Report Finds that Privatizing Houston EMS would Save Money

[Veneficus]

The IAFF? What was their proposal

When it was announced that there would be a contract for Gulf coast disaster response, Gary Ludwig published a piece how it shouldn't go to a private company but cited that the US fire service had an "army" ready to respond.

It detailed a joint response like used in wildland fires, but his "plan" was so pathetically inadequete and unrealistic to disaster response that it destroyed any credibility he or the fire service might have had. (I doubt apart from providing specialty teams to a larger agency, their policy level plans will ever get serious consideration again, it really made them look like an unitelligent gang who had no idea what they were dealing with.)

It did not take into account the logistical complications of multiple agency responses.

It did not take into account who would provide medical oversight. (Can you imagine what would happen in a disaster if different providers with different training could do whatever they wanted or normally did?)

The whole plan was based upong mobilizing a fleet of ambulances to transport emergency victims out of the disaster zone and to hospitals outside. (which is not only done, but the nature of disaster response requires prolonged on scene treatment as well as healthcare post disaster from conditions that result.) There are not enough hospitals in the world for something like that. Much less ambulances to drive everyone to one.

 

[shfd739]

When it was announced that there would be a contract for Gulf coast disaster response, Gary Ludwig published a piece how it shouldn't go to a private company but cited that the US fire service had an "army" ready to respond.

It detailed a joint response like used in wildland fires, but his "plan" was so pathetically inadequete and unrealistic to disaster response that it destroyed any credibility he or the fire service might have had. (I doubt apart from providing specialty teams to a larger agency, their policy level plans will ever get serious consideration again, it really made them look like an unitelligent gang who had no idea what they were dealing with.)

It did not take into account the logistical complications of multiple agency responses.

It did not take into account who would provide medical oversight. (Can you imagine what would happen in a disaster if different providers with different training could do whatever they wanted or normally did?)

The whole plan was based upong mobilizing a fleet of ambulances to transport emergency victims out of the disaster zone and to hospitals outside. (which is not only done, but the nature of disaster response requires prolonged on scene treatment as well as healthcare post disaster from conditions that result.) There are not enough hospitals in the world for something like that. Much less ambulances to drive everyone to one.

This sounds like a fun read. Is it still floating around somewhere?

After a certain storm we had an EMS Task Force comprised of mostly fire based medics/ambulances from a southern state in the county for 10 days. The help was appreciated and somewhat needed..However they whined about doing nothing, whined if they had to be on duty more than 12 hours, whined if they didnt get their downtime,hot meal, etc. Our people handled subsequent storm responses without near the complaints of these guys.

 

[Veneficus]

This sounds like a fun read. Is it still floating around somewhere?

After a certain storm we had an EMS Task Force comprised of mostly fire based medics/ambulances from a southern state in the county for 10 days. The help was appreciated and somewhat needed..However they whined about doing nothing, whined if they had to be on duty more than 12 hours, whined if they didnt get their downtime,hot meal, etc. Our people handled subsequent storm responses without near the complaints of these guys.

I cannot find it with a google search, it was at least a few years ago, and as I mentioned, it was laughable, so it may have been removed from JEMS or wherever I read it. (I am pretty sure it was an EMS tade magazine because I recall writing a response.)

I can only imagine what your experience must have been like.

(don't you know you have to provide the equal of thanksgiving dinner twice a day to the fire service?)

I tell you, no wonder they complain about privates.

 

[Veneficus]

found it:

http://www.jems.com/article/operations-protcols/government-solicits-national-a

"˙The fire service has the largest supply of EMS transport vehicles in the United States and a network able to respond anywhere in the contiguous United States. This is duplicative and disappointing that they wouldn_t look at our system, a system that is already in place,Ó said Deputy Chief Gary Ludwig, chair of the IAFC EMS Section."

Should you like to PM me your email, I have also dug a copy of my response out of my email archives.

 

[RocketMedic]

I'd love to see that, Veneficus.

 

[shfd739]

I cannot find it with a google search, it was at least a few years ago, and as I mentioned, it was laughable, so it may have been removed from JEMS or wherever I read it. (I am pretty sure it was an EMS tade magazine because I recall writing a response.)

I can only imagine what your experience must have been like.

(don't you know you have to provide the equal of thanksgiving dinner twice a day to the fire service?)

I tell you, no wonder they complain about privates.

It wasnt really a bad experience just the typical "we are fire, hear us roar" that got old. If youre visiting my backyard dont try to take it over.

Contrast that with another large private service that rotated us extra medics for months and Id take the private service folks. The private service medics were more low key and blended with us better.

Just my observations.

 

[usalsfyre]

The private service medics were more low key and blended with us better.

The second biggest reason I don't ever see myself back in the fire service. Too often the mentality is similar to what you find in high school locker rooms.

