Cleveland to merge fire and EMS

[46Young]

I understand this from an employee stand point, but from a clinical and tax payer stand point. It holds no water.

No benefit clinically, you've got me there. My county's answer is to put at least two medics on every ALS call, rather than have anyone flying alone. As far as dual role and proficiency, I'll say that a paramedic's education is front loaded, unlike fire, where you spend your entire rookie year studying and drilling. Medics come ready made as far as education is concerned. Let's face it, EMS is only a narrow slice of the medical profession. It really isn't that difficult to become proficient in EMS transport. In fire, to promote, we now need degrees, as well as various classes, such as Officer I,II,III, and Instructor I,II,III. We're taking Pump Operator classes, as well as whatever seminars we can get selected for. Our relevant degrees are in areas such as Fire Science, EMS AAS, and Emergency Management.

The good thing is, we can (we're required to, in fact) drill both EMS and suppression topics on a regular basis. It's not too difficult to maintain proficiency in both disciplines, provided you're in a regular flip flop rotation.

As far as costs, the pro combination argument is that having dual role personnel saves on OT/holdover costs, since personnel are more interchangeable. It's less difficult to fill vacancies. Overall, you'll need less employees in a combined system than you would if both were seperate. In addition, there's much less turnover in a fire based system, so there's less of a hiring cost. The ALS first response allows the department to operate with less ambulances. It would be ideal, of course, to have the EMS fleet upstaffed instead, but it's unrealistic to expect this when most (probably all) single role EMS departments seek to operate with the least amount of units possible. SSM is an extreme example of this (as ineffective as it is).

We can argue that the fire based employees are paid much more than they would be in a non-fire service, but isn't the main complaint in EMS the poor pay? I say that the fire based people have that liveable wage that everyone else (save a few systems in TX and WA) long for. Of course, if you replace a $70,000/yr FF/medic and a $50,000/yr FF/EMT with a $16/hr medic and an $11/hr EMT (if you're lucky) there will be cost savings, but you get what you pay for.

Our medics get $70k/yr after internship, but they can do both jobs. You cut the average career medic's yearly compensation (40k/yr) in half, you have $20k. Since our FF's come out making $50k (figure around 15k of that for EMT, half of an average $30/yr), these salaries aren't really out of line, IMO. Not out of line considering that we work an average 56 hour workweek, 53 of which are straight time per FLSA. For every five employees the county hires, they're saving the costs of two 40 hour employees. So, that $70k medic would only be maybe a $50k medic or less, and that $50k FF would only be a $35k FF. Not so generous when you look at it that way.

This is why I say that while systems in places such as NC are good, the pay still sucks. They're working 56 hour schedules as well (IIRC), so if a medic is only making $30-something a year to start, their hourly is quite poor. I found this out in Charleston SC. I was hired at around $38k/yr on a 24/48. My hourly was $11-$11.50, not more than that. If you're working a 56 hour schedule (48 hour even) and your base is less than 60k give or take, you're getting jacked.

 

[Fish]

No benefit clinically, you've got me there. My county's answer is to put at least two medics on every ALS call, rather than have anyone flying alone. As far as dual role and proficiency, I'll say that a paramedic's education is front loaded, unlike fire, where you spend your entire rookie year studying and drilling. Medics come ready made as far as education is concerned. Let's face it, EMS is only a narrow slice of the medical profession. It really isn't that difficult to become proficient in EMS transport. In fire, to promote, we now need degrees, as well as various classes, such as Officer I,II,III, and Instructor I,II,III. We're taking Pump Operator classes, as well as whatever seminars we can get selected for. Our relevant degrees are in areas such as Fire Science, EMS AAS, and Emergency Management.

The good thing is, we can (we're required to, in fact) drill both EMS and suppression topics on a regular basis. It's not too difficult to maintain proficiency in both disciplines, provided you're in a regular flip flop rotation.

