Privatized EMS in Placentia CA

wirk242

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How is this different than the laco model? Dual medic squabulance with bls engines and bls transport. Main difference I see is that there are at least 6 less career medic positions in socal.
 

DesertMedic66

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How is this different than the laco model? Dual medic squabulance with bls engines and bls transport. Main difference I see is that there are at least 6 less career medic positions in socal.
The difference is that in LA the only 911 medics are from the fire department. With this the medics will be from a private company (something that 99% of CA uses daily without issue). It is supposed to be vastly cheaper then continuing to contract with OCFA.
 

jgmedic

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Its not different. Flycars(Squads) have existed for years in LACo, they're all over Riverside and SBCo. However it's just as stupid for Lynch to use their ambos as non-transport units as it is for Redondo Beach, Costa Mesa, Compton or any FD to do. Im all in favor of this happening, but Lynch's rep in EMS is terrible, and Im scared for what that's gonna bring. Plus, do you really think they're going to pay their medics commensurate with an FD 911 medic in OC, or anywhere close?
 

VentMonkey

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Im all in favor of this happening, but Lynch's rep in EMS is terrible, and Im scared for what that's gonna bring.
I agree, it’s a waste of resources, but I really don’t know too much about Lynch. Why is their rep terrible?

I thought OCFA wasn’t exactly known for their medical care either. Again, my OC-EMS knowledge is archaic, and limited at best.
 

wirk242

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That is exactly what I saying. This is not a big step forward. This is not a career medic gig. It's going to be a stepping stone at best for most.

Lynch will be able to pay people dirt cheap because they are the only private als in the OC. Medics will put up with it untill they get called up. And now there is 6-12 less medic jobs with real benefits, decent pay and a retirement in OC.

I get it, not everyone wants to work for a fire department. But there are not many options for medics where you can raise a family, buy house and not live in Bakersfield.
 

VentMonkey

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I get it, not everyone wants to work for a fire department. But there are not many options for medics where you can raise a family, buy house and not live in Bakersfield.
Fair enough...I guess. Former Angelino here
FWIW.

I’m ~2 hours from the beach, mountains, the “real” city etc with better drives to and from and the same/ similar amount of traffic it takes most people in LA/ OC to get to and from said destinations.

Plus, the coast has reasonably prettier beaches than the overcrowded LA beaches, maybe with the exception of the ones in OC.

That said, it took me a while to settle in from a large city dweller to living in a more insular town. Goods and bads I like it here overall. I’m just saying, you don’t know what you don’t know til ya’ know it.
 

RocketMedic

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Fair enough...I guess. Former Angelino here
FWIW.

I’m ~2 hours from the beach, mountains, the “real” city etc with better drives to and from and the same/ similar amount of traffic it takes most people in LA/ OC to get to and from said destinations.

Plus, the coast has reasonably prettier beaches than the overcrowded LA beaches, maybe with the exception of the ones in OC.

That said, it took me a while to settle in from a large city dweller to living in a more insular town. Goods and bads I like it here overall. I’m just saying, you don’t know what you don’t know til ya’ know it.
I live in the objectively-nicest part of the Houston Metro and would take Bakersfield 12/10 times over this muggy swamphole.
Bakersfield is like a 1/3rd scale San Antonio, which is the best city on Earth. But Bakersfield has better positioning. Only better position is like...Visalia or something. Maybe Fresno. The CA Central Valley is pretty awesome because everything is close. Texas, all adventures start with a 3-hour drive unless you're in Austin or San Antonio.
 

jgmedic

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When I was in OCEMS Lynch was known to be the most Ricky Rescue company around, regularly heard their EMTs brag about driving code 3 on SNF transfers or whatever BS call just to beat traffic, to a man, they had multiple trauma shears and tape rolls on their BDU pants or boots unzipped, shirts untucked, just a gongshow all around. @VentMonkey, OCFA is terrible at EMS in general, had god complexes, and working closely with them made me know exactly how I didnt want to be as a medic and FF. What @wirk242 said is the truth, Lynch will pay bottom dollar for medics who are stuck on transfer trucks and are wannabe firemen, and in OC, they will have lines of those guys out the door.
 

RocketMedic

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Strong work.
 

DesertMedic66

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That is exactly what I saying. This is not a big step forward. This is not a career medic gig. It's going to be a stepping stone at best for most.

