What do you guys think about this?

[NomadicMedic]

AMR will pay municipalities for the right to run 911 in their area if the payer mix is right and it keeps competition out of the local transport market.

See: Seattle.

 

[DrParasite]

Ehhh, not sure if I agree. In CA, fire departments are not know to make the city a lot of money. Instead they are usually very costly for the city. Adding on EMS to that is likely to just add to the costs while not offsetting it.

Fire departments (the suppression side) are known black holes for money (the PD is also a money loser, always has been, always will be). Heck, most public sector areas are, however that "cost" is offset by the service provided to the community

EMS is unusual because it provides a service to the community, but it also expected to pay for itself (even though much of the revenue generated goes back into the general fund, not the EMS department's budget). In the private sector, this is shown by poorer wages, poorer equipment, standup 24s, and the mistaken concept that "an ambulance not on a run is costing money and could be eliminated." In the public sector, this leads to the idea that you can just outsource EMS because it has gotten to expensive and suffer no loss in service levels provided (and as many NJ cities found out, that was nowhere near the case).

 

[FiremanMike]

Fire departments (the suppression side) are known black holes for money (the PD is also a money loser, always has been, always will be). Heck, most public sector areas are, however that "cost" is offset by the service provided to the community

EMS is unusual because it provides a service to the community, but it also expected to pay for itself (even though much of the revenue generated goes back into the general fund, not the EMS department's budget). In the private sector, this is shown by poorer wages, poorer equipment, standup 24s, and the mistaken concept that "an ambulance not on a run is costing money and could be eliminated." In the public sector, this leads to the idea that you can just outsource EMS because it has gotten to expensive and suffer no loss in service levels provided (and as many NJ cities found out, that was nowhere near the case).

If the payer mix truly is as described, those fire departments tend to generate essentially the same revenue as the private company, except now the money is going into the general fund and not back out as dividends..

 

[DesertMedic66]

If the payer mix truly is as described, those fire departments tend to generate essentially the same revenue as the private company, except now the money is going into the general fund and not back out as dividends..

Most private companies in CA who run 911 also run BLS/ALS/CCT IFTs to help increase their budget. Billing and collecting on the 911 side is typically very poor. On the IFT side, they are insurance approved transports so payment is pretty much guaranteed.

 

[FiremanMike]

Most private companies in CA who run 911 also run BLS/ALS/CCT IFTs to help increase their budget. Billing and collecting on the 911 side is typically very poor. On the IFT side, they are insurance approved transports so payment is pretty much guaranteed.

This entirely depends on the payer mix. There is a department nearby in a more affluent area who brings in more billing revenue than us and they literally take 25% of our run volume in a busy year..

 

[Amberlamps916]

Just imagine how much money Santa Barbara County could make by running it's own 3rd service EMS agency, with as many ambulances as fire engines, especially if it was funded by transport billing and supplemented by taxpayer funds.....

The EMS labor union brought this possibility up to all five board of supervisors in individual meetings. They asked why fire or privates have to be involved in EMS in the first place.

No good answers from them as to why not.

Also, they brought up the fact that the number one highest paid employee in the county is a fire captain medic who pulled $346k in one year. Look it up on transparentcalifornia.com and search by county.

 

[FiremanMike]

The EMS labor union brought this possibility up to all five board of supervisors in individual meetings. They asked why fire or privates have to be involved in EMS in the first place.

No good answers from them as to why not.

Also, they brought up the fact that the number one highest paid employee in the county is a fire captain medic who pulled $346k in one year. Look it up on transparentcalifornia.com and search by county.

If someone really wants to spend every waking hour at the firehouse and soak up all that overtime, I could care less. I’d rather be at home..

 

[KingCountyMedic]

If someone really wants to spend every waking hour at the firehouse and soak up all that overtime, I could care less. I’d rather be at home..

Exactly! I feel working that much is horrible for you and your coworkers and your patients and should be discouraged, BUT I get sick of all the folks that ***** about how much $$$ some cop or firefighter makes in a year working overtime. THEY ARE AT WORK!!! You want them to do it for free? Don't like your job? Get a better one.

 

[Amberlamps916]

Exactly! I feel working that much is horrible for you and your coworkers and your patients and should be discouraged, BUT I get sick of all the folks that ***** about how much $$$ some cop or firefighter makes in a year working overtime. THEY ARE AT WORK!!! You want them to do it for free? Don't like your job? Get a better one.

Their point was how do the board of supervisors think it'll be cheaper for fire to run EMS if they are paying engine guys this much? Their pensions are an average of their three highest income years.

 

[FiremanMike]

Their point was how do the board of supervisors think it'll be cheaper for fire to run EMS if they are paying engine guys this much? Their pensions are an average of their three highest income years.

Staffing is staffing is staffing. Unless he's an admin personnel who can make up their own overtime (rare), he's covering hours that need to be covered, either by him or by someone else. It has been understood in the past that it is actually cheaper to pay someone time and a half to cover hours than it is to have another employee hired to cover those hours (once you factor in benefits)..

Side-bar, I believe in California they only calculate base pay, but I could be wrong on that. My state does count overtime pay..

 

[DrParasite]

Staffing is staffing is staffing. Unless he's an admin personnel who can make up their own overtime (rare), he's covering hours that need to be covered, either by him or by someone else.

We used to have an admin chief officer (i think he was a DC or BC) who worked bankers hours, but when one the duty chiefs ended up out, he picked up the OT. So he would work 9 to 5 in the office, than 7pm to 7am as the shift commander (sleeping most of the time), and then back to 9am to 5pm for his day job.

I do agree with you, the shifts need to be covered by someone, and it's not like they aren't working the hours. Their argument is paying a Fire medic captain, who makes 150k a year as his base, OT to ride on the ambulance, is a heck of a lot more expensive than paying a single role ambulance paramedic employed by the city/county time and a half (at a base of 75k a year), OT for that same shift.

 

[FiremanMike]

We used to have an admin chief officer (i think he was a DC or BC) who worked bankers hours, but when one the duty chiefs ended up out, he picked up the OT. So he would work 9 to 5 in the office, than 7pm to 7am as the shift commander (sleeping most of the time), and then back to 9am to 5pm for his day job.

I do agree with you, the shifts need to be covered by someone, and it's not like they aren't working the hours. Their argument is paying a Fire medic captain, who makes 150k a year as his base, OT to ride on the ambulance, is a heck of a lot more expensive than paying a single role ambulance paramedic employed by the city/county time and a half (at a base of 75k a year), OT for that same shift.

The numbers keep going up and up for the fire salary..

Yes, I will absolutely stipulate that a single role private service medic makes less than a municipal fire medic. The notion that I reject, however, is that running 2 separate entities (fire and private ems or fire and public EMS) is cheaper than running a single department doing both. The money comes from somewhere, either tax funds or increased insurance rates for everyone in the area..

 

[DrParasite]

The numbers keep going up and up for the fire salary..

That's because I don't know what a Fire Medic captain makes in Ca. In case you were wondering, a Firefighter III in Los Angeles makes about 95k a year. The top earning public employee (who is a FFIII) make 300k in OT.

Compare that to santa barbara county, where a fire captain makes 115k. A shift FF makes between 86k and 90k, at least according to https://transparentcalifornia.com/salaries/search/?a=santa-barbara-county&q=firefighter&y=2018

Still waaay more than most single role medics make.