As far as costs, the pro combination argument is that having dual role personnel saves on OT/holdover costs, since personnel are more interchangeable. It's less difficult to fill vacancies. Overall, you'll need less employees in a combined system than you would if both were seperate. In addition, there's much less turnover in a fire based system, so there's less of a hiring cost. The ALS first response allows the department to operate with less ambulances. It would be ideal, of course, to have the EMS fleet upstaffed instead, but it's unrealistic to expect this when most (probably all) single role EMS departments seek to operate with the least amount of units possible. SSM is an extreme example of this (as ineffective as it is).

We can argue that the fire based employees are paid much more than they would be in a non-fire service, but isn't the main complaint in EMS the poor pay? I say that the fire based people have that liveable wage that everyone else (save a few systems in TX and WA) long for. Of course, if you replace a $70,000/yr FF/medic and a $50,000/yr FF/EMT with a $16/hr medic and an $11/hr EMT (if you're lucky) there will be cost savings, but you get what you pay for.

Our medics get $70k/yr after internship, but they can do both jobs. You cut the average career medic's yearly compensation (40k/yr) in half, you have $20k. Since our FF's come out making $50k (figure around 15k of that for EMT, half of an average $30/yr), these salaries aren't really out of line, IMO. Not out of line considering that we work an average 56 hour workweek, 53 of which are straight time per FLSA. For every five employees the county hires, they're saving the costs of two 40 hour employees. So, that $70k medic would only be maybe a $50k medic or less, and that $50k FF would only be a $35k FF. Not so generous when you look at it that way.

This is why I say that while systems in places such as NC are good, the pay still sucks. They're working 56 hour schedules as well (IIRC), so if a medic is only making $30-something a year to start, their hourly is quite poor. I found this out in Charleston SC. I was hired at around $38k/yr on a 24/48. My hourly was $11-$11.50, not more than that. If you're working a 56 hour schedule (48 hour even) and your base is less than 60k give or take, you're getting jacked.

In the private sector there is poor pay, they don't have big liberal unions fighting to suck every ounce of funds out of a city like the fire department does. In the third service sector pay and benefits is good though. And we have to be honest with ourselves, an AS degree in Fire science is a joke, the only thing I am missing from completing my AS degree in Fire science is the actually academy. The courses felt like 4th grade level, and what is taught in the Fire academies(I only know this because I led PT at one) is just as easy. There is nothing difficult about the requirements to become a FF. That is why you get an *** load of applicants per each hire, because everyone wants to get a lot of pay, and awesome retirement and not really do to much. Am I anti-Fire Fighters? No, not by an stretch. I am just anti-Fire department expansion into EMS and anti- extremely high salaries for FFs when EMS and PD make so much less. And the job of a FF in no way compares to PD as far as danger is concerned. Everyday on the Job, every traffic stop, every house they enter is dangerous. For a FF, their jobs get dangerous 1-3 times a year when they go on a fire. And everyone forgets about EMS? EMS is now more dangerous than FD. We had more line of Duty Deaths than the FD did last year, wheres the love?


How come you don't think SSM is effective?

 

[46Young]

In the private sector there is poor pay, they don't have big liberal unions fighting to suck every ounce of funds out of a city like the fire department does. In the third service sector pay and benefits is good though. And we have to be honest with ourselves, an AS degree in Fire science is a joke, the only thing I am missing from completing my AS degree in Fire science is the actually academy. The courses felt like 4th grade level, and what is taught in the Fire academies(I only know this because I led PT at one) is just as easy. There is nothing difficult about the requirements to become a FF. That is why you get an *** load of applicants per each hire, because everyone wants to get a lot of pay, and awesome retirement and not really do to much. Am I anti-Fire Fighters? No, not by an stretch. I am just anti-Fire department expansion into EMS and anti- extremely high salaries for FFs when EMS and PD make so much less. And the job of a FF in no way compares to PD as far as danger is concerned. Everyday on the Job, every traffic stop, every house they enter is dangerous. For a FF, their jobs get dangerous 1-3 times a year when they go on a fire. And everyone forgets about EMS? EMS is now more dangerous than FD. We had more line of Duty Deaths than the FD did last year, wheres the love?


How come you don't think SSM is effective?

I've got 87 FF LODD's in 2010 vs 35 EMS LODD's in 2010:

http://www.usfa.fema.gov/fireservice/fatalities/statistics/casualties.shtm

http://nemsms.org/notices10.htm

Were you referring to deaths per every 1000 members?


