
> Edit:  Just saw on Wikipedia... 4,000 employed.  What the heck?  15 per station, per day... even if you take out ancillary staff, that's still like 10 per station per day, and that's being generous on the ancillary side.



They've got a total of 130 apparatus when counting only the engines, trucks, Haz-Mat and Rescue units alone, and that's not counting command staff and various day work positions such as instructors, fire prevention, PR, logistics, etc. etc. Assuming four on each rig, that's 520/day x 4 shifts, or around 2080 to staff the rigs. There are 50 ambulances and 27 medic units, for 154 personnel, so that's 616 right there, plus another 70 for pad. Many of the larger FD's have one or two pad personnel per station to detail out for vacation/sick relief, training, etc. With 92 stations, that's another 150-200 people. There's airport units, squads, and other units I'm not familiar with, so that's more people yet again.

If you laid off every ambulance position, and also cut each engine company by one, that's "only" 656 positions. What happens during a proposed Reduction in Force is that then dept will first look to eliminate positions due to attrition, or move office personnel back to the field. That will save more than a few jobs. Also, with a dept that has a headcount of 3851, you're probably losing 100/yr in retirement, probably more. If you lay off a bunch of FF's, you'll have to recruit more in the next year or two, and every year thereafter. In my dept, it costs at least 50k/FF to recruit, test, and train in the academy. Medics are closer to 100k each. This fact makes it less beneficial to lay off so many. They might lose a couple of hundred if the fire apparatus destaffing goes through. If they go from four shifts to three, then you're looking at a much higher number.


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## 46Young

socalmedic said:


> @linuss, according to the HFD website they have 104 stations (1-105 with 1 closed) and 4 shifts. 4000 / 104 / 4 is approximately 10 per station per day including overhead. it appears that the majority of their stations are multi resource stations so that makes sense.
> 
> I cant see 1800 loosing their jobs if this proposed plan goes through. a few hundred tops if anyone gets laid off. I am sure there are already hundreds of vacancy's, my citys FD has 23 stations and 76 vacancy. in addition to the retirements that are to come. and i am sure this will be a "tiered" roll out meaning that ems will go first, then the extra guy on the truck, then the extra guy on the engine. if they do it right they could cover all the lost positions with retirement incentives.



This is where I was getting my stats:

http://www.houstontx.gov/fire/abouthfd/


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## 46Young

Fish said:


> I do not know a lot about them clinically, so maybe someone else can answer that for you. I was mainly concerned with everyones opinions on whether or not this would be a money saving change and although we all know the Union would fight it, will them or the City prevail if the city decides to privatize EMS?



Sure, it would save money. When you go from a municipal employee with a well stocked apparatus with all due pay and benefits, to a $8-$12/hr person with much more modest benefits and (if they're lucky) a DC (not a pension) retirement, run by a for profit corporation, it's not difficult to see why.

The Union will argue against the privates using examples of past failed relationships in other municipal systems. There are enough examples of private companies leaving when the contract becomes unprofitable for them, substandard equipment, the low average tenure (experience) of their employees, taking chances by pulling available 911 units to run the more profitable IFT, the lower hiring standards (the public trust being placed with EMS), the average employee tenure (experience) being subtandard due to that type of job being transient, or a "stepping stone," etc. These are the same arguments that FD's use to take over an existing privately operated 911 system, so the talking point must be effective. These may or may not be true for the privates bidding for the contract, but there have been enough problems with private EMS that these negative attributes could be projected onto the good employers.

Then you get into how dual role personnel curb OT due to their versatility, and other staffing/deployment discussions skewed to favor the FD.


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## 46Young

Fish said:


> I am not for anyone losing their Jobs, I know these HFD fellas have got families to take care of and no one wants to wish unemployment on another. But, Fire Depts. to it to themselves by not running lean Departments. And I know this comment will draw flack but, I am Anti-Union....... Why should the Union's opinion in this ever matter ever overide/trump what the Mayor/City Council and its Citizens want(a balanced budget) not just in this particular matter but ever!



Why? With the Union, the employees have a strong opposing voice when matters such as this come up. For example, D.C. has beat back numerous attempts to go from four shifts to three. That would screw a lot of people that live far away, but they've held on to their schedule.

Without a voice, the city could just do whatever it wants without any opposition whatsoever. That's bad for the employee. My Union saved my job and 90 something others back in 2008 when the County Executive wanted to implement a Reduction in Force. We also fought off rolling brownouts, and got the sunset clause of our DROP removed, which was a huge benefit for our retirements.


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## medicsb

My point in mentioning Dr. Ken Mattox earlier was that he doesn't just hand out compliments to anyone; he is VERY critical of medical practices, EMS or otherwise.  Despite whatever easiness trauma should be, I think it is pretty often not done nearly as well as one would think in EMS, so I think a compliment from Dr. Mattox is not something to be dismissed easily.  Anyhow, it was offtopic of me to bring up, so I'll move on.

Anyhow... I, despite being in favor of EMS being split from fire, won't root for people losing their jobs or service being removed from a current provider unless there is demonstrated need to do so.  Need to balance a budget isn't necessarily a "demonstrated need" in my opinion (though, this is not to say that there isn't some fat in need of trimming).  EMS is worth paying for with tax money and I do not think it is something to be tossed to private companies just to save money.


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## bigbaldguy

Fish said:


> Well since the big bald guy decided to flurry everyones taste buds by talking about drinks, I think he is buying first round.



I'll have a fuzzy navel and slippery nipples for everybody!


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## DrParasite

usalsfyre said:


> From what I've seen of HFD's EMS system (they were the original push behind TEEX 10 week medic program) it'd be hard for care to suffer that much.
> 
> DrParasite, I know you love to hate privates but I know of several who provide far better benefits and work environments than many FDs I've been involved with.


you know, you might be right.  

