HomeMy WebLinkAboutS3-Fire Department
.,.
CITY OF SAN BERNARDINO - REQUEST FOR COUNCIL ACTION
Dept:
Fire Department
ORIGINAL
Subject: Discuss and take possible action
regarding status of emergency
medical services.
From:
Larry Pitzer, Fire Chief
Date:
April 2, 1997
Synopsis of Previous Council action:
11/04/96
Mayor and Common Council approved the implementation
of the financing outlined by the Director of Finance
for funding of the EMS transport start-up costs.
10/07/96
Mayor and Common Council directed the Fire Department
to begin EMS transport services on May 1, 1997.
Recommended motion:
That the Mayor and Common Council discuss and take possible action
regarding status of emergency medical services.
Contact person: Larry Pitzer
Phone:
5286
Supporting data attached:
Yes
Ward:
All
FUNDING REQUIREMENTS:
Amount:
N/A
Source: (Acct. No.l N/A
(Acct. DescriPtion) N / A
Finance:
Council Notes:
75-0262
Agenda Item No.
1//7/97
5-3
STAPF REPORT
The Fire Department's EMS transportation service is scheduled to
begin on May 1. The following summarizes the activities to date
related to implementation:
Twenty (20) new paramedic/firefighters started their
employment and began their month-long intensive training
program April 1. In addition, the EMS Program Director, Ruth
Grubb, will be on board April 14. The selection process for
the remaining administrative positions will soon be completed.
Ambulances have been delivered to the Fire Department.
Lettering of the ambulances is underway, and staff will soon
begin driver training.
other necessary equipment has been ordered, such as radios,
computers, MDT's, etc., and installation will be completed the
third week in April. Protective Clothing, safety equipment,
and uniforms have been or will soon be delivered. The
purchase of vans for the administrative personnel as well as
EKG monitors and defibrillators, and awarding of the medical
director contract, are on today's Council agenda for approval.
Rates for ambulance transportation have been established to
allow for the recovery of the costs of the service to the
city, as well as repayment of the loan that is funding start-
up costs.
Filming of a 30 minute informational program is almost
complete, and the program will soon begin airing on Channel 3.
Speaking engagements have been scheduled with several
community groups to inform the community about this new
service. A Media Day and Ribbon-Cutting ceremony have also
been scheduled.
Attached is a summary of the EMS expenditures through March 31, and
the projected expenditures through April 30.
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CITY OF SAN BERNARDINO
INTER-OFFICE MEMORANDUM
TO: Larry Pitzer, Fire Chief
FROM: Robert 1. Simmons. Sr. Assistant City Attorney
DATE: March 26, 1997
RE: City of Orange Emergency Transport Plan
COPY TO: James F. Penman. City Attorney; Stephanie D. Easland, Deputy City Attorney;
Lori Sassoon, City Administration
I am enclosing a copy of a report on the progress of emergency transport in the City of
Orange. I believe it isself-explanalOry.
.J .J-,
N'6-...-.-T7--.
Robert 1. Simmons
Sr. Assistant City Attorney
Entered into Record at
CouncillCmyDevCms Mtg:
i-I!7/J7
by
re Agenda Item
50
q~I(l~
City ClerklCOC Secy
City 01 San Bernardino
RLS/i. [Fire.mc:dll:"
Mar-2~-~' Ua:44A
.....U.L 1;'-:
Februar:
.
"
Post.lt' Fax Note
TO
7671 0...
".... ."
AGEN[
Fax'
TO: Honorable Mayor and
Members of the Cirv Council
THRU: David L. Rudat,
City Manager
FRO:V!: Bob Clevenger
Fire Chief
Reviewed/Verified By:
City Manager
Finance Oircctor
To Be Presented By:
Dick Dittberner
i 1. SUBJECT
The Orange Fire Department (OFD) presents a progress report on the Emergency
Transportation Program.
/2. RECOMMENDATIO:\"--------
T::e Fire Department recomrnencis t~at the Orange City Council receive and file this
Re?ort.
3. FISCAL IMPACT
l
:'\one.
1-- --.-----. --- --- --- - ..
,~. ACTHORlZATION/GCIDELIXES
I
1\ot appiicable.
:
-
'5. DISCUSSION and BACKGROC~D
I
On October 23. 1995. the Ora!:;: ':~;'. Cvuncii approved a recommendation by the
C:rr ~la:u!;e: a::ci the Fir~ C:ie: :::~: :;.e ''::':.1::;e Fire Department (OFD) begin an
Ernergencv T rdnsoortarion P!"o~r:;,;r:. --\3: i...::::~ci. :he Program transports individuals
i::\'oh:eci i~.l medlcai i::cider.t i;Qr.: ::~~ s;~::~ c: ,1n incicie~t to a local hospit.ll using Fire--
b.lsd rescue ambulances.
c.)Uncil Goals
......~ .....;,.,'. cr- '; . "l"'; .:... .......C'...._;... ..... -""....; ~l t' 1'1 .' .
,.Ie 1.....\ s ~~'ais.n ena....ng ...e F'-~'-", ........_,_ .1e 0 Q':>In!?;.
· T,) improve "rcspcnse nrr..es" :cr tr_1::S?ort SCr\'lC~S. ensuring that a "rescue~
(ambWalicei "'-QuId ~:rt,W .H ,,:1 i::,;:.icnr scene faster tha.n before. uResponse time" is
ITDl
PAGE
2/25/97
Mar-26-9' 08:45A
'.
t"'.u~
defined by the OPD as the time transpired from the moment that the OFD receives
the call from Dispatch to the arrival of the first unit on the scene of the emergency.