As far as SSM,

http://www.emsworld.com/article/103...wers-response-times-and-enhances-patient-care

And yes, fire science is a Mickey Mouse degree; that's why we train and study well beyond what's offered in that degree and the fire academy. It's only the bare bones basics.

Also, our frequency of fires are less than they have been, but they are no less dangerous when they do occur, and we're also expected to resond in a timely fashion regardless. It's probably the only fire that citizen will ever have. We are also subject to various cancers. This is why we're protected under the Heart and Lung Bill, with seven presumptive cancers. The average firefighter dies ten years earlier than the average life expectancy.

I worked urban EMS for five years. I wrestled with the EDP's, I've jumped out of the way on highway incidents, and I've been in theback during two ambulance MVA's. You'll only suffer an exposure or needle stick if you let it happen. I find fire suppression more dangerous. We have type V construction that fails much more quickly with a larger fire load and void spaces, and synthetic materials/plastics that make a room flash in mere minutes vs 20-30 minutes in legacy models. The potential for injuries is much greater as well, although I'll give the repetitive use injury edge to EMS. About half of firefighter fatalities are due to cardiac events. What is it in EMS? (Not breaking chops, I'm really wondering).

Ever consider that the low barrier to entry for many fire departments is for purposes of quota hiring? Merit based hiring is all but dead in most large departments. For example, we have the CPAT, a watered down ability test that is little more than a joke. FDNY used to require two year's worth of college, but that's been taken away to include more people. Chicago's entrance exam is pass/fail. I wonder why?

The barrier for entry in EMS is still lower than that, though. So is the pay.

I feel that all emergency services should be on par with the fire service, not that the fire service compensation should be knocked down to a step above welfare wages like EMS in some places.

 

[JPINFV]

We are also subject to various cancers. This is why we're protected under the Heart and Lung Bill, with seven presumptive cancers. The average firefighter dies ten years earlier than the average life expectancy.

...and how often are fire fighters seen on the videos on Statter911 who are in the smoke (especially when doing roof work or working a car fire) without proper respiratory protection? I honestly wonder what the rate of cancer is in fire fighters who consistently and properly use their SCBA when fighting a fire. Eating smoke may be sexy, but if the cost is cancer, than I'd rather not be sexy. ...and yes, the same critique goes for EMS providers who fail to utilize proper BSI.

About half of firefighter fatalities are due to cardiac events. What is it in EMS? (Not breaking chops, I'm really wondering).

I wonder what the mortality and disability rate would be on both sides if you take away factors that don't involve the business. There's a difference between dying in the line of duty and dying at work. Dying from an MI at the station should not be considered a LODD, regardless of the service.

 

[Fish]

I've got 87 FF LODD's in 2010 vs 35 EMS LODD's in 2010:

http://www.usfa.fema.gov/fireservice/fatalities/statistics/casualties.shtm

http://nemsms.org/notices10.htm

Were you referring to deaths per every 1000 members?


As far as SSM,

http://www.emsworld.com/article/103...wers-response-times-and-enhances-patient-care

And yes, fire science is a Mickey Mouse degree; that's why we train and study well beyond what's offered in that degree and the fire academy. It's only the bare bones basics.

Also, our frequency of fires are less than they have been, but they are no less dangerous when they do occur, and we're also expected to resond in a timely fashion regardless. It's probably the only fire that citizen will ever have. We are also subject to various cancers. This is why we're protected under the Heart and Lung Bill, with seven presumptive cancers. The average firefighter dies ten years earlier than the average life expectancy.

I worked urban EMS for five years. I wrestled with the EDP's, I've jumped out of the way on highway incidents, and I've been in theback during two ambulance MVA's. You'll only suffer an exposure or needle stick if you let it happen. I find fire suppression more dangerous. We have type V construction that fails much more quickly with a larger fire load and void spaces, and synthetic materials/plastics that make a room flash in mere minutes vs 20-30 minutes in legacy models. The potential for injuries is much greater as well, although I'll give the repetitive use injury edge to EMS. About half of firefighter fatalities are due to cardiac events. What is it in EMS? (Not breaking chops, I'm really wondering).