IF the private service doesn't cut salaries, doesn't cut benefits, does include a pension/retirement plan, and uses equipment that is decent, than the transition form HFD to private won't be detrimental of the EMS system and the patients who are treated by it.  

So if the private can meet all those requirements, and still save the taxpayers money, than go for it.  otherwise, I stand by my original statement.


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## 46Young

DrParasite said:


> you know, you might be right.
> 
> IF the private service doesn't cut salaries, doesn't cut benefits, does include a pension/retirement plan, and uses equipment that is decent, than the transition form HFD to private won't be detrimental of the EMS system and the patients who are treated by it.
> 
> So if the private can meet all those requirements, and still save the taxpayers money, than go for it.  otherwise, I stand by my original statement.



If that was the case, the operating costs for the private provider wouldn't be much lower than what the FD was already providing, so there would be no point in going private. Personnel costs are usually the largest part of an operating budget. Actually, the dual role FF's would make it easier to fill schedule holes and curb OT more than a single role department could. Unless the private intends to use System Status Management to get by with the least amount of employees possible. The FD/Union would caution against this flawed practice anyway, as they have done successfully in the past.


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## socalmedic

DrParasite said:


> you know, you might be right.
> 
> IF the private service doesn't cut salaries, doesn't cut benefits, does include a pension/retirement plan, and uses equipment that is decent, than the transition form HFD to private won't be detrimental of the EMS system and the patients who are treated by it.
> 
> So if the private can meet all those requirements, and still save the taxpayers money, than go for it.  otherwise, I stand by my original statement.



this is not a dig at DrParasite, quote is only included to show relevance to the topic at hand.

 I work for the big bad three letter company, my division as a paramedic I make equal to a Firefighter with the same tenure. our oldest ambulance is a 2008 with 120,000 miles with its replacement already ordered. our stations could use some upgrades but they are safe and comfey. we have 15 trucks on 24 hour shifts following the fire departments kelly schedule, we have a few day cars to run the transfers. 1/2 of our trucks are dual medic, with a multi tiered paramedic level allowing for career ladder. the mean tenure of our paramedic workforce is 13 years. all of our training CE are paid for. we have a 401k program with 3% matching. 4 weeks of vacation per year. we have all of this because we are union. and yes the company still turns a profit, so it can be done.

Edit: this division has had this operating model for over 30 years.


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## shfd739

DrParasite said:


> you know, you might be right.
> 
> IF the private service doesn't cut salaries, doesn't cut benefits, does include a pension/retirement plan, and uses equipment that is decent, than the transition form HFD to private won't be detrimental of the EMS system and the patients who are treated by it.
> 
> So if the private can meet all those requirements, and still save the taxpayers money, than go for it.  otherwise, I stand by my original statement.



There are a few privates around Houston that would be plenty capable of handling their EMS. And they all pay well, have nice equipment and have retirement plans


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## sweetpete

Anyone who thinks it's a good idea to cut a FF off the apparatus has never fought a fire in an urban setting.

You simply can't do this job safely with 3 guys on a truck unless you sit around waiting for the next in truck. Even then, you still have to wait for them to arrive to be RIT before the first crew can even make entry to perform a search/rescue.

And as has already been mentioned, HFD rotates FFs off the ambulance/squad to the pumper/ladder every few shifts. So, to do away with this system is only going to force more OT somewhere.

Lastly, after having worked in the "private" industry for a company that provided both FIRE and EMS I can honestly state that the training of a municipal service and the training of a private are light years apart. The city I work for now requires training every shift (except on Saturdays/Sundays) as opposed to maybe once a month for the private I worked for.

In my opinion, there's no comparison. And I'm certainly not saying EVERY private is bad. I'm just pro-city.<_<


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## 46Young

sweetpete said:


> Anyone who thinks it's a good idea to cut a FF off the apparatus has never fought a fire in an urban setting.
> 
> You simply can't do this job safely with 3 guys on a truck unless you sit around waiting for the next in truck. Even then, you still have to wait for them to arrive to be RIT before the first crew can even make entry to perform a search/rescue.
> 
> And as has already been mentioned, HFD rotates FFs off the ambulance/squad to the pumper/ladder every few shifts. So, to do away with this system is only going to force more OT somewhere.
> 
> Lastly, after having worked in the "private" industry for a company that provided both FIRE and EMS I can honestly state that the training of a municipal service and the training of a private are light years apart. The city I work for now requires training every shift (except on Saturdays/Sundays) as opposed to maybe once a month for the private I worked for.
> 
> In my opinion, there's no comparison. And I'm certainly not saying EVERY private is bad. I'm just pro-city.<_<



My department's truck staffing video illustrates the importance of proper staffing:

https://www.youtube.com/watch?v=a_K-K6o5cGc

We also have mandatory monthly training, as well as inservice and OOS multi company drills. People still think we lounge around all day playing X-box and watching movies though.


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## Fish

Hey 46, you work for Fairfax right?


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## Shishkabob

46Young said:


> My department's truck staffing video illustrates the importance of proper staffing:



One could argue that if you didn't do interior attacks, you really wouldn't need the extra man as there would be no need for a 2 in 2 out mentality.  



Staffing 3 instead of 4 not only saves the yearly salary for the 4th (per truck, per shift), but also the risk of injury or loss of life (and associated monetary costs) from doing interior attacks when unwarranted (ie, no confirmed trapment)


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## RocketMedic

Isn't Houston full of oil industry stuff?

DrParasite, quite a few privates are just as good or better than fire departments or thidd-services. AMR, Paramedics Plus, Arcadian, and MedStar come to mind.


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## usalsfyre

sweetpete said:


> Anyone who thinks it's a good idea to cut a FF off the apparatus has never fought a fire in an urban setting.


Actually I have.



sweetpete said:


> You simply can't do this job safely with 3 guys on a truck unless you sit around waiting for the next in truck. Even then, you still have to wait for them to arrive to be RIT before the first crew can even make entry to perform a search/rescue.


