FD EMS vs Private

Anjel said:
Genesee county. They still have ALS, but they have sherif medics that will ride in if it is a BLS unit that responds.
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For awhile there were issues because if you are treated by the Sheriff's dept. you aren't billed for the ALS because they are funded through taxes. If a private company showed up and they happened to be ALS you were billed for service. so it came down to if the sheriff showed up they could jump on anyone's truck ALS or BLS and run the call if they chose. Another issue was then the sheriff guys would take the "good" calls and dump stuff they didn't want onto the private companies.
 
Veneficus said:
That is because the purpose of FDs performing EMS is to save firefighter jobs, not to provide jobs for nonfirefighters.
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This!

That's the only reason fire had taken over EMS is to pay their bills that they can't cover with just fire runs.
 
Hunter said:
This!

That's the only reason fire had taken over EMS is to pay their bills that they can't cover with just fire runs.
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At my fire department this just isn't the case. We receive ~70% of our budget through fire fees and ~20% through EMS billing; the remainder through contracts with the county and various towns.

We took on ALS transport to serve a community need.

That being said, if we didn't combine the two funding sources we wouldn't have 4 career staff 24x7x365 (19 total; chief, asst chief, captain, 4 shifts of 4 folks).
 
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Christopher said:
At my fire department this just isn't the case. We receive ~70% of our budget through fire fees and ~20% through EMS billing; the remainder through contracts with the county and various towns.

We took on ALS transport to serve a community need.

That being said, if we didn't combine the two funding sources we wouldn't have 4 career staff 24x7x365 (19 total; chief, asst chief, captain, 4 shifts of 4 folks).
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Unfortunately your department is the exception, not the rule.

FDs I have been with in the past used the run numbers generated by EMS calls as the basis for their budget proposals. However, nowhere near the budget increases went towards anything remotely EMS related, but there was always nice big shiney new fire equipment. A lot that wasn't ever used or needed.

However, our staffing levels (aka my job) and keeping the lights on depended on these budgets. It wasn't until after I left the fire service that they began actually billing for EMS.

I am sure most fire departments don't actually "rely" on the money generated from EMS to keep the lights on. It probably doesn't come close to paying even 1 full time salary, which with benefits and pay 15 years ago was near $1million a year at our regional departments.

But I would be very surprised to learn that these "medical responses" whether it is CFR or ALS transport don't still play a large role in the budgeting.

As I often say, if you want the answers to most things, just follow the money.
 
Veneficus said:
Unfortunately your department is the exception, not the rule.

FDs I have been with in the past used the run numbers generated by EMS calls as the basis for their budget proposals. However, nowhere near the budget increases went towards anything remotely EMS related, but there was always nice big shiney new fire equipment. A lot that wasn't ever used or needed.

However, our staffing levels (aka my job) and keeping the lights on depended on these budgets. It wasn't until after I left the fire service that they began actually billing for EMS.

I am sure most fire departments don't actually "rely" on the money generated from EMS to keep the lights on. It probably doesn't come close to paying even 1 full time salary, which with benefits and pay 15 years ago was near $1million a year at our regional departments.

But I would be very surprised to learn that these "medical responses" whether it is CFR or ALS transport don't still play a large role in the budgeting.

As I often say, if you want the answers to most things, just follow the money.
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Considering the expense of providing EMS...I dunno. 1300 transports a year (2200-2300 EMS calls, 800-900 fire calls) is only able to cover 20% of our expenses! Granted, we put the shiny new stuff on EMS at least as much if not more than on the fire side.

There are plenty of examples of FD based EMS that does it right. Blaming fire depts is an indirect means of attacking the real problem:

Paying for EMS coverage is completely messed up.

Fire departments don't get into it for the money, perhaps for the call volume, but it doesn't represent anything close to a sustainable funding source. Taxes or fire fees are the bulk of a fire department's revenue.

The more likely cause is people pointing out call volumes going down on fire while EMS goes up, yet fire depts get larger budgets. The squeaky wheel gets the grease. It makes business sense to take on the Loss Leader so you can keep the doors open. Can't blame a business for making that sorta move.
 
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Christopher said:
Considering the expense of providing EMS...I dunno. 1300 transports a year (2200-2300 EMS calls, 800-900 fire calls) is only able to cover 20% of our expenses! Granted, we put the shiny new stuff on EMS at least as much if not more than on the fire side.

There are plenty of examples of FD based EMS that does it right. Blaming fire depts is an indirect means of attacking the real problem:

Paying for EMS coverage is completely messed up.

Fire departments don't get into it for the money, perhaps for the call volume, but it doesn't represent anything close to a sustainable funding source. Taxes or fire fees are the bulk of a fire department's revenue.

The more likely cause is people pointing out call volumes going down on fire while EMS goes up, yet fire depts get larger budgets. The squeaky wheel gets the grease. It makes business sense to take on the Loss Leader so you can keep the doors open. Can't blame a business for making that sorta move.
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I don't blame them for doing it. Like I said, when my job depended on it, I carried the banner for it.