Ever consider that the low barrier to entry for many fire departments is for purposes of quota hiring? Merit based hiring is all but dead in most large departments. For example, we have the CPAT, a watered down ability test that is little more than a joke. FDNY used to require two year's worth of college, but that's been taken away to include more people. Chicago's entrance exam is pass/fail. I wonder why?

The barrier for entry in EMS is still lower than that, though. So is the pay.

I feel that all emergency services should be on par with the fire service, not that the fire service compensation should be knocked down to a step above welfare wages like EMS in some places.

Private services are a "You got a cert? Well come aboard!!!!!!!!!!" Not at third services, we are talkin 3-4 days of testing.

I was going off of this one for the year 2010, sorry:

FD
http://www.tdi.texas.gov/reports/fire/documents/fmloddannul10.pdf

EMS
http://www.dshs.state.tx.us/emstraumasystems/emshon.shtm

 

[Fish]

As far as SSM,

[Also, our frequency of fires are less than they have been, but they are no less dangerous when they do occur, and we're also expected to resond in a timely fashion regardless. It's probably the only fire that citizen will ever have. We are also subject to various cancers. This is why we're protected under the Heart and Lung Bill, with seven presumptive cancers. The average firefighter dies ten years earlier than the average life expectancy.

Right, I can't tell you how often I see Fire FIghters not takeing proper precautions on scene either though. So you got to wonder how much not taking proper PPE effects those statistics. Plus all of the Fire Fighters getting cancer and dieing Ten years earlier are mostly those who were the "old school" fire fighters that took pride in having lead lungs and not wearing proper ppe. I think we will see those statistics decrease with the push for proper ppe

Leading cause of death is cardiac related, how many out of shape fire fighters do we see?


What is it in EMS? (Not breaking chops, I'm really wondering).

It is traumatic deaths, accidents, getting hit by vehicles.
.

I agree, EMS should be brought to the pay/benefits level FD has and that FD should not be decreased. I just don't agree when FD cries for more and more.

 

[Fish]

Dying from an MI at the station should not be considered a LODD, regardless of the service.

I agree, a life time of poor health habits, or poor family history should not equate for a LODD. Just because you happened to have had the MI while you were at a Fire Scene or medical scene instead of walkin up the steps at home.

 

[Fish]

You will still never get me to agree that a Fire Fighter or a Medic should be making more than Police Officer, Corrections Officer, or Member of our military.

 

[Everett]

Most places seem to be going this route for various reasons.

I agree with the principal of consolidating municipal fire and ems, however not the cross training.

I believe it is important for both police and fire to be trained in some type of first responder aspect, or atleast CPR and first aid. However, I whole heartedly do not agree with the fact that a firefighter must become a paramedic or vice versa.

There are some that should only do one, and there are those who can/should do both. Leave it as an option.

 

[46Young]

...and how often are fire fighters seen on the videos on Statter911 who are in the smoke (especially when doing roof work or working a car fire) without proper respiratory protection? I honestly wonder what the rate of cancer is in fire fighters who consistently and properly use their SCBA when fighting a fire. Eating smoke may be sexy, but if the cost is cancer, than I'd rather not be sexy. ...and yes, the same critique goes for EMS providers who fail to utilize proper BSI.



I wonder what the mortality and disability rate would be on both sides if you take away factors that don't involve the business. There's a difference between dying in the line of duty and dying at work. Dying from an MI at the station should not be considered a LODD, regardless of the service.

Very nice. We just had one of our FF's die in his sleep not even a month ago:

http://www.fairfaxfirefighters.org/index.cfm?section=1
http://www.fairfaxfirefighters.org/memorial.cfm?action=detail&id=1

There have been many documented cases of FF's dropping dead on a call, on the way back from a call, later at the station, and in their sleep following a significant incident. We've had several mambers in our department treated for (c0nfirmed) MI's on the job, and one cardiac arrest save after he dropped while running around the station. Waking abruptly to tones and the ensuing adrenaline slam isn't healthy, although this isn't exclusive to the fire service. What is unique is the fact that we get dressed in heavy gear, carry heavy tools, and have to remain fully encapsulated, on air, and have to endure that for an extended period of time. The inability to disperse heat, the adrenaline dump, and the dehydration will reveal underlying cardiac issues. We even have new technology with softer tones that gradually increase in volume to mitigate the abrupt awakening somewhat.

