Privatized EMS in Placentia CA

deadhead

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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)
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.
Good question. I haven't seen same situation in over 35 years in EMS, but our business is constantly evolving. For Lynch the financial incentive for BLS seems to be in the form of the subsidy they will receive from the City. The contracted BLS transport provider (whether it's EAS or someone else) is responsible for billing, and as with the FD's, they can negotiate a contract with Lynch for bundled billing. However, under these kind of contracts the BLS transport provider would be limited to reimbursing the ALS provider only its direct cost of ALS services and any pass through revenue would have to represent a fair and reasonable payment to your provider for their role as an ALS first responder.
 

Uclabruin103

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Someone is trusting Lynch with 911? I worked there a few years ago, and it was a joke of a medic program. Every shift I'd find expired drugs in the box, monitor batteries that'd last less than an hour, Zoll M-series monitors, no AEDs on their BLS units. Don't get me started on being dispatched to chest pains, stroke-like symptoms, and breathing problems with 40+ minutes ETAs. Someone has to be getting a payout to trust this company with care of their citizens.
 

ITBITB13

Forum Lieutenant
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Someone is trusting Lynch with 911? I worked there a few years ago, and it was a joke of a medic program. Every shift I'd find expired drugs in the box, monitor batteries that'd last less than an hour, Zoll M-series monitors, no AEDs on their BLS units. Don't get me started on being dispatched to chest pains, stroke-like symptoms, and breathing problems with 40+ minutes ETAs. Someone has to be getting a payout to trust this company with care of their citizens.
Wow. If this is true I can only imagine the stories.. You’re the kind of guy that should’ve gone up and talked at the city council meeting.

Well I know OCEMS is pretty strict on stuff, and constantly go out and inspect ambulances. So I’m sure Lynch will be subject to the same scrutiny. If they still operate like that, I’m sure they’ll learn real quick after they get caught the first time and everyone finds out.
 

VentMonkey

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Someone is trusting Lynch with 911? I worked there a few years ago, and it was a joke of a medic program. Every shift I'd find expired drugs in the box, monitor batteries that'd last less than an hour, Zoll M-series monitors, no AEDs on their BLS units. Don't get me started on being dispatched to chest pains, stroke-like symptoms, and breathing problems with 40+ minutes ETAs. Someone has to be getting a payout to trust this company with care of their citizens.
It sounds like they’re just like any other non-fire ALS program in LA and OC. As an aside, it took a while, but I am glad we’re finally going to integrate the AutoPulse throughout our company and fire agencies.
 

FoleyArtist

Another Medic to Murse
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Someone is trusting Lynch with 911? I worked there a few years ago, and it was a joke of a medic program. Every shift I'd find expired drugs in the box, monitor batteries that'd last less than an hour, Zoll M-series monitors, no AEDs on their BLS units. Don't get me started on being dispatched to chest pains, stroke-like symptoms, and breathing problems with 40+ minutes ETAs. Someone has to be getting a payout to trust this company with care of their citizens.
I worked there in the last 3 years and by then Lynch had all Zoll X monitors that uploads everything to your epr. all rigs have portable wifi. you were given 2 batteries per unit but only needed one to get through a 11 hr shift and that's even if you ran calls all day. 5-7 als ift calls. only on 2-3 occasions did I find expired meds during my time there and that's because someone prior was not doing the first of the month checks.

In my own opinion there is/was an active effort from certain employee(s) to try to make Lynch's als program as legitimate as a third service from say ATCEMS or NOLA. or frankly to match other bigger private amb companies footprint on the industry. push for power gurneys, uniform changes, patch redesigns and medic rockers, badges, etc. but would fall on deaf ears ($$$) or would be poorly executed with inferior products than initial proposed.

everything else stated by uclabruin is pretty much on the level. I just wanted to clarify some dated information.

I am very interested to see how this plays out not only for Lynch but for changing the tide of how EMS has operated in OC for decades. There definitely needs to be power shifts within the company for this program to succeed, dispatching needs to be relegated to PD or metro net, etc. and those 911 units better not be pulled to run ALS IFT's because "it hasn't ran a medical aid in x hours and they're on the clock."
 

dbui9

Forum Ride Along
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I worked there in the last 3 years and by then Lynch had all Zoll X monitors that uploads everything to your epr. all rigs have portable wifi. you were given 2 batteries per unit but only needed one to get through a 11 hr shift and that's even if you ran calls all day. 5-7 als ift calls. only on 2-3 occasions did I find expired meds during my time there and that's because someone prior was not doing the first of the month checks.

In my own opinion there is/was an active effort from certain employee(s) to try to make Lynch's als program as legitimate as a third service from say ATCEMS or NOLA. or frankly to match other bigger private amb companies footprint on the industry. push for power gurneys, uniform changes, patch redesigns and medic rockers, badges, etc. but would fall on deaf ears ($$$) or would be poorly executed with inferior products than initial proposed.

everything else stated by uclabruin is pretty much on the level. I just wanted to clarify some dated information.