Lynch will be able to pay people dirt cheap because they are the only private als in the OC. Medics will put up with it untill they get called up. And now there is 6-12 less medic jobs with real benefits, decent pay and a retirement in OC.

I get it, not everyone wants to work for a fire department. But there are not many options for medics where you can raise a family, buy house and not live in Bakersfield.
From the medical side it is not a huge step forward. For Orange County as a system it is a huge step. How long has OCFA been in control? Not only did the city move away from the fire department having the only 911 paramedics but the city also moved away from OCFA as a whole for both ambulance and fire services because they found out how much money they could save.

Is it for the best? Who knows. The city seems to think it is.
 

wtferick

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When I worked in Westminster, one of the Placentia guys picked up OT. He had a very strong opinion on how Orange County should push towards Private Paramedics. Maybe we shall soon get there? 🤷🏼‍♂️
 

DrParasite

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Such an interesting setup..... currently the county FD is all FF/PM, and they first respond and initiate ALS care. the ambulance is separate, typically BLS only, and is a transportation vehicle only. If the patient requires ALS care, the FF/PM transports with the ambulance, while the engine follows behind, OOS for subsequent calls (I am assuming never leaving their first due, as all hospital that the patient gets transported to are still in the city limits). Once care is turned over, the FF/PM gets back into the truck and they are now able to head back to the house.

So now they are going to expel the OCFRA, and run their own FD as just suppression units, contract out their primary medical response to a private ALS agency who will respond to calls in a non-transporting ambulance, and still use a BLS transporting ambulance. very interesting.....

Looking into my crystal ball, here is what I predict happening: Placentia will form their own department, and try to recruit the OCFA guys who cover their area. They will get political BS from OCFA every time they do, but still call them every time they need a ladder truck or mutual aid assistance for an actual fire. it will get messy, esp when OCFA units cut through Placentia to go to another call in the county. I also predict the costs will rise in the next year, as a full time chief is hired, shift commander/batt chief, and administrative officers are hired (training, medical, etc), as well as 911 communications.

But things will improve, since you won't be tying up suppression resources on medical calls (and by typing up, I mean the following of the ambulance to the hospital to get the medic back). It's cheaper, because Placentia money is spent only on Placentia, instead of the entire county, which is good, until you need help from the county and they decide to send you a bill for services rendered. Outside of the fear mongering on the side of the union and the OCFA, I predict day to day not much will change.

I'm generally pro county wide public safety systems, but after living in one, see that they do have drawbacks, particularly when you don't have resources to cover your area because they are assisting someone elsewhere. Or when you are in a rich area, and tax revenue is spent elsewhere to support poorer areas of the county to ensure they have proper staffing and equipment too.

and my opinion on FF/PM on the engines is that it is a waste of money, as are non-transporting ambulances staffed by 2 FF/PMs. I will also say that by converting the EMS responders from FF/PM to single role PM, you are losing 2 firefighters, who would be able to assist you should you get that actual structure fire if they were not on an EMS run. But it should be interesting.
 

Medic496

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So very wasteful to use ambulances as non-transporting vehicles. They could do the same thing with like a Ford Focus or something if they care that much about costs and Emergency is still transporting.
I appreciate your perspective and agree with you. ANY proposer could've used motorcycles, squads or drones if they wanted. However, the selection of ambulances (type 2) for response is identical to what OCFA had been doing in the past with their medic units and the bonus is it provides an extra transport resource during a large scale emergency. Ambulance providers are the greatest source of surge capacity for EMS responders and transport units due to their dual mission of both 911 and IFT.
 

DrParasite

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I appreciate your perspective and agree with you. ANY proposer could've used motorcycles, squads or drones if they wanted. However, the selection of ambulances (type 2) for response is identical to what OCFA had been doing in the past with their medic units and the bonus is it provides an extra transport resource during a large scale emergency. Ambulance providers are the greatest source of surge capacity for EMS responders and transport units due to their dual mission of both 911 and IFT.
I appreciate your perspective, but it's still wasteful. If you send an ambulance, why not transport in said ambulance? if you are sending a first responder to initiate care until the ambulance gets there, great, but then it's poor patient care to have a patient circle the drain while a transport capable vehicle that is designed to transport sick patient sits outside unused. It's one thing if the vehicle isn't designed to transport a patient (motorcycle, squad, drone, fire engine, etc), but an ambulance is......