In life safety situations 2 in 2 out doesn't apply. You cant do 2 in 2 out with a four man crew as your 2 out cant be engaged in other activities (incident commander and engineer)You can maintain 2 in 2 out with 6 people, but you can't mount a full interior attack. Which may keep people from thinking with their balls and having roofs fall on their head.



sweetpete said:


> And as has already been mentioned, HFD rotates FFs off the ambulance/squad to the pumper/ladder every few shifts. So, to do away with this system is only going to force more OT somewhere.


Explain. If the positions are privatized the city is not responsible for staffing them. Therefore the employees are no longer needed.



sweetpete said:


> Lastly, after having worked in the "private" industry for a company that provided both FIRE and EMS I can honestly state that the training of a municipal service and the training of a private are light years apart.


Yep, most privates refuse to accept 10 weeks of paramedic school. 



sweetpete said:


> The city I work for now requires training every shift (except on Saturdays/Sundays) as opposed to maybe once a month for the private I worked for.


Training on what? If the majority of time is spent on FD training (or the guys on the EMS unit aren't allowed time to train) then it's kinda worthless when we're talking about EMS service delivery right?



sweetpete said:


> In my opinion, there's no comparison. And I'm certainly not saying EVERY private is bad. I'm just pro-city.


Of the places I've worked, one of the FDs I was at did the worst job, the other did the best. Just because a city is involved means nothing.


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## Shishkabob

Rocketmedic40 said:


> quite a few privates... MedStar ....



MedStar isn't a private :glare:


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## usalsfyre

Linuss said:


> MedStar isn't a private :glare:


Y'all are just AMR rejects .


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## Shishkabob

Last I checked, the Ambulance Authority kicked out their under-performing private contractors years ago


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## usalsfyre

Linuss said:


> Last I checked, the Ambulance Authority kicked out their under-performing private contractors years ago



Details details 

MedStar is self supporting though, right?


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## Shishkabob

Yup, self-supporting, pretty much all from patient billing (even though as we all know, most bills go unpaid...)  


Less than 0.12% of the budget comprises of subsidies from it's member cities.   Infact, the amount of subsidies coming in doesn't even pay for my salary for the year.


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## usalsfyre

Linuss said:


> Yup, self-supporting, pretty much all from patient billing (even though as we all know, most bills go unpaid...)
> 
> 
> Less than 0.12% of the budget comprises of subsidies from it's member cities.   Infact, the amount of subsidies coming in doesn't even pay for my salary for the year.



So in essence, you operate as a non-profit private entity . 

I will admit it's easier to run a kickass system when you don't have to show a profit. That said, it's also nice when you can convince the owner of a need and it's ordered a week later rather than six months of committees and budget concerns later.


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## Shishkabob

In all technicality, it's a government entity based off the Public Utility Model idea, just not owned by any single city government 




Your and mine LAST employer was a non-profit... do you REALLY want to put these 2 agencies grouped together?


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## Fish

usalsfyre said:


> So in essence, you operate as a non-profit private entity .
> 
> I will admit it's easier to run a kickass system when you don't have to show a profit. That said, it's also nice when you can convince the owner of a need and it's ordered a week later rather than six months of committees and budget concerns later.



Are you with ETMC?


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## Shishkabob

No, he's not there


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## Fish

Champion?


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## RocketMedic

My mistake, us Far West Texans literally have nothing like that. El Paso Fire does a good job in the city and UMS does a *reasonable* job on federal installations out here, but our private 911 for the county doesn't even carry benzodiazepines and analgesics are entirely a LOL moment (don't go status-epilepticus in El Paso County), and the other privates here are smallish IFTs. To our east, we've got volunteers, my part-time employer, and a few small privates and city departments and more volunteers, and to the north and west, we've got AMR (by far the most progressive system in the Borderland). Pay is best at the federal contractor UMS, then AMR/EPFD, then the hinterlands, with the IFT and county IFT/911 at the _far_ bottom (some of their paramedics work 24 hours for $130 if they're unlucky and the company doesn't count their hours). 

Compared to out here, Central and East Texas look like EMS paradises. Southern NM doesn't look too bad though.

Privatizing Houston _screams_ Acadian, Paramedics Plus or AMR, does it not?


----------



## 46Young

Fish said:


> Hey 46, you work for Fairfax right?



Yes.


----------



## 46Young

Linuss said:


> One could argue that if you didn't do interior attacks, you really wouldn't need the extra man as there would be no need for a 2 in 2 out mentality.
> 
> 
> 
> Staffing 3 instead of 4 not only saves the yearly salary for the 4th (per truck, per shift), but also the risk of injury or loss of life (and associated monetary costs) from doing interior attacks when unwarranted (ie, no confirmed trapment)



Not that simple. Just because there are no reported trapped doesn't mean that there's no one inside. Also, many structures are multiple dwellings. If the fire is discovered early enough, we're going to handle it, instead of letting a whole row burn down just because everyone got out.

Many fires can be handled before they involve enough of the structure to warrant a defensive operation. That's the decision of the first due officer, and then whoever they transfer command to. We're not going to let a room and contents fire burn a whole house down just because everyone got out. That's just silly. Things we look at when deciding whether or not to go in would be the type of structure, how long it's been burning, how much is involved, among other things. Rural departments may do surround and drown most of the time due to lack of resources.

