Privatized EMS in Placentia CA

Jim37F

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Interesting, I guess I never really had much thought on protocols out there. What would a Basic's scope look like if EMR is comparable to LACo?
I know they can start IVs and give some meds (at least under a medics direction.... I've seen a couple times the medic hopping into the drivers seat saying "yeah just start a line and give some Zofran") beyond that I'd have to look up specifics
 

DrParasite

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Not sure why.

Our EMR level is the same as EMT-B in LA/OC. I cant think of anything I did as a State certified EMT in LA I cannot do as an EMR here...
*sigh* it's not always about what you can do, it's about what you know..... One day we will get away from the skills based thinking.

Even if you look up NREMT, the practical exams are pretty much the same for EMR and EMT (I think there is one minor difference when it comes to administering oxygen). I don't know anything about Hawaii's EMR program, or the LA/OC EMT program, but I imagine they are differences in length right? My upcoming EMT class is ~240 hours, with multiple tests, lots of reading, and not enough hands on real world clinical time.

I was teaching an EMT con ed class on OBGYN emergencies for a local volunteer FD, and in my class were 10 county certified first responders, and 3 EMTs. the 10 county first responders had "deer in the headlights" looks after the 3 hour class was completed. I asked afterwards what their first responder course consisted of, and was told it was CPR and an 8 or 16 hour first responder course..... now i understand the deer in the headlights, because they had never heard of this stuff.

It's not always about the skills you can do, it's the knowledge you have as to why you are doing them.
It's mostly a handful of senior career FF1s who are close to retiring as FF1s, but we cant even convince everyone in the Dept to take the NREMT. But once those guys retire, that will be standard for everyone (its a requirement to graduate Recruit Academy, has been for a little while, so all us newer guys have it).
Yes you can. It's actually quite easy to. Your fire chief tells those old timers that, as a condition of employment, they need to be certified as EMTs, and maintain that certification for the duration of their career here. They have two years to do it, otherwise, they are terminated. It's not that hard.

You just said the EMR is the same as the LA EMT, so it should be easy for these veteran firefighters to complete the class.

And before you say it, if they are just first responding, and spending 5 minutes with the patient before EMS arrives, than it won't make much of a difference. but if you get that trainwreck, or that complicated patient, or are requested to be the extra hands to help EMS out going to the hospital..... It's still about raising standards, being professional, and serving the citizens better.
I know they can start IVs and give some meds (at least under a medics direction.... I've seen a couple times the medic hopping into the drivers seat saying "yeah just start a line and give some Zofran") beyond that I'd have to look up specifics
Interesting... Zofran is explicitly listed as a paramedic only drug, because of the need to get a 12 lead to confirm no QT widening, but I wish it was BLS because that complication is so rare prehospitally.....
 

Jim37F

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Well as far as our dept. is concerened (minus the handful of older dinosaurs) our EMR training IS National Registry EMT training. Passing NREMT is a graduation requirement from the Academy. So we still have EMT training for first responder work. Which is appropriate as we're a non transporting first responder only department, assisting a career municipal third service EMS Department.

Which is a different model from LA/OC where Placentia FD will presumably still staff at least one Fire/Medic on their engines to go on every toe pain call and be the medic in charge on scene until they turf to Lynch/Emergency for transport.
 

rescue1

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Does anyone know if FD even has to respond or will EMS be handled by EMS? How does it work in third service states/counties? FD for certain criteria like full arrests and MVAs?
My third service in PA got fire for confirmed rescues, things on fire, and highway calls for blocking, nothing else. Accidents, cardiac arrests, etc got EMS and police only. Worked pretty well, and having worked in systems with FD first response I vastly preferred just having EMS on scene--same agency, no one tries to take charge, etc.
 

ITBITB13

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According to the article: "each of the two new fire engines coming to Placentia will be staffed by three full-time firefighters and a reserve firefighter. " I would imagine if they had ladders on top, they would have said that you are wrong: you have a legal obligation to protect your AHJ; unless you have a specific mutual aid contract in place, there is no requirement for you to provide assistance to others, especially if it puts your AHJ at risk (due to your resources being elsewhere and unable to provide services for your AHJ).
Could’ve sworn it was a quint, engine, and patrol.

And during the meeting they touched on mutual aid vs automatic aid. I thought mutual aid was essentially illegal unless you could justify not having the resources, and automatic aid required a contract.

I wonder if Lynch and Emergency are going to work together to integrate their employees on one another’s rigs and stuff
Another good question. Anyone know anything about this?

