Va. Fire, EMS considering merger

Combining the departments could save $300,000 per year

August 27, 2012 03:23 AM

By F.M. Wiggins
The Progress - Index

PETERSBURG, Va. — In 2011, Southside Virginia Emergency Crew responded to 6,664 calls for ambulance service. The Petersburg Department of Fire, Rescue and Emergency Services responded with the crew to about one third of those calls. In the eyes of some, including City Manager William Johnson, there is too much duplication of the same service.

“The chief and I still need to have further conversations with them,” Johnson said earlier this month of Southside Virginia Emergency Crew. “The way it was presented at the Council Advance, it could reduce some costs and improve the quality of service.”

The underlying question is whether the city fire department will try to better coordinate with the nonprofit ambulance service that was traditionally based on volunteers or whether the city should combine the two and take over all emergency services in Petersburg.

A presentation made at the City Council Advance on Aug. 3 by the Petersburg fire department indicated that the cost savings would start with $300,000 a year - that’s the amount the city currently contributes to Southside Virginia Emergency Crew for its annual operations budget.

During the presentation, Fire Chief T.C. Hairston said that over the past several years more than 2,000 new living units have opened in the downtown area.

“Another 500 are in the pipeline,” Hairston said.

Hairston said that from this point forward there will also be 10,000 people a day turning 65 as the “baby boomer” generation ages. That’s particularly important because it means there may be an increased demand for emergency services.

Fire Department Capt. Kevin Michalek said the fire department has been providing medical services since at least 1982 when all firefighters were also required to be trained emergency medical technicians.

Michalek said that the conversation about SVEC has been a long one. In 1992 an informal study was undertaken by interns from Virginia State University, four years later the “Blue Ribbon Study” was done which was made up of community leaders, SVEC representatives, business owners and fire personnel. The 1996 study led to the city providing initially $80,000 a year in support of the crew’s operations. The crew hired full-time staff as a result as well.

But Michalek said that study was “biased” with five SVEC representatives and only one fire department representative on the review panel.

In 2008 as part of the city’s Efficiency Review, the issue was examined again. That study said that the city should assume full responsibility of emergency medical services, Michalek said.

The study noted that if EMS staffing was increased along with the number of ambulances in fire stations, it could reduce the engine company response times and the city would also maintain accountability.

The study also noted that the Market Street Fire Station should be closed.

“We do need to look at our operational processes,” Johnson said following the advance. “It’s going on around the country.”

He said that the city will look at all the operations and determine how the city currently interacts with the Southside Virginia Emergency Crew.

If Michalek’s report is accurate, that interaction currently is sometimes non-existant, while other times it puts the care of the patient at odds with what might be the best possible care and sometimes leads to redundant responses. “In a lot of cases, every time an ambulance goes out, so does an engine company,” Michalek said in his report to council.

Based on numbers from 2011, SVEC responded to 6,640 calls for service, the fire department responded to approximately a third of those calls — 2,027 — with the emergency crew. In part, Michalek said, this is based on a policy that dictates the fire department must respond to life-threatening emergencies with the crew. That policy is based simply on how the call comes in to dispatch, he said.

In total, the fire department responded to 2,179 EMS calls in 2011 — 93 percent of those were with Southside Virginia Emergency Crew.

“Do we need a duplication of efforts?” Johnson asked rhetorically following the advance.

Michalek shared anecdotally that on one particular call where both the emergency crew and the fire department were dispatched, a child suffered severe burns. The fire department began treating the child with a new product. “The [Advanced Life Support] personnel from Southside stopped the treatment because he wasn’t familiar with the product,” Michalek said.

In part, Michalek said that this is because the two don’t train together.

Michalek also said that combining the services could help expedite care for patients. That’s in part just based on where fire stations are located in the city and response times. Most of the city’s EMS-related calls come from outside the ideal 5-minute response area for SVEC.

Southside Virginia Emergency Crew only has one location on Graham Road where all of its calls are dispatched from.

The crew isn’t strictly volunteer anymore either. It hasn’t been since at least the mid-1990s when the city started to provide funds for paid staff. According to Michalek, SVEC has 14 full-time providers, two-full time staff, and 15 volunteers of which five are active.

These numbers were not able to be verified by The Progress- Index. Executive Director Edward “Bubby” Bish said that the organization would not comment until after a meeting with Johnson set for later this week.

The fire department has 78 EMS providers.

Statewide, there is no one predominant way of doing things either. Statistics provided by Michalek at the advance indicate 37 percent of the state is a combination of fire and EMS; 30 percent has a fire department-based EMS, 5 percent is directly under the county government; 21 percent relies on volunteer EMS while another 7 percent has a combination of private fire and rescue services.

By combining services, Michalek said the city would have more oversight and accountability. Additionally, he said the city could save $300,000 per year that is annually contributed to SVEC and most of the infrastructure is already in place to combine the services.

Michalek said the crew’s current board of directors could transition to become an advisory board, the current executive director’s position with the crew could become the assistant EMS coordinator, and with new hires, additional EMS providers could be working for the fire department.

“The money saved could pay for a new ambulance,” Michalek said.

Councilman Ken Pritchett said at the advance that more communication needs to happen before any further discussion is made about combining or taking over services.

He also pointed out that the starting salary for a firefighter is $27,000 — about $6,000 less than the salary for the paid EMS providers with the emergency crew.

Michalek said that the starting salary is primarily for while a firefighter is in candidate school and that the salary increases after that time.

“If we’re hiring more people, we would need $800,000 more minimum to hire the same number of people from the crew,” Pritchett said, adding there needs to be a great deal of further discussion between the city and the crew.

Pritchett, a member of the board of directors for the emergency crew, also pointed out that SVEC recently obtained several brand new ambulances. “For the city to buy three more vehicles, that would be a lot of money.”

Pritchett also asked whether it had been considered that the fire department could potentially repaint and use the new ambulances if the city assumes the duties of SVEC. Michalek said that it would depend on whether or not the vehicles meet the fire department’s standards. Hairston also pointed out that the savings would also be met through reduced wear and tear on fire engines — larger, heavier vehicles which are dispatched about a third of the time with the crew.

“We’re standing here talking about EMS assuming we have a functioning effective EMS system,” Michalek said. He detailed how that isn’t the case in Petersburg with a national average of cardiac arrest survival of 3 to 6 percent. “Five years ago the survival from cardiac arrest in Petersburg was 0.1 percent. That shows we don’t have an efficiency in the EMS system.”

He added that at a minimum the fire department and emergency crew need to come together for training.
“We know money is a factor,” he said. “Money, pride and politics keep getting in the way.”

Hairston added that he would ask that City Council not just listen to the fire department’s perspective and invite the crew to give a presentation to City Council.

Johnson at the advance said that there might be some initial up- front costs with combining the two, but that response times and quality of service are the critical issues.

“It’s an issue we need to address,” Johnson said at the advance.