Here's the recent NIST study that shows how much quicker a four person crew can perform 22 essential firefighting tasks than a three person crew (hint: a lot more goes on than just squirting water and breaking windows):

http://www.nist.gov/el/fire_research/residential-fire-report_042810.cfm


----------



## Veneficus

46Young said:


> Not that simple. Just because there are no reported trapped doesn't mean that there's no one inside. Also, many structures are multiple dwellings. If the fire is discovered early enough, we're going to handle it, instead of letting a whole row burn down just because everyone got out.
> 
> Many fires can be handled before they involve enough of the structure to warrant a defensive operation. That's the decision of the first due officer, and then whoever they transfer command to. We're not going to let a room and contents fire burn a whole house down just because everyone got out. That's just silly. Things we look at when deciding whether or not to go in would be the type of structure, how long it's been burning, how much is involved, among other things. Rural departments may do surround and drown most of the time due to lack of resources.
> 
> Here's the recent NIST study that shows how much quicker a four person crew can perform 22 essential firefighting tasks than a three person crew (hint: a lot more goes on than just squirting water and breaking windows):
> 
> http://www.nist.gov/el/fire_research/residential-fire-report_042810.cfm



Not to turn this into a fire forum but...

A 4-5 man crew in an independant functioning unit on the fire ground. 

1 pump/ladder operator
1. officer
2. crew members

A 3 man engine or ladder forces the use of a second engine/ladder to be effective.

If you are using your officer as a crew member, he is not providing oversight command and control. 

That is exactly how people get into situations where they are not aware of surroundings, what else is going on.

I am not sure how anyone can argue a 3 man crew is enough for anything related to structural firefighting.

I am also not sure how needing 2 engines or ladders to perfomr the job of 1 is money saving or efficent?

The reason many smaller departments cannot save buildings is multifactorial.

1. type of building construction
2. experience of the officers and crew (ability/efficency)
3. not enough initial response resources.

If you haven't done it, fighting a fire takes manpower to effectively do multiple simultaneous tasks if you plan to do anything more than save a basement.

The very idea of 2 in 2 out is stupid. 

Firstly, a rescue of a firefighter cannot be done by 2 men. I haven't been involved in fire for some time but the last I heard It was something near 20 men to effectively maintain ongoing operations and search/rescue a firefighter.

Secondly, the longer you wait before starting interior operations, the more dangerous it becomes to do so. Waiting on 1/2 dozen or more partial strength companies to start interior operations is just a multiple fatality waiting to happen.

Thirdly, The very idea of searching for victims while dragging around a charged line and hoping to effect a save is stupid beyond reason. 

Finally, if your municipality cannot afford to staff the required fire suppression persons for, search, interior, and structure saving operations, then you should definately not be risking peoples lives playing games with mutual aid arriving from 100 miles distant in order to get enough people on a fire ground.

Just call any structure and life a loss and prevent any more fatalities. Particularly firefighters responding.


----------



## 46Young

Veneficus said:


> Not to turn this into a fire forum but...
> 
> A 4-5 man crew in an independant functioning unit on the fire ground.
> 
> 1 pump/ladder operator
> 1. officer
> 2. crew members
> 
> A 3 man engine or ladder forces the use of a second engine/ladder to be effective.
> 
> If you are using your officer as a crew member, he is not providing oversight command and control.
> 
> That is exactly how people get into situations where they are not aware of surroundings, what else is going on.
> 
> I am not sure how anyone can argue a 3 man crew is enough for anything related to structural firefighting.
> 
> I am also not sure how needing 2 engines or ladders to perfomr the job of 1 is money saving or efficent?
> 
> The reason many smaller departments cannot save buildings is multifactorial.
> 
> 1. type of building construction
> 2. experience of the officers and crew (ability/efficency)
> 3. not enough initial response resources.
> 
> If you haven't done it, fighting a fire takes manpower to effectively do multiple simultaneous tasks if you plan to do anything more than save a basement.
> 
> The very idea of 2 in 2 out is stupid.
> 
> Firstly, a rescue of a firefighter cannot be done by 2 men. I haven't been involved in fire for some time but the last I heard It was something near 20 men to effectively maintain ongoing operations and search/rescue a firefighter.
> 
> Secondly, the longer you wait before starting interior operations, the more dangerous it becomes to do so. Waiting on 1/2 dozen or more partial strength companies to start interior operations is just a multiple fatality waiting to happen.
> 
> Thirdly, The very idea of searching for victims while dragging around a charged line and hoping to effect a save is stupid beyond reason.
> 
> Finally, if your municipality cannot afford to staff the required fire suppression persons for, search, interior, and structure saving operations, then you should definately not be risking peoples lives playing games with mutual aid arriving from 100 miles distant in order to get enough people on a fire ground.
> 
> Just call any structure and life a loss and prevent any more fatalities. Particularly firefighters responding.



Pretty much....


----------



## 46Young

shfd739 said:


> There are a few privates around Houston that would be plenty capable of handling their EMS. And they all pay well, have nice equipment and have retirement plans



By "retirement plans," I'll assume you mean a pension (defined benefit) instead of a 401k (defined contribution). I've seen more and more privates and non-profits go to hybrid systems, or to DC plans altogether, and if you're lucky, you can be grandfathered in. If you're not so lucky, you just get a lump sum dumped into your 401k instead. 

I'm even seeing some municipal and state employers look into DC plans, although I don't see how that would work, since most who work municipal instead of private trade a lower salary for the pension and job security.

No pension is safe with private employers.


----------



## Fish

Rocketmedic40 said:


> Privatizing Houston _screams_ Acadian, Paramedics Plus or AMR, does it not?



I would think so, I do not know who else is big enough for it. I know Acadian is large, but I wonder if they are large "enough" they have zero operations that are near this size, maybe Bexar County? AMR and Paramedics plus are a been there done tha for large County and City services and could easily move in, one thing to point out is that ETMC (Paramedics Plus's mothership) runs EMS for Pasadena, Tx. Which is the city next door to Houston.


----------



## Veneficus

Fish said:


> I would think so, I do not know who else is big enough for it. I know Acadian is large, but I wonder if they are large "enough" they have zero operations that are near this size, maybe Bexar County? AMR and Paramedics plus are a been there done tha for large County and City services and could easily move in, one thing to point out is that ETMC (Paramedics Plus's mothership) runs EMS for Pasadena, Tx. Which is the city next door to Houston.