 

[Fish]

The second biggest reason I don't ever see myself back in the fire service. Too often the mentality is similar to what you find in high school locker rooms.

What is the third what is the third???????

 

[triemal04]

found it:

http://www.jems.com/article/operations-protcols/government-solicits-national-a

"˙The fire service has the largest supply of EMS transport vehicles in the United States and a network able to respond anywhere in the contiguous United States. This is duplicative and disappointing that they wouldn_t look at our system, a system that is already in place,Ó said Deputy Chief Gary Ludwig, chair of the IAFC EMS Section."

Should you like to PM me your email, I have also dug a copy of my response out of my email archives.

Was there another article that went more in depth on what you were talking about before? Because, taking the given information at face value and ignoring the comment from Memphis Molly, the questions being asked by the others in the article are valid. Though that still doesn't make their plan the best.

The NWCG runs ROSS, and it's allready used by many of the groups that are responsible for wildfires nationwide. While it's used right now for wildland firefighting resources, I'd think it could be easily adapted to work for any type of resource.

If you look at what was being asked for by the feds, having a database that could track and manage multiple resources from multiple agencies and states would be required for it to run smoothly. It's a good bet that whoever was awarded the contract has set up a system like that. If that was the case, I can see why someone might have questioned why a system that was allready in place and running fairly smoothly wasn't used.

Of course, that still doesn't answer who would have run it if ROSS was used; the NWCG? Someone else? Hell, who or what eventually did get awarded the contract?

 

[RocketMedic]

I think AMR won it.

 

[Fish]

I think AMR won it.

Yes they did, they have the largest supply of ambulances and had them deployed in no time.

 

[Veneficus]

Was there another article that went more in depth on what you were talking about before? Because, taking the given information at face value and ignoring the comment from Memphis Molly, the questions being asked by the others in the article are valid. Though that still doesn't make their plan the best.

The NWCG runs ROSS, and it's allready used by many of the groups that are responsible for wildfires nationwide. While it's used right now for wildland firefighting resources, I'd think it could be easily adapted to work for any type of resource.

I am sure there was a more indepth article, when the contract was being considered it was the hot topic of the day in the disaster community and being discussed everywhere. That was the only one I could find without doing an extrensive search.

If you look at what was being asked for by the feds, having a database that could track and manage multiple resources from multiple agencies and states would be required for it to run smoothly. It's a good bet that whoever was awarded the contract has set up a system like that. If that was the case, I can see why someone might have questioned why a system that was allready in place and running fairly smoothly wasn't used.

I am not on the inside decision making process of it, but I think it may have been a requirement because no unified command and control exists within the fire service. (and you know every white hat who sent a unit would think thay had to contribute)

I think the logistics (what really mitigates disaster) and oversight of a multiple agencies with independant operating standards would have been a nightmare.

Finally, because of the nature of disaster response, mobilizing a bunch of transport ambulances without the ability to provide onsight medical care both during and immediately after, is totally useless.

A private company also has the ability to immediately increase its staffing.

Could you imagine what would happen if post disaster 100 or so medics needed to be recruited for the the duration of operations?

It would take the fire service months to even run their hiring process.

Not to mention who is picking up the tab for these units to be out of their primary community? Wear and tear on the vehicles, etc?

 

[triemal04]

I am sure there was a more indepth article, when the contract was being considered it was the hot topic of the day in the disaster community and being discussed everywhere. That was the only one I could find without doing an extrensive search.

Probably, and I'm not asking that you look for more. It's just that the article you linked actually might have a workable plan, albiet one that would need to be described in much greater detail before it could be considered an option and would probably still need to be revised. Again, while it may not have been the best option, it is a valid question to ask; why duplicate a service that is allready being provided, though using different resources? Really, I was just curious about the comment you made; didn't seem to match what was reported.

I am not on the inside decision making process of it, but I think it may have been a requirement because no unified command and control exists within the fire service. (and you know every white hat who sent a unit would think thay had to contribute)

Actually, what I meant wasn't that a database would be required in the RFP, but that one would need to be used to actually track the resources available, the resources being used, where they were, etc etc. There's probably better ways to do it, and (if AMR was the one who got the contract) they probably have developed/had one of their own.

You also need to rememeber, wildfires are not structural fires. And I mean that beyond the most obvious ways. The logistics and structure involved in large fires really isn't that different than what's involved in a disaster; yes, different resources would need to be mobilized, but the process and command/control would be very similar. Anecdotally as I have no way of knowing if this is true, many of the advisors that were brought in to NYC after 9/11 to help coordinate the responce (the total responce, not just the fire side) where people from wildfire groups.

I think the logistics (what really mitigates disaster) and oversight of a multiple agencies with independant operating standards would have been a nightmare.