I respectfully disagree there are "a lot" of departments doing it right. Infact I can name all the ones that cover more than a million people that do.

Tax dollars to be able to handle call volume is a relatively stable funding source. From fire levies to laws dictating budget percentages, the FD is very adept at keeping its share of the pie.

Again, not a fault, a requirement. It is hard to fault people for trying to keep their job.

However, the US fire service is not keen to embrace regional coverage nor willing to accept the amount of job and salary loss to do it.

Again, keeping your own job. If you are the chief of a department of 19, in a regionalized system, you might be lucky to still have a job. You certainly won't be the chief, and you would be even luckier to be an officer.

My last LT has more knowledge and experience than 90% of "non-big city" fire chiefs. Any single captain or B chiefs could probably run 3/4ths of the state without much effort.

It is sometimes referred to as the "my little kingdom" approach to fire departments.

Be careful about buying into fire service altruism. It is easy to get caught up in the propaganda and very difficult to see the forest from the trees.
 
Veneficus said:
I don't blame them for doing it. Like I said, when my job depended on it, I carried the banner for it.

I respectfully disagree there are "a lot" of departments doing it right. Infact I can name all the ones that cover more than a million people that do.

Tax dollars to be able to handle call volume is a relatively stable funding source. From fire levies to laws dictating budget percentages, the FD is very adept at keeping its share of the pie.

Again, not a fault, a requirement. It is hard to fault people for trying to keep their job.

However, the US fire service is not keen to embrace regional coverage nor willing to accept the amount of job and salary loss to do it.

Again, keeping your own job. If you are the chief of a department of 19, in a regionalized system, you might be lucky to still have a job. You certainly won't be the chief, and you would be even luckier to be an officer.

My last LT has more knowledge and experience than 90% of "non-big city" fire chiefs. Any single captain or B chiefs could probably run 3/4ths of the state without much effort.

It is sometimes referred to as the "my little kingdom" approach to fire departments.

Be careful about buying into fire service altruism. It is easy to get caught up in the propaganda and very difficult to see the forest from the trees.
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I work for a 3rd service private as well as an FD, plus a day job at a Fortune 10 company...I'm easily the most cynical person around when it comes to corps/gov'ts :)

I see 3rd service private doing it right and doing it wrong. I see FD's doing it right and doing it wrong. I see municipal services doing it right and doing it wrong.

Basically, it isn't who delivers the care but instead how they deliver the care. And you hit on probably the biggest factor: how the folks in charge want it delivered.

(As for the fd altruism, it isn't our dept which is altruistic but rather the people because at the end of the day the budget will be met)
 
I feel that this kind of thread makes everything go like this:

http://qkme.me/3sbdjl


Not saying your thread is troll bait at all...but you can see how much momentum this thread gains.

Let's all agree to disagree :deadhorse:

3sbdjl
 
I thought this one was much more civil than most.
 
Painting with a very broad brush

I love FD EMS. pension, good benefits, stationed at a fire house, have a bunk room, lockers, kitchen, and a supervisor is usually a person who will help you out.

I hate FD EMS. firefighters don't want to be on the ambulance, they are just doing their shift until they can get back on the engine. that leads to poor patient care and poor attitudes. Not only that, but just because you have an EMT cert doesn't mean you know what EMS is.... how much con ed above the minimum have you completed? Do you know the difference between sick and not sick? And on the EMS systems that fall under the FD (FDNY, DC, Detroit, Philly, etc), where the EMS is part of the FD in name, but understaffed, underpaid, redheaded stepchild is often used for run numbers, but the funding still goes to the suppression side, and despite EMS having between 2x and 4x as many runs as the suppression side, there are usually more suppression units than ems units. And all too often, the EMS crews are looking to transfer to the fire side, to make more money, go on less runs, and be treated much better.

I hate private EMS. pay sucks, management treats their staff as easily replaceable, and you get run into the ground because they won't pay for additional trucks (because a truck not going on a run isn't making any money for the company, and that gets into the bottom line). contracts change hands yearly, so you can work for the same private in the same area for 10 years, and if a new company wins the contract, you start at the bottom of the pay and seniority area if you want to stay in that area.... else you get laid off. Trucks are falling apart, missing critical equipment, and all too often you find worthless slugs in uniforms, because there are no requirements to get the job except to have a pulse. "we don't care if you kill patients, as long as your paperwork meets the billing requirements and you don't crash the ambulance" is very common.

Private EMS.... cheaper for the taxpayer, they bill the people who use the service more than the government.... I guess that's the only good thing....

to each his or her own. I still think the FD should put out fires, and the EMS agency should deal with the sick and injured on their own. and the EMS chief should be equal to the fire chief, and the EMS supervisors should stand up for their people like the fire supervisors do.
 
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