Los Angeles County officials have given initial approval of the Long Beach Fire Department’s proposed alternative emergency-medical-services (EMS) delivery model that would change the staffing on all ambulances from two paramedics to one firefighter-paramedic and one emergency medical technician (EMT). The new change would also increase the number of paramedic rescue ambulances with advanced-life-support (ALS) capabilities from eight to 10.
Long Beach Fire Chief Mike DuRee announced the county’s approval during an update to the Long Beach City Council at the Dec. 11 meeting, adding that the fire department is expected to start implementing the proposed rapid medical deployment pilot program sometime in February. The City Council approved moving to the new EMS staffing model during the budget process last year as an alternative to switching from four-person to three-person crews. The new model, which was expected to take about a year to implement, is in addition to the proposed closure of Fire Station 8 in Belmont Shore.
Since August of last year, the fire department and the City’s emergency medical services agency has been working on the plan with county officials from the medical services agency of the Los Angeles County Department of Public Health Services, he said.
According to DuRee, ultimately, the new system would place one paramedic on each fire engine in the city so there would be “two paramedics on the scene on every paramedic response in the city.” He added that maintaining four-person crews allows the City to “handle most any problem with the first arriving unit.”
Before the fire department is allowed to start implementing the changes, however, the County requires the department to initiate an electronic patient-care reporting program, which is expected to enable the department to use technology to better track patient care and reporting and will make billing “instantaneous,” DuRee said. The department is also required to provide two years worth of retrospective data on the City’s current EMS system, which hasn’t formally been studied since it was put in place in 1972, he said.
“The fire department has never done a study as to the effectiveness of the two-paramedic ambulance [model],” DuRee said, adding that electronic data collection will look at performance and allow the department to compare with the new paramedic system.
He asserted that the proposed system is not what is called a “one-and-one” system in which there is one paramedic and one EMT per ambulance and no additional paramedics in the system. “The system that we’re moving to actually is just a redistribution of our existing assets,” DuRee said. “It’s actually, for lack of a better way to describe it, two paramedics on every scene of every call. They just arrive on a different apparatus.”
The change will allow the department to not only increase the number of ALS capabilities, but “every single fire engine in the city will have a firefighter paramedic on board, thus lowering [the City’s] overall response times to deliver the highest level of medical care citywide,” he said.
The Long Beach Firefighters Association Local 372, however, has expressed opposition to the plan, stating that the new system will end up making the department’s quality of patient-care services worse.