I am sure Acadian could do it without a whole lot of effort.

Probably wouldn't be a bad idea either.


----------



## Fish

Veneficus said:


> I am sure Acadian could do it without a whole lot of effort.
> 
> Probably wouldn't be a bad idea either.



One thing is for sure, they pay the most.


----------



## Veneficus

Fish said:


> One thing is for sure, they pay the most.



Acadian is a very respectable company.

I have never seen any private organization nor many public ones that can match their quality in just about every aspect of their business.

(I am no longer employed by them and I don't get paid to endorse them, but I give credit where credit is due.)


----------



## shfd739

Veneficus said:


> I am sure Acadian could do it without a whole lot of effort.
> 
> Probably wouldn't be a bad idea either.



It would be a lot of effort lol. But we could handle it. 

ETMC is in Pasadena and would be another one that could do a good job with Houston.


----------



## shfd739

Veneficus said:


> Acadian is a very respectable company.
> 
> I have never seen any private organization nor many public ones that can match their quality in just about every aspect of their business.
> 
> (I am no longer employed by them and I don't get paid to endorse them, but I give credit where credit is due.)



What area did you work in?


----------



## Fish

Veneficus said:


> Acadian is a very respectable company.
> 
> I have never seen any private organization nor many public ones that can match their quality in just about every aspect of their business.
> 
> (I am no longer employed by them and I don't get paid to endorse them, but I give credit where credit is due.)



Did you work for them as a Medic? and where at?


----------



## Veneficus

shfd739 said:


> It would be a lot of effort lol. But we could handle it.



Coming from the company that had a more realistic bid for gulf coast disaster response than both the IAFF proposal and AMR?

Do I detect some modesty in the big green monster?


----------



## Veneficus

Fish said:


> Did you work for them as a Medic? and where at?



Many years ago south of Baton Rogue.

I have only good things to say about the company, but I am too Yankee for the deep south.


----------



## triemal04

usalsfyre said:


> In life safety situations 2 in 2 out doesn't apply. You cant do 2 in 2 out with a four man crew as your 2 out cant be engaged in other activities (incident commander and engineer)You can maintain 2 in 2 out with 6 people, but you can't mount a full interior attack. Which may keep people from thinking with their balls and having roofs fall on their head.


Being wrong on semantics is still being wrong.  So...wrong and wrong.  Leave the discussions about firefighting to people who know about it.  Preferably not on a forum about EMS.  I will say though, that the NFPA 2/2 guideline could be written better, and, as practiced by far to many departments, needs a lot of work.



usalsfyre said:


> Yep, most privates refuse to accept 10 weeks of paramedic school.


Sorry...had to stop laughing before I could start typing.  Most privates, and most hospital-based, and most municipal...hell, most EMS agencies will accept someone who holds the appropriate certification regardless of where they went to school.  Don't try and delude yourself or others into thinking otherwise.



46Young said:


> No pension is safe with private employers.


To be fair though, no pension is safe with public employers either.  There have been enough lawsuits and revisions to the system here in the last few years to make me very happy I also have a personal retirement account.

A public retirement plan might be harder to change, but that doesn't mean that it isn't possible to still be screwed when it's your turn to go.  I can see the benefit to employee of having a pension based of a 401(k) or deferred comp account with an employer match program in that they know what they have when they retire, and there isn't a possibility of their benefits being...altered...a few years later.


----------



## Fish

Veneficus said:


> Many years ago south of Baton Rogue.
> 
> I have only good things to say about the company, but I am too Yankee for the deep south.



I for some reason thought you lived in England


----------



## Fish

Veneficus said:


> Coming from the company that had a more realistic bid for gulf coast disaster response than both the IAFF proposal and AMR?
> 
> Do I detect some modesty in the big green monster?



The IAFF? What was their proposal


----------



## Fish

triemal04 said:


> Sorry...had to stop laughing before I could start typing.  Most privates, and most hospital-based, and most municipal...hell, most EMS agencies will accept someone who holds the appropriate certification regardless of where they went to school.  Don't try and delude yourself or others into thinking otherwise



Most EMS agencies? Absolutely not....... Do Fire services USUALLY look for the fastest and cheapest Paramedic school around? Absolutely yes..... Infact most Fire Deptartments do not even have a Medical component to their hiring process, so make fun of private EMS services for the hire anyone with a pulse mentality all you want. But, Fire Departments do not do much better when it comes to screening for Medical knowledge and ability. 

No I do not work a private service(before you try to take that approach in your rebutle)


----------



## triemal04

Fish said:


> Most EMS agencies? Absolutely not....... Do Fire services USUALLY look for the fastest and cheapest Paramedic school around? Absolutely yes..... Infact most Fire Deptartments do not even have a Medical component to their hiring process, so make fun of private EMS services for the hire anyone with a pulse mentality all you want. But, Fire Departments do not do much better when it comes to screening for Medical knowledge and ability.
> 
> No I do not work a private service(before you try to take that approach in your rebutle)


I'm not talking about sending people to paramedic school; I know HFD does that, and lousy as NCTI may be I'd still rather work with someone from there versus a quick patch factory like TEEX.

I'm not talking about the hiring and testing process for getting a job either; I agree that, generally speaking fire department's do a poor job of testing for medical knowledge, even for paramedics.  (yes, there absolutely are ones that do very good, but, admittedly, in general not that great)

I'm specifically referring to the comment that a private ambulance service wouldn't accept someone from a 10-week paramedic program.  That is such a load of bull:censored::censored::censored::censored: it shouldn't even have been mentioned.  While I have no doubt that some services will ask for where someone was taught, overall...in every type of service...it doesn't happen.  An applicant's knowledge may, and should, be tested, but as long as they meet the agencies standard and have the appropriate certifications...where they were taught is rarely an issue.