If OCFA refuses to respond in a timely matter, isn't Placentia neighboring Anaheim and Brea with their own independent FDs? How do they feel about all this drama? On the other side of Brea is La Habra, an Orange County city that contracts with... LA County Fire Dept... it would be embarrassing for OCFA if LACo units in La Habra arrived in Placentia before OCFA did....
A placentia City council member (the one who presented the PowerPoint) said they already had aid contracts with other neighboring cities. As far as LACo units responding, I’m sure OCFA would love the increased presence of LACo resources.
Fire rolls on all medical aid calls, otherwise their budgets would be cut by 60-70%.
Probably the biggest reason why OCFA is so against this whole thing. It’s gonna save the city money, and their biggest nightmare would be for other cities to catch wind of it and pursue their own private FD with private ALS/BLS resources..
 

EMT Rookie

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I think that's a pretty safe bet, however, if the pay and benefits are comparable, and they have a FF who is offered a captain position, or a captain who is offered a chief's position, especially if their chances of getting it at OCFA are slim..... Again, I think it will be offered, but I agree, I don't think many will take it, unless they really want to get off the ambulances.....
according to the article, it was 3 FT FFs and 1 reserve FF, and only two engines.... no ladder was mentioned. I'm guessing BLS only, as they have lynch in a non-transporting ALS QRV to handle the EMS callsI agree (although I think having career FFs only being EMR level is embarrassing, and if you want to be a career FD, you should at least be an EMT level department). A fully staffed EMS agency should be able to handle the majority of EMS calls without the FD to hold their hand, or stop the clock. Alas, too many places will over staff the FD first responders to compensate for an understaffed EMS system.... But that's another topic for another day...
So they are going to send a lynch QRV with 2 ALS personnel and a 3 person BLS engine to all ALS coded calls? I can understand going on Echos (cardiac arrest and such, when you need muscle and hands, not necessarily ALS providers), or ALS calls if they are closer than the ALS squads (which shouldn't happen in most cases), but going on all calls sounds kinda redundant and wasteful to me.
That would be my one area of concern. If the new Placentia FD had a major incident, OCFA would refuse to respond due to political BS, despite being the closest mutual aid provider. Still have that question about who is providing a ladder/special service for those structure fire calls handled by PFD, since they are only staffing two engines.....
No, the city is getting a quint to go with the two engines - one of the engines will be an unstaffed reserve engine.
 

dbui9

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What sort of org/staffing is the new Placentia FD looking at? I.e. 3 or 4x Engines with 3 or 4 FFs plus a Ladder (or relying on OCFA Mutual Aid for one?) Just curious? I'm assuming at least one fire medic on each engine?

Or is EAS losing Placentia totally and Lynch transports everything?
Placentia Fire Station 1 (Currently OCFA Station 35) will be staffed with:
  • Engine 1: Fire Captain/EMT, Engineer/EMT, FF/EMT, Reserve FF/EMT
Placentia Fire Station 2 (Currently OCFA Station 34) will be staffed with:
  • Quint (RFP calls it a Truck?): Fire Captain/EMT, Engineer/EMT, FF/EMT, Reserve FF/EMT
  • Type 6 Wildland Engine/QRV: 2x Reserve FF/EMT to respond to calls that don't require an engine
  • Reserve Engine: Unstaffed - used for ISO and training purposes. RFP states it can be staffed with 4x Reserve FF if situation arises.
Not sure where they'll house these vehicles but they will also have:
  • Command Incident Vehicle
  • One Ton Pickup Truck
  • 9 Passenger Van

So as of now, EAS still holds the BLS transporting contract in the city until May 31st 2020. Lynch EMS will provide ALS medical services and FD will respond if required for high priority calls when they take over in July 2020 I believe. I'm not too sure what happens when EAS's contract is up. I'm guessing that Lynch will both handle the ALS and BLS services in the city. EAS will be cut down to Yorba Linda and Brea BLS transports. EAS's CEO, COO, and Operations Manager were at the city hall meeting and I'm sure they weren't too pleased with what happened.
 