As far as eating smoke, good departments have SOP's in place that clearly state when the FF is mandated to don the proper PE. With all of the plastics and synthetic materials found in modern homes, most of us know that a few breaths of thick smoke will take us out. I'm willing to wager that these "smoke eaters" are not career FF's from medium to large sized departments.

 

[46Young]

Private services are a "You got a cert? Well come aboard!!!!!!!!!!" Not at third services, we are talkin 3-4 days of testing.

I was going off of this one for the year 2010, sorry:

FD
http://www.tdi.texas.gov/reports/fire/documents/fmloddannul10.pdf

EMS
http://www.dshs.state.tx.us/emstraumasystems/emshon.shtm

I understand.

As far as the hiring process, at Charleston County EMS all I had to do is fly down for an interview, obtain a background check from the NYPD, a driving abstract, and pass an entrance exam at a CBT center. For the FD, I had to drive down for the entrance exam, drive again for a CPAT practice session, another day for the CPAT, the next trip was three days - one day for the medical/physical, one day for the psych eval, and two days for two polygraphs. Many of us had to do two polys. In Charleston, we had a one day county orientation, then I was on the street. At Fairfax, I had a 23 week fire academy and a 16 week ALS internship/testing.

 

[JPINFV]

So unless you want to define "LODD" as "fire fighter dies," what's a reasonable demarcation between "LODD" and "non-LODD"? ...and to be fair, watch me go off the next time someone suggests that wearing seat belts in the back of the ambulance isn't conductive to care.

As far as mandated, are you telling me you've never seen people bend the rules, even mandated rules?

 

[46Young]

I agree, EMS should be brought to the pay/benefits level FD has and that FD should not be decreased. I just don't agree when FD cries for more and more.

You don't ask, you don't get. The worst they can say is "no." If we didn't ask for more, we'd have about the same deal as..... EMS, who has no voice outside of some local unions such as FDNY EMS Local 2507, or 1199 for some of the NYC 911 participating hospitals. Not saying that we deserve more, but this job is how we pay our bills. If we can get more, we're going to go for it. If the requests are too unreasonable, we'll simply be denied. We also operate in a right-to-work state, so our influence is purely political, as in no collective bargaining.

 

[46Young]

I agree, a life time of poor health habits, or poor family history should not equate for a LODD. Just because you happened to have had the MI while you were at a Fire Scene or medical scene instead of walkin up the steps at home.

I addressed this a couple of posts ago. This is why we have our Occupational Health Center, where we have very comprehensive yearly physicals including pulmonary function testing, blood work, urinalysis, stress tests, vision and hearing, and further testing if anything comes up. We also have a yearly Work Performance Evaluation, which is annual timed obstacle course while on air and full gear. We do the most possible in hiring and yearly evaluations to determine fitness for duty. We also have a mandatory on duty physical training policy.

The thing is, you can't say if it's poor lifestyle choices or job stressors that cause a death, so it's presumptive. It's nice to have the benefit of the doubt, instead of "sorry about your luck." This was fought for vigorously so that the FF's survivors would be taken care of.

 

[46Young]

You will still never get me to agree that a Fire Fighter or a Medic should be making more than Police Officer, Corrections Officer, or Member of our military.

You'll get no argument from me about the military. The Corrections Officers definitely get the short end of the stick. Here in my county, FF's and cops get roughly the same starting salary, although the FF's work more hours. Remember what I said earlier, we get paid well, but we're also working more hoursn than a cop or C.O.