Hopefully your regional emergency management has a plan for what to do during a large scale emergency. I can assure you that plenty of systems handle large scale emergencies without sending their EMS providers as first responders in non-transporting ambulance. If anything, it shows how your system should have additional 911 ambulances built into the system to handle surges.

Just because OCFA has been doing it in the past doesn't make it any less wasteful.

Now if you are planning on using it as a flycar or chase car, and want to have the transport capabilities available on the rare instances that the ambulance is tied up on another call or unavailable, I can see that; however, as a first responder vehicle, there are more efficient ways to do that.
 

rescue1

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MONOC in NJ does the same thing with transport ambulances being used as ALS fly cars. I never understood why they'd wait on scene for a volunteer bus to transport their ALS patient to the hospital but I guess that's over my pay grade.
 

Generic

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DrParasite

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MONOC in NJ does the same thing with transport ambulances being used as ALS fly cars. I never understood why they'd wait on scene for a volunteer bus to transport their ALS patient to the hospital but I guess that's over my pay grade.
MONOC is a little different, because 1) by DOH or state regulation, they weren't able to transport in those trucks, as the only time this was permitted is when the ALS agency and BLS agency were the same entity (which was why only RWJ, UMDNJ and JCMC were given waivers, as their hospital based BLS services provided coverage to areas where their ALS units held the CNs) 2) they may or may not have gotten the waiver to allow them to transport (many people say they were told they were given it, but no one actually saw the waiver) and most importantly 3) if the system was working as designed, the MONOC ALS unit was supposed to arrive AFTER the BLS transport unit, which is not how this was occurring in Orange County, where the OCFA are acting as non-transport capable first responders, not a transport capable ALS agency.

There is a lot of history that led to this, plus political clout by the NJFAC in Trenton that made the system the way it was, as well as an increasing call volume without an equally rising funding to additional ambulances (or paid staffing), and some crappy dispatchers that would request an ALS unit for a BLS patient because the BLS agency didn't have any available units and the cop was tired of waiting with the patient......

So yeah, while there are some similarities, there are some very critical differences that make what OCFA does very different than what occurs at MONOC
 

rescue1

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MONOC is a little different, because 1) by DOH or state regulation, they weren't able to transport in those trucks, as the only time this was permitted is when the ALS agency and BLS agency were the same entity (which was why only RWJ, UMDNJ and JCMC were given waivers, as their hospital based BLS services provided coverage to areas where their ALS units held the CNs) 2) they may or may not have gotten the waiver to allow them to transport (many people say they were told they were given it, but no one actually saw the waiver) and most importantly 3) if the system was working as designed, the MONOC ALS unit was supposed to arrive AFTER the BLS transport unit, which is not how this was occurring in Orange County, where the OCFA are acting as non-transport capable first responders, not a transport capable ALS agency.

There is a lot of history that led to this, plus political clout by the NJFAC in Trenton that made the system the way it was, as well as an increasing call volume without an equally rising funding to additional ambulances (or paid staffing), and some crappy dispatchers that would request an ALS unit for a BLS patient because the BLS agency didn't have any available units and the cop was tired of waiting with the patient......

So yeah, while there are some similarities, there are some very critical differences that make what OCFA does very different than what occurs at MONOC
I've definitely transported patients in a MONOC MICU before (this year), though idk if that was kosher by state regulations.
NJ is a strange place for EMS--when I did my MONOC time we would beat the volleys in 90% of the time in one town, but the next town over would be paid and cancel ALS constantly. Coming from my all paid, all ALS transport Pennsylvania system it was very jarring.
 

DrParasite

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I have no doubt it was done, but some places have a reputation for playing fast and lose with certain rules... as well as ambitiously trying to change them to suit your purposes.

It you had gotten out of Monmouth and Ocean county, you would have seen an even more interesting environments. you have volunteers beating medics to the scene, cancelling the medics, and handling patients all on their own.... or even stranger, 2 to 3 paramedic units covering an entire county, all in SUV Flycars.... and NO FD involvement in EMS..... Very different compared to some other states.

It's far from perfect, and some places are more questionable than others, but if you could make it there, you could make it anywhere.
 
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