wtferick

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Placentia Fire Station 1 (Currently OCFA Station 35) will be staffed with:
  • Engine 1: Fire Captain/EMT, Engineer/EMT, FF/EMT, Reserve FF/EMT
Placentia Fire Station 2 (Currently OCFA Station 34) will be staffed with:
  • Quint (RFP calls it a Truck?): Fire Captain/EMT, Engineer/EMT, FF/EMT, Reserve FF/EMT
  • Type 6 Wildland Engine/QRV: 2x Reserve FF/EMT to respond to calls that don't require an engine
  • Reserve Engine: Unstaffed - used for ISO and training purposes. RFP states it can be staffed with 4x Reserve FF if situation arises.
Not sure where they'll house these vehicles but they will also have:
  • Command Incident Vehicle
  • One Ton Pickup Truck
  • 9 Passenger Van
So as of now, EAS still holds the BLS transporting contract in the city until May 31st 2020. Lynch EMS will provide ALS medical services and FD will respond if required for high priority calls when they take over in July 2020 I believe. I'm not too sure what happens when EAS's contract is up. I'm guessing that Lynch will both handle the ALS and BLS services in the city. EAS will be cut down to Yorba Linda and Brea BLS transports. EAS's CEO, COO, and Operations Manager were at the city hall meeting and I'm sure they weren't too pleased with what happened.
Yorba Linda would be the only OCFA City that Care does not operate? I wonder if this would cost a monopoly issue for Care.
 

dbui9

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Yorba Linda would be the only OCFA City that Care does not operate? I wonder if this would cost a monopoly issue for Care.
I know that CARE has medics in LA County, and I'm pretty sure OCFA told CARE not to put in a bid cause that'd put them at odds with all their BLS contracts. Emergency's CEO went up to the mic and first thing he said was he was not approached/intimidated by OCFA to not submit a bid. Pretty sure he was told not to. Weird that he said that because EAS doesn't operate an ALS/Medic program.
 

wtferick

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I know that CARE has medics in LA County, and I'm pretty sure OCFA told CARE not to put in a bid cause that'd put them at odds with all their BLS contracts. Emergency's CEO went up to the mic and first thing he said was he was not approached/intimidated by OCFA to not submit a bid. Pretty sure he was told not to. Weird that he said that because EAS doesn't operate an ALS/Medic program.
I'm pretty sure Care is going to push for Medics in the OC after this.
 

deadhead

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I know that CARE has medics in LA County, and I'm pretty sure OCFA told CARE not to put in a bid cause that'd put them at odds with all their BLS contracts. Emergency's CEO went up to the mic and first thing he said was he was not approached/intimidated by OCFA to not submit a bid. Pretty sure he was told not to. Weird that he said that because EAS doesn't operate an ALS/Medic program.
Hi. Just to offer a couple of points of clarification. 1. The first thing our CEO said at the council meeting was that we would have liked to have submitted a bid, but that the numbers did not match up for us and that is why we did not respond. The very last thing he said was that neither the OCFA or the firefighters union threatened us or told us not to bid. They didn't and we have had a very good relationship with both for over 32 years. I've been involved in the process all along, and neither the OCFA or the local have approached us or tried to intimidate us. 2. You're correct. We don't currently operate a ALS program. However, we were qualified to bid based on our past paramedic experience in LA County. We simple did not respond to the RFP because in our case the numbers didn't work out.
 

deadhead

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What sort of org/staffing is the new Placentia FD looking at? I.e. 3 or 4x Engines with 3 or 4 FFs plus a Ladder (or relying on OCFA Mutual Aid for one?) Just curious? I'm assuming at least one fire medic on each engine?

As far as the EMS goes, dec sounds like an interesting model, just skimming the other posts, are they really looking at a private to be a non transporting squad? With a second private being transport? I.e. is a Placentia FD engine gonna show up with a Lynch ALS unit AND an EAS BLS unit, with Lynch medic riding in on the EAS ambulance for ALS transports? Or cancel EAS and transport themselves, while EAS only takes BLS transports? (a la Seattle Medic One and AMR?)

Or is EAS losing Placentia totally and Lynch transports everything?

Anyways, I'm more interested in this bucking the whole OC system. I never worked with/for OCFA, only know their reputation largely thru these forums lol but it def sounds like it'd be a good thing to have other options beyond engine medics making $100K/yrand private min wage EMTs doing the actual transporting and wall holding...

I like my current system best. Fire is BLS/EMR only, with municipal third service ALS ambulance, Fire only going on maybe half of EMSs calls?

Hall definitely shows that a private co, run properly, can fill in. Hopefully Lynch/EAS can do that as well, vs some of the AMR divisions around...
Hi. EAS is not losing Placentia. We are still the emergency 911 transport provider for the city and we intend to remain their provider. The contract for Placentia (and also Yorba Linda and some unincorporated territory) is administered by the County HCA. It's a completely separate animal.
 

deadhead

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It sounds like they are dropping Emergency Ambulance completely. Not sure.