----------



## Fish

triemal04 said:


> I'm not talking about sending people to paramedic school; I know HFD does that, and lousy as NCTI may be I'd still rather work with someone from there versus a quick patch factory like TEEX.
> 
> I'm not talking about the hiring and testing process for getting a job either; I agree that, generally speaking fire department's do a poor job of testing for medical knowledge, even for paramedics.  (yes, there absolutely are ones that do very good, but, admittedly, in general not that great)
> 
> I'm specifically referring to the comment that a private ambulance service wouldn't accept someone from a 10-week paramedic program.  That is such a load of bull:censored::censored::censored::censored: it shouldn't even have been mentioned.  While I have no doubt that some services will ask for where someone was taught, overall...in every type of service...it doesn't happen.  An applicant's knowledge may, and should, be tested, but as long as they meet the agencies standard and have the appropriate certifications...where they were taught is rarely an issue.



Copy....... and agreed


----------



## RocketMedic

I think the real question is whether or not HFD provides quality care. I don't know, never worked there, never been, and I've never really cared. So do they, or can Houston do better (and cheaper, apparently.)?


----------



## Fish

46Young said:


> Yes.



How is it there?


----------



## 46Young

Fish said:


> How is it there?



Besides going from running only ALS job types back home (NY) to now running everything and getting real patients once in a blue, things are great here. I'm making more than the supervisors back home, and also more than what was offered as the hiring range for the Assistant Director for Charleston County EMS (used to work there too, back in '07-'08). If I stayed single role EMS only, I'd probably have moved on to another career due to burnout, and maybe stayed per diem at the most. I'd be a ten year person, and I don't see myself doing field EMS and nothing but for that long, let alone for 25-30 years. It's too much like Groundhog Day. Here, there's so many different directions to go in the department. It keeps you fresh. 

What do you want to know in particular?


----------



## Fish

46Young said:


> Besides going from running only ALS job types back home (NY) to now running everything and getting real patients once in a blue, things are great here. I'm making more than the supervisors back home, and also more than what was offered as the hiring range for the Assistant Director for Charleston County EMS (used to work there too, back in '07-'08). If I stayed single role EMS only, I'd probably have moved on to another career due to burnout, and maybe stayed per diem at the most. I'd be a ten year person, and I don't see myself doing field EMS and nothing but for that long, let alone for 25-30 years. It's too much like Groundhog Day. Here, there's so many different directions to go in the department. It keeps you fresh.
> 
> What do you want to know in particular?



How did you like Charelston County EMS? You got offered the Assistant Director spot? What did that pay?

Where in NY did you work?


----------



## Veneficus

Fish said:


> The IAFF? What was their proposal



When it was announced that there would be a contract for Gulf coast disaster response, Gary Ludwig published a piece how it shouldn't go to a private company but cited that the US fire service had an "army" ready to respond.

It detailed a joint response like used in wildland fires, but his "plan" was so pathetically inadequete and unrealistic to disaster response that it destroyed any credibility he or the fire service might have had. (I doubt apart from providing specialty teams to a larger agency, their policy level plans will ever get serious consideration again, it really made them look like an unitelligent gang who had no idea what they were dealing with.)

It did not take into account the logistical complications of multiple agency responses.

It did not take into account who would provide medical oversight. (Can you imagine what would happen in a disaster if different providers with different training could do whatever they wanted or normally did?)

The whole plan was based upong mobilizing a fleet of ambulances to transport emergency victims out of the disaster zone and to hospitals outside. (which is not only done, but the nature of disaster response requires prolonged on scene treatment as well as healthcare post disaster from conditions that result.) There are not enough hospitals in the world for something like that. Much less ambulances to drive everyone to one.


----------



## shfd739

Veneficus said:


> When it was announced that there would be a contract for Gulf coast disaster response, Gary Ludwig published a piece how it shouldn't go to a private company but cited that the US fire service had an "army" ready to respond.
> 
> It detailed a joint response like used in wildland fires, but his "plan" was so pathetically inadequete and unrealistic to disaster response that it destroyed any credibility he or the fire service might have had. (I doubt apart from providing specialty teams to a larger agency, their policy level plans will ever get serious consideration again, it really made them look like an unitelligent gang who had no idea what they were dealing with.)
> 
> It did not take into account the logistical complications of multiple agency responses.
> 
> It did not take into account who would provide medical oversight. (Can you imagine what would happen in a disaster if different providers with different training could do whatever they wanted or normally did?)
> 
> The whole plan was based upong mobilizing a fleet of ambulances to transport emergency victims out of the disaster zone and to hospitals outside. (which is not only done, but the nature of disaster response requires prolonged on scene treatment as well as healthcare post disaster from conditions that result.) There are not enough hospitals in the world for something like that. Much less ambulances to drive everyone to one.



This sounds like a fun read. Is it still floating around somewhere?

After a certain storm we had an EMS Task Force comprised of mostly fire based medics/ambulances from a southern state in the county for 10 days. The help was appreciated and somewhat needed..However they whined about doing nothing, whined if they had to be on duty more than 12 hours, whined if they didnt get their downtime,hot meal, etc. Our people handled subsequent storm responses without near the complaints of these guys.


----------



## Veneficus

shfd739 said:


> This sounds like a fun read. Is it still floating around somewhere?
> 
> After a certain storm we had an EMS Task Force comprised of mostly fire based medics/ambulances from a southern state in the county for 10 days. The help was appreciated and somewhat needed..However they whined about doing nothing, whined if they had to be on duty more than 12 hours, whined if they didnt get their downtime,hot meal, etc. Our people handled subsequent storm responses without near the complaints of these guys.



I cannot find it with a google search, it was at least a few years ago, and as I mentioned, it was laughable, so it may have been removed from JEMS or wherever I read it. (I am pretty sure it was an EMS tade magazine because I recall writing a response.)