A starting FF here gets a little under $50k/yr before differentials and FLSA (if on shift work). That's around $17/hr, since nearly all of our hours are straight time. A 40 hour employee making $17/hr would only be making around 36k/yr. The extra hours are built in OT (actually, it's straight time). My hourly right now is only around $23/hr (I've been in a few years, and also got a promotion), plus $5k/yr in ALS cert pay, some night diff, and between $2 and $3/hr riding pay for being the ALS provider on the engine nd medic, respectively. The cert pay is worth $1.72/hr, the night diff about $0.70/hr, and the riding pay about $2.50/hr. So, my base hourly rate is about $28/hr. If I was a 40 hour employee, my yearly income would be around $58k. Remember, a paramedic in my area will make around 40k/yr, s half of that is 20k. Take that from my yearly 50 hour rate, and that leaves 38k as a Technician, one rank above FF before the built in OT. That's not as grandiose a salary as it would seem at first glance. The LEO's hourly rate is in the 20's.

When working 25 years to qualify for normal service retirement, we actually work an average of 33.75 forty hour workweek-years. That's 8.75 years of built in OT at a straight time rate over our career to get our base pay.

 

[46Young]

So unless you want to define "LODD" as "fire fighter dies," what's a reasonable demarcation between "LODD" and "non-LODD"? ...and to be fair, watch me go off the next time someone suggests that wearing seat belts in the back of the ambulance isn't conductive to care.

As far as mandated, are you telling me you've never seen people bend the rules, even mandated rules?

People bend the rules, but our department SOP's clearly state that the department is not responsible for illness, injury, or death from improper PPE use, or non-compliance with seatbelt policy (wear them at all times). You fail to use your PPE, wear it wrong, or decide to finish getting dressed going down the road instead of at the station so that you can belt up right away, you're on your own.

LODD vs non LODD is pretty much death from an acute event while on the clock, and for a certain time period after the shift, I think it's 24 hours, for sudden death.

 

[46Young]

Most places seem to be going this route for various reasons.

I agree with the principal of consolidating municipal fire and ems, however not the cross training.

I believe it is important for both police and fire to be trained in some type of first responder aspect, or atleast CPR and first aid. However, I whole heartedly do not agree with the fact that a firefighter must become a paramedic or vice versa.

There are some that should only do one, and there are those who can/should do both. Leave it as an option.

Around 300 or so out of 1600 of our force are paramedics, and we have no mandation to be ALS, only that if you're hired as a FF/medic, you must keep the cert until you can promote out of the position. Everyone must be EMT's though.

 

[Fish]

I understand.

As far as the hiring process, at Charleston County EMS all I had to do is fly down for an interview, obtain a background check from the NYPD, a driving abstract, and pass an entrance exam at a CBT center. For the FD, I had to drive down for the entrance exam, drive again for a CPAT practice session, another day for the CPAT, the next trip was three days - one day for the medical/physical, one day for the psych eval, and two days for two polygraphs. Many of us had to do two polys. In Charleston, we had a one day county orientation, then I was on the street. At Fairfax, I had a 23 week fire academy and a 16 week ALS internship/testing.

1 DAY? Boo! Charelston just won EMS service of the year too, I would have expected more.

Hey will you PM me and tell me about Charelston a little more in detail? I almost applied there instead of where I am now and always wondered the "what could have been"

Where I am at now, Orientation isssssss I wanna say 1 and /1/2 months - 2 months??????? FTO Time is a minimum of 40 shifts.

We have a pre testing screening process, a 3 day testing process, backgrounds, pysichals(spelt that wrong) Interviews.

 

[Fish]

You don't ask, you don't get. The worst they can say is "no." If we didn't ask for more, we'd have about the same deal as..... EMS, who has no voice outside of some local unions such as FDNY EMS Local 2507, or 1199 for some of the NYC 911 participating hospitals. Not saying that we deserve more, but this job is how we pay our bills. If we can get more, we're going to go for it. If the requests are too unreasonable, we'll simply be denied. We also operate in a right-to-work state, so our influence is purely political, as in no collective bargaining.

I have asked, begged, pleaded, bribed, threatend, protested, decleared war, and still I get no love....... Ok only one of those are true.

 

[JPINFV]

I also want to make something clear, because I think based on your earlier post that it was taken the wrong way. I wasn't trying to be a **** with how I was discussing the definition of LODDs. It's an emotional issue, but when discussing policies and statistics, an issue where emotion needs to be removed.