I am very interested to see how this plays out not only for Lynch but for changing the tide of how EMS has operated in OC for decades. There definitely needs to be power shifts within the company for this program to succeed, dispatching needs to be relegated to PD or metro net, etc. and those 911 units better not be pulled to run ALS IFT's because "it hasn't ran a medical aid in x hours and they're on the clock."
Just wanted to throw out some more info about what you said. Lynch's RFP stated that they were doing uniform changes (probably includes new patches as well I hope) for the new 911 medics. Placentia's Fire RFP said dispatching would be handled by the current city's police dispatch after going through additional training. The 911 units will be on a kelly schedule where they will be stationed at the fire station and will not be pulled to run IFT-ALS calls. Only IFT-ALS medics who are also trained for 911 ALS will be pulled from IFT if needed, not the other way around.
 

FoleyArtist

Another Medic to Murse
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Just wanted to throw out some more info about what you said. Lynch's RFP stated that they were doing uniform changes (probably includes new patches as well I hope) for the new 911 medics. Placentia's Fire RFP said dispatching would be handled by the current city's police dispatch after going through additional training. The 911 units will be on a kelly schedule where they will be stationed at the fire station and will not be pulled to run IFT-ALS calls. Only IFT-ALS medics who are also trained for 911 ALS will be pulled from IFT if needed, not the other way around.
I'm naturally a pessimist. In the before time I heard bowers used to be in house with Vernon fd when they did als. they'd regularly get pulled for ifts and contributed to the loss of the contract. Bls ift units would have to respond code 3 from white memorial or the Westminster car from their oc sister company.

when the schedule needs to be staffed it needs to be staff. to the public, no one will know the 911 trained medic from the ift. the new medic from the seasoned medic. you can always grab a spare "loaner" uniform shirt from the closet and fill that seat. there have been incidents where ALS Emt training was non existent cuz we need bodies. I'm not saying that's soley a Lynch problem these are a private ambulance company problem.

culture change. as long as private amb companies treat the field staff as expendable people will still leave for FD, LEO, RN, PA, etc. even some municipality AO's because benefits and retirement.

history can repeat itself from the mistake of past amb companies in similar position, and Lynch will be under the microscope.

I truly wish Lynch the best, but I hypothesize after the first year someone like Falck/AMR will come in and say that's a good run (good proof of concept that's happening everywhere else) but here's how we can do it better for your city.
 

VentMonkey

Ajaw
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In the before time I heard bowers used to be in house with Vernon fd when they did als. they'd regularly get pulled for ifts and contributed to the loss of the contract. Bls ift units would have to respond code 3 from white memorial or the Westminster car from their oc sister company.
And in the before the before time AMR was in house with them. They were Cerritos division paramedics assigned there. They had Vernon FD uniforms, helmets, etc. etc. and ran out of Vernon FD ambulances with no sign of them being AMR medics aside their nifty little badges.

Once they botched that program they were slowly integrated into the rest of the division (one became a supe IIRC, and another a training coordinator). Yup, good ole privatized EMS...
 

Tigger

Dodges Pucks
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How much money is this Lynch company going to get from the city to provide this service? They are going to have a hard time billing patients for their services.

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.....
Perhaps in some places, it is on standing orders for every Colorado EMT.
 

Remi

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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.....
Who requires an EKG before administering zofran?
 

rescue1

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Requiring an EKG to administer Zofran seems to me to be at the same level of doing an endoscopy after giving ibuprofen.

I'm pretty sure the complication of QT prolongation was seen when patients were given IV doses of around 32mg, and it was still not terribly significant.
 

DesertMedic66

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http://instagr.am/p/BzJiLGBhn59/

Just the headlines posted When its really from 2013. Whats the plan here? Create doubt right?
A fire department in CA trying to discredit a private ambulance company? Shocking.... /s
 

ITBITB13

Forum Lieutenant
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http://instagr.am/p/BzJiLGBhn59/

Just the headlines posted When its really from 2013. Whats the plan here? Create doubt right?
Most definitely.

A fire department in CA trying to discredit a private ambulance company? Shocking.... /s
4503
 

DrParasite

The fire extinguisher is not just for show
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Who requires an EKG before administering zofran?
It's listed in the flowchart for my local EMS protocol, of which I am not a part of.... UP 3 in case you are interested... I am sure others in the states do the same thing
Requiring an EKG to administer Zofran seems to me to be at the same level of doing an endoscopy after giving ibuprofen.

I'm pretty sure the complication of QT prolongation was seen when patients were given IV doses of around 32mg, and it was still not terribly significant.
No arguments there... still a decision above my paygrade...
 

DesertMedic66

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Right, but does that still work in this day and age? Theres so many different ways to obtain information and absorb content.
Yes and no. For the people who only read the headlines, yes. For those who actually read the article, probably not.

For several months to half a year San Bernardino County Firefighter Association was going after AMR on almost all Facebook and Instagram posts about response time and system par levels, they also started to go after ICEMA. AMR and ICEMA fired back at them with different articles about the fire department not providing them with any of their response time data or mutual aid requests. After that happened there has been no more posts from them about AMR or ICEMA.

I may have created a meme that got me blocked on their Facebook page...
 

ITBITB13

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Yes and no. For the people who only read the headlines, yes. For those who actually read the article, probably not.

For several months to half a year San Bernardino County Firefighter Association was going after AMR on almost all Facebook and Instagram posts about response time and system par levels, they also started to go after ICEMA. AMR and ICEMA fired back at them with different articles about the fire department not providing them with any of their response time data or mutual aid requests. After that happened there has been no more posts from them about AMR or ICEMA.

I may have created a meme that got me blocked on their Facebook page...
You can’t say you have a good meme and not post it on here.
 
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