I can only imagine what your experience must have been like.

(don't you know you have to provide the equal of thanksgiving dinner twice a day to the fire service?) 

I tell you, no wonder they complain about privates.


----------



## Veneficus

found it:

http://www.jems.com/article/operations-protcols/government-solicits-national-a

"˙The fire service has the largest supply of EMS transport vehicles in the United States and a network able to respond anywhere in the contiguous United States. This is duplicative and disappointing that they wouldn_t look at our system, a system that is already in place,Ó said Deputy Chief Gary Ludwig, chair of the IAFC EMS Section."

Should you like to PM me your email, I have also dug a copy of my response out of my email archives.


----------



## RocketMedic

I'd love to see that, Veneficus.


----------



## shfd739

Veneficus said:


> I cannot find it with a google search, it was at least a few years ago, and as I mentioned, it was laughable, so it may have been removed from JEMS or wherever I read it. (I am pretty sure it was an EMS tade magazine because I recall writing a response.)
> 
> I can only imagine what your experience must have been like.
> 
> (don't you know you have to provide the equal of thanksgiving dinner twice a day to the fire service?)
> 
> I tell you, no wonder they complain about privates.



It wasnt really a bad experience just the typical "we are fire, hear us roar" that got old. If youre visiting my backyard dont try to take it over.

Contrast that with another large private service that rotated us extra medics for months and Id take the private service folks. The private service medics were more low key and blended with us better.

Just my observations.


----------



## usalsfyre

shfd739 said:


> The private service medics were more low key and blended with us better.


The second biggest reason I don't ever see myself back in the fire service. Too often the mentality is similar to what you find in high school locker rooms.


----------



## Fish

usalsfyre said:


> The second biggest reason I don't ever see myself back in the fire service. Too often the mentality is similar to what you find in high school locker rooms.



What is the third what is the third???????


----------



## triemal04

Veneficus said:


> found it:
> 
> http://www.jems.com/article/operations-protcols/government-solicits-national-a
> 
> "˙The fire service has the largest supply of EMS transport vehicles in the United States and a network able to respond anywhere in the contiguous United States. This is duplicative and disappointing that they wouldn_t look at our system, a system that is already in place,Ó said Deputy Chief Gary Ludwig, chair of the IAFC EMS Section."
> 
> Should you like to PM me your email, I have also dug a copy of my response out of my email archives.


Was there another article that went more in depth on what you were talking about before?  Because, taking the given information at face value and ignoring the comment from Memphis Molly, the questions being asked by the others in the article are valid.  Though that still doesn't make their plan the best.

The NWCG runs ROSS, and it's allready used by many of the groups that are responsible for wildfires nationwide.  While it's used right now for wildland firefighting resources, I'd think it could be easily adapted to work for any type of resource.  

If you look at what was being asked for by the feds, having a database that could track and manage multiple resources from multiple agencies and states would be required for it to run smoothly.  It's a good bet that whoever was awarded the contract has set up a system like that.  If that was the case, I can see why someone might have questioned why a system that was allready in place and running fairly smoothly wasn't used.

Of course, that still doesn't answer who would have run it if ROSS was used; the NWCG?  Someone else?  Hell, who or what eventually did get awarded the contract?


----------



## RocketMedic

I think AMR won it.


----------



## Fish

Rocketmedic40 said:


> I think AMR won it.



Yes they did, they have the largest supply of ambulances and had them deployed in no time.


----------



## Veneficus

triemal04 said:


> Was there another article that went more in depth on what you were talking about before?  Because, taking the given information at face value and ignoring the comment from Memphis Molly, the questions being asked by the others in the article are valid.  Though that still doesn't make their plan the best.
> 
> The NWCG runs ROSS, and it's allready used by many of the groups that are responsible for wildfires nationwide.  While it's used right now for wildland firefighting resources, I'd think it could be easily adapted to work for any type of resource.



I am sure there was a more indepth article, when the contract was being considered it was the hot topic of the day in the disaster community and being discussed everywhere. That was the only one I could find without doing an extrensive search.



triemal04 said:


> If you look at what was being asked for by the feds, having a database that could track and manage multiple resources from multiple agencies and states would be required for it to run smoothly.  It's a good bet that whoever was awarded the contract has set up a system like that.  If that was the case, I can see why someone might have questioned why a system that was allready in place and running fairly smoothly wasn't used.



I am not on the inside decision making process of it, but I think it may have been a requirement because no unified command and control exists within the fire service. (and you know every white hat who sent a unit would think thay had to contribute)

I think the logistics (what really mitigates disaster) and oversight of a multiple agencies with independant operating standards would have been a nightmare.

Finally, because of the nature of disaster response, mobilizing a bunch of transport ambulances without the ability to provide onsight medical care both during and immediately after, is totally useless.

A private company also has the ability to immediately increase its staffing.

Could you imagine what would happen if post disaster 100 or so medics needed to be recruited for the the duration of operations?

It would take the fire service months to even run their hiring process.

Not to mention who is picking up the tab for these units to be out of their primary community? Wear and tear on the vehicles, etc?


----------



## triemal04

Veneficus said:


> I am sure there was a more indepth article, when the contract was being considered it was the hot topic of the day in the disaster community and being discussed everywhere. That was the only one I could find without doing an extrensive search.


Probably, and I'm not asking that you look for more.  It's just that the article you linked actually might have a workable plan, albiet one that would need to be described in much greater detail before it could be considered an option and would probably still need to be revised.  Again, while it may not have been the best option, it is a valid question to ask; why duplicate a service that is allready being provided, though using different resources?  Really, I was just curious about the comment you made; didn't seem to match what was reported.