That would be no different than using a bunch of non-fire EMS providers from different agencies. Even if it was all AMR employees, they still use different policies/procedures for each operation so the same problem would arise.

Again, while it would be different, since the resources needed would be much different than what's in use, using a system that is allready in place for similar events and works pretty well...why not duplicate it?

Also, you need to look at what the RFP was asking for; transport capabilities. While there may have been more to it, all that was asked for in the article you posted was the ability to move large numbers of people.

Finally, because of the nature of disaster response, mobilizing a bunch of transport ambulances without the ability to provide onsight medical care both during and immediately after, is totally useless.

A private company also has the ability to immediately increase its staffing.

Could you imagine what would happen if post disaster 100 or so medics needed to be recruited for the the duration of operations?

It would take the fire service months to even run their hiring process.

Not to mention who is picking up the tab for these units to be out of their primary community? Wear and tear on the vehicles, etc?

But again, while there may have been more to the RFP, all that I can see being asked for IS the ability to transport patients. More is needed, and that might not have been reported by the author of the article, but it does make a bit of sence that there would be 2 seperate contracts; 1 for transport, and 1 for static medical deployments. While the same group might get both, and coordination between the two would be needed, they are 2 different things to worry about.

The staffing is an issue. I know after Deepwater blew AMR went on a hiring frenzy to get people to the gulf to staff their aid stations. But...depending on exactly who would have been in charge if the ROSS system was used...there are a lot of firefighter/paramedics out there, and a lot of fire department ambulances. Increasing staffing beyond that would be an issue though. You also need to remember that, the system set up for wildfires that uses the ROSS database referenced includes many, many, many non-FD resources. No reason it couldn't here either.

Believe me, I'm not saying that the fire service should have been awarded the contract and put in charge. To be honest knowing what I do (which ain't much), that one article doesn't even make a lot of sense; there is so much info missing it's ridiculous. My only points are that your comments just didn't seem to add up from that 1 article (and if there were others you were reading then I understand) and that it's a valid question; why not look at adapting a similar system that is allready in place to disaster responce?

 

[46Young]

How did you like Charelston County EMS? You got offered the Assistant Director spot? What did that pay?

Where in NY did you work?

Charleston wasn't my cup of tea. I've posted about them several times on this forum. Just run a search. On this thread, I wrote about my work experience in post #'s 9, 25, and 28.

http://www.emtlife.com/showthread.php?t=13483&highlight=quality+ems+agencies

No, I wasn't offered the Assistant Director's position. I basically worked there for about six months, until Fairfax offered me a job, then I quickly left. I loved the area, and we may retire there someday, but the job wasn't for me. What I was saying is that Charleston County EMS posted the Asst. Director's position on the county employment page sometime last year (or maybe in '10, I can't remember. They wanted a four year healthcare degree, and were offering somewhere in $65-$70k/yr range. At the time I was reading that, my base salary at my current employer was in the mid $70's (as a two year person), which is about $7k more than a medic at top step, and more than the A.D. offering. That let mem know that I made the right choice in leaving.

If I had never received the offer from Fairfax, I already had a full time offer from MUSC EMS, which payed well and had a schedule of three 12's, so I would have dropped to per diem with Charleston, knocked out an RN degree, and then looked into Myrtle Beach FD, Horry County Fire, or Hilton Head, That was the plan B.

Edit: I have a buddy that also used to work for NS-LIJ CEMS in NY who was hired there just ahead of me. After I left, he did the same, and now works in a cushy admin position for one of the hospitals that his wife works at as a nurse. They're set.

 

[marshmallow22]

Houston should look at going to 3rd service... like Austin.

 

[46Young]

Houston should look at going to 3rd service... like Austin.

I would go for that over here. I could do fire full time, and be a per diem/part time medic for the private 911 provider. The private company that comes in could hire the Houston medics that want to make some extra bucks.

I know a few FDNY guys that do this. They were already medics to begin with, already in the NYC 911 system for either FDNY or one of the hosptals, so they were making $30/hr + when they're off duty.

 

[Fish]

Houston should look at going to 3rd service... like Austin.

I think third service is the best possible EMS model, unfortunatley I do not see how this would save Houston money? It would only improve quality of care.

 

[Veneficus]

I think third service is the best possible EMS model, unfortunatley I do not see how this would save Houston money? It would only improve quality of care.

I don't think it is fair to say it would improve the quality.

There are 1 or 2 really poor 3rd service agencies out there. I actually worked for a 3rd service which is hands down the worst EMS agency I ever saw.

 

[RocketMedic]

Where was that?

 

[Fish]

I don't think it is fair to say it would improve the quality.

There are 1 or 2 really poor 3rd service agencies out there. I actually worked for a 3rd service which is hands down the worst EMS agency I ever saw.

Which one?