As to mutual aid from OCFA. They would honestly only really be getting help from Yorba Linda and Villa Park. All the other cities are Metro Net (City Departments)

Good for Lynch nonetheless.
wtferick, No. they are not dropping EAS. The contract is strictly for ALS response and treatment, not for transport. The transport contract is administered by the County and is completely separate.
 

dbui9

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Hi. Just to offer a couple of points of clarification. 1. The first thing our CEO said at the council meeting was that we would have liked to have submitted a bid, but that the numbers did not match up for us and that is why we did not respond. The very last thing he said was that neither the OCFA or the firefighters union threatened us or told us not to bid. They didn't and we have had a very good relationship with both for over 32 years. I've been involved in the process all along, and neither the OCFA or the local have approached us or tried to intimidate us. 2. You're correct. We don't currently operate a ALS program. However, we were qualified to bid based on our past paramedic experience in LA County. We simple did not respond to the RFP because in our case the numbers didn't work out.
Ah, I see. Didn't even know EAS had medics in LA County. Are you guys for sure going to stay as the BLS provider for the city? Will that mean you guys will be transporting with 2 EMTs for a BLS transport and 2 EMTs + 1 Lynch PM for an ALS transport to the hospital? Thanks for the clarification.
 

deadhead

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View attachment 4482
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.
Ah, I see. Didn't even know EAS had medics in LA County. Are you guys for sure going to stay as the BLS provider for the city? Will that mean you guys will be transporting with 2 EMTs for a BLS transport and 2 EMTs + 1 Lynch PM for an ALS transport to the hospital? Thanks for the clarification.
Yes. We had medics for many years and we may reimplement our program. We are the BLS transport agency through June 2020 and are in the RFP process at present. We are certainly hoping to stay as the transport provider. We've been doing it in Placentia for 25 years and it's been a pleasure serving the City, and also working with the OCFA. If we retain our contract we'll work with Lynch exactly the same way be do with OCFA and BFD. We would provide the transport and they would provide the follow up. I'd suspect that in the case of a critical patient both Lynch PM's would follow up and someone else would be tasked with driving their unit to the receiving facility. Who knows how things will work out in a year. It's going to be interesting to say the least.
 

Jim37F

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@deadhead So if this all goes thru, are we gonna see a Lynch ALS unit and an Emergency BLS unit respond on all medicals? And if so, would Lynch transport ALS calls while EAS goes available or Lynch medics riding in the EAS unit like the current squad model?

Or based on EMD at dispatch, only send Lynch to ALS coded calls and EAS to BLS coded calls?

(Edit: looks like you may have answered this in previous post while I was still typing this lol)
 

dbui9

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Yes. We had medics for many years and we may reimplement our program. We are the BLS transport agency through June 2020 and are in the RFP process at present. We are certainly hoping to stay as the transport provider. We've been doing it in Placentia for 25 years and it's been a pleasure serving the City, and also working with the OCFA. If we retain our contract we'll work with Lynch exactly the same way be do with OCFA and BFD. We would provide the transport and they would provide the follow up. I'd suspect that in the case of a critical patient both Lynch PM's would follow up and someone else would be tasked with driving their unit to the receiving facility. Who knows how things will work out in a year. It's going to be interesting to say the least.
Is there a link to EAS's RFP? I've been reading all the RFPs for Placentia on their website so I'm just curious. It'll be interesting to see the integration of EAS and Lynch on these calls. What do you think about the whole situation about Lynch getting the ALS contract? Have you ever worked with any of their medics/emts?
 

Addrobo

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How is this going to work in terms of billing for Lynch? If they don't transport BLS patients then what is the financial incentive for them to do this?

Just curious because I've never seen a situation like this with two private ambulances responding to the same incident.
 

deadhead

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Is there a link to EAS's RFP? I've been reading all the RFPs for Placentia on their website so I'm just curious. It'll be interesting to see the integration of EAS and Lynch on these calls. What do you think about the whole situation about Lynch getting the ALS contract? Have you ever worked with any of their medics/emts?
If you are referring to the proposal - EAS has not submitted it yet. Our response and any others may be available through the HCA after they are awarded. The RFP can be found on the OC BOS website. Assuming we will retain the area - we would work with Lynch similar to our relationship with OCFA. We haven't had any interactions with their paramedics but expect to have a professional relationship with them.
 
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