Veneficus said:


> I am not on the inside decision making process of it, but I think it may have been a requirement because no unified command and control exists within the fire service. (and you know every white hat who sent a unit would think thay had to contribute)


Actually, what I meant wasn't that a database would be required in the RFP, but that one would need to be used to actually track the resources available, the resources being used, where they were, etc etc.  There's probably better ways to do it, and (if AMR was the one who got the contract) they probably have developed/had one of their own.  

You also need to rememeber, wildfires are not structural fires.  And I mean that beyond the most obvious ways.  The logistics and structure involved in large fires really isn't that different than what's involved in a disaster; yes, different resources would need to be mobilized, but the process and command/control would be very similar.  Anecdotally as I have no way of knowing if this is true, many of the advisors that were brought in to NYC after 9/11 to help coordinate the responce (the total responce, not just the fire side) where people from wildfire groups.



Veneficus said:


> I think the logistics (what really mitigates disaster) and oversight of a multiple agencies with independant operating standards would have been a nightmare.


That would be no different than using a bunch of non-fire EMS providers from different agencies.  Even if it was all AMR employees, they still use different policies/procedures for each operation so the same problem would arise.

Again, while it would be different, since the resources needed would be much different than what's in use, using a system that is allready in place for similar events and works pretty well...why not duplicate it?  

Also, you need to look at what the RFP was asking for; transport capabilities.  While there may have been more to it, all that was asked for in the article you posted was the ability to move large numbers of people.



Veneficus said:


> Finally, because of the nature of disaster response, mobilizing a bunch of transport ambulances without the ability to provide onsight medical care both during and immediately after, is totally useless.
> 
> A private company also has the ability to immediately increase its staffing.
> 
> Could you imagine what would happen if post disaster 100 or so medics needed to be recruited for the the duration of operations?
> 
> It would take the fire service months to even run their hiring process.
> 
> Not to mention who is picking up the tab for these units to be out of their primary community? Wear and tear on the vehicles, etc?


But again, while there may have been more to the RFP, all that I can see being asked for IS the ability to transport patients.  More is needed, and that might not have been reported by the author of the article, but it does make a bit of sence that there would be 2 seperate contracts; 1 for transport, and 1 for static medical deployments.  While the same group might get both, and coordination between the two would be needed, they are 2 different things to worry about.

The staffing is an issue.  I know after Deepwater blew AMR went on a hiring frenzy to get people to the gulf to staff their aid stations.  But...depending on exactly who would have been in charge if the ROSS system was used...there are a lot of firefighter/paramedics out there, and a lot of fire department ambulances.  Increasing staffing beyond that would be an issue though.  You also need to remember that, the system set up for wildfires that uses the ROSS database referenced includes many, many, many non-FD resources.  No reason it couldn't here either.

Believe me, I'm not saying that the fire service should have been awarded the contract and put in charge.  To be honest knowing what I do (which ain't much), that one article doesn't even make a lot of sense; there is so much info missing it's ridiculous. My only points are that your comments just didn't seem to add up from that 1 article (and if there were others you were reading then I understand) and that it's a valid question; why not look at adapting a similar system that is allready in place to disaster responce?


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## 46Young

Fish said:


> How did you like Charelston County EMS? You got offered the Assistant Director spot? What did that pay?
> 
> Where in NY did you work?



Charleston wasn't my cup of tea. I've posted about them several times on this forum. Just run a search. On this thread, I wrote about my work experience in post #'s 9, 25, and 28.

http://www.emtlife.com/showthread.php?t=13483&highlight=quality+ems+agencies

No, I wasn't offered the Assistant Director's position. I basically worked there for about six months, until Fairfax offered me a job, then I quickly left. I loved the area, and we may retire there someday, but the job wasn't for me. What I was saying is that Charleston County EMS posted the Asst. Director's position on the county employment page sometime last year (or maybe in '10, I can't remember. They wanted a four year healthcare degree, and were offering somewhere in $65-$70k/yr range. At the time I was reading that, my base salary at my current employer was in the mid $70's (as a two year person), which is about $7k more than a medic at top step, and more than the A.D. offering. That let mem know that I made the right choice in leaving.

If I had never received the offer from Fairfax, I already had a full time offer from MUSC EMS, which payed well and had a schedule of three 12's, so I would have dropped to per diem with Charleston, knocked out an RN degree, and then looked into Myrtle Beach FD, Horry County Fire, or Hilton Head, That was the plan B.

Edit: I have a buddy that also used to work for NS-LIJ CEMS in NY who was hired there just ahead of me. After I left, he did the same, and now works in a cushy admin position for one of the hospitals that his wife works at as a nurse. They're set.


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## marshmallow22

Houston should look at going to 3rd service... like Austin.


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## 46Young

marshmallow22 said:


> Houston should look at going to 3rd service... like Austin.



I would go for that over here. I could do fire full time, and be a per diem/part time medic for the private 911 provider. The private company that comes in could hire the Houston medics that want to make some extra bucks.

I know a few FDNY guys that do this. They were already medics to begin with, already in the NYC 911 system for either FDNY or one of the hosptals, so they were making $30/hr + when they're off duty.


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## Fish

marshmallow22 said:


> Houston should look at going to 3rd service... like Austin.



I think third service is the best possible EMS model, unfortunatley I do not see how this would save Houston money? It would only improve quality of care.


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## Veneficus

Fish said:


> I think third service is the best possible EMS model, unfortunatley I do not see how this would save Houston money? It would only improve quality of care.



I don't think it is fair to say it would improve the quality. 

There are 1 or 2 really poor 3rd service agencies out there. I actually worked for a 3rd service which is hands down the worst EMS agency I ever saw.


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## RocketMedic

Where was that?


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## Fish

Veneficus said:


> I don't think it is fair to say it would improve the quality.
> 
> There are 1 or 2 really poor 3rd service agencies out there. I actually worked for a 3rd service which is hands down the worst EMS agency I ever saw.



Which one?


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## RocketMedic

Indeed, we need places to avoid.


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