. To provide the service without increasing the cost of paramedic subscriptions (a
service whereby enrollees pay 536 per year for unlimited paramedic incident sel"'/ice
calls) or increasing transportation costs to Orange residents and businesses.
. To reduce Fire's reliance on the City General Fund by supporting certain Transport
Program positions with the EMT Transport Fund.
Proc~s - Rtfnr~ 2nd ~ fr~r
Here's how the system worked before the program and 3fter (changes in italics):
Before Transport Program
. Medical cmergency.
. 9.1.1 call comes into Police Di~'Pateh.
Police: tOl'Wards call to fire Dispatch.'
. Dispatch contacts OFD and privatc
ambulance company.
. AI':wal oi OFD Advanced LIfe S::ppor:
(ALS) f;reti~h:r:paramedic team on an
"eng,ne" or OFD BaSIC Ute S~ppOl1
(RI.S) team wllh OFD lirctighter:
emergency m.:dlcal techniCIans (Ee, !T.; 1
un a ..truckot (~otc that 3D inYi1sl\.t ?:"ccedl.re
lequlrrfthe prt'st'nce l)itYwn flKJ'iIU'T1edl.;'S),
. Arrival of private-sector rransport ~;m
(indudes only EMTs).
. PalIcnt stabdil.eu for cravel.
. OFD paramedic board., prIvate ar::orliJ::ce
wllh pall.-nt, remains wirh patie"-t \:nl:i
check-m OIL ho~pltaJ. .
. om team follow~ pnvate sector trans!,,,,,
unit to hOSflllaJ. awail~ paramedic. 5
discharge. Cpon di"char\:e. team rer~r~.'
to station.
. Orr.nrr. "",1,) 1/.'IvniiJ.Vc-t t"~pa:ch p~rru::rln1:l '.',' 'l'i' ,":,
r"'''UfJ()'' f-'Vv:,'ff,
After Transport Program
. MediCal emergency,
.9-1-1 ("all comes inra Police Disparch.
Pnlice forwards ca// rn MelroNer Fire
Dispatch. ·
. MerrnNel Disparch COnlOC/'s OFD.
. Arrival of om ALS team on an "engine"
or OFD BLS ream on a "trUCk:'
. Arrival o/OFD rescue unil slaffed ....ilh a
paramedic (OFD noles IJuJr the arrival of
a rescul! can precede thl! engine or truck).
. With parumedic from engin. and
paramedic from rescue, team IrIlI)I
,'Qnduct invasiw procedure, if required.
. Patient stabilized for trave!.
.' OFD rescue ullir transports individual /0
hospital, engine or trud rlllU11IS 10
station.
. /./pOll pa/iem delivery, OFD rescue unil
returns 10 slalion
In the abo,'e comparison. note that rhere .lre :""0 different types of OPD unitS that could
arrive at the scene of an incident to perter::: iite support, One lype is a "truck" staffed by
OFD personnel who arc Firefighter. nIT 5. ;\5 rhis tcam can provide only basic life support
(BLS), or non-invasi\'e first aid. the C:;y'> ~o.li has been to increase the number of "engines"
suffed by at least one Firefighter, P,lr;1mec.:~. OFD refers to the "engines. as Paramedic
Assessment linits (P AUs). PAUs ar~ c::::s:dered advanced life support (ALS) units. These
(ums cm perfor!1,l im'asive techniqu~s ~s soon as a .mother paramedic arrives. To eft~ure thoLt
~he ;.". paramedic getS on scene quickh', ;::. OFD Trmsport Program combines an ambulance
driver (typic~' ..~ Firefighter/EMT) ",'jth ;1 Firefighter/Paramedic Oft units called "rescues" -
th...e unitS ,Ire also con~idered to be ALS unirs.
ITEM
PAGE
2/25/97
Mar-26-97 08:45A
...... \J~
Results Afur t 6 Months
After more than a year in operation, here are the results of the Transport Program's activities,
both in terms of response cim..s and financiai i ml"l"rs.
. Response Times. The first two sets of cham look at response times. Figures 1 and 2
compare average response times before and after the Program's implementation. They show
that an ambulance is now on scene a full five minutes, 11 seconds faster on average than
before the Program. They show, too, chat ~ better distribution of paramedics on engines
and rescues has enabled us to get an ALS unit on scene one minute and thirty-six seconds
iaster than before the Emergency Transport Program.
For Engines ulith Paramedics fFiprr I}
For Rescue/Ambulances (Fi,...1)
~_12
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::~D
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'0"48
9'36 .
':2"
7.12
fiOO
~...
3.36
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~:OlJ
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.\nother 'kppropriate measure Dr ?errormanc~ is shown in Figures 3 and 4 - the fractile
response time. Fracriie resp()r.s~ rime is the ?crcentage of time that a unit is on-scene
",'ahin a g:';en time frame. Bdore the Trolr.'Forr Program, ambulances arrived on scene in
:~SS than b mint,res oniy 11','" of ::;~'rime. ~::;.:e die Program's inception, 83% of rescues
;ldve drrived within 0 minutes 0: r::e 9.[.1 ,~.:.
Before Transport'Program mi''''')
lifter Transport Program (Fi".,. 4)
ro..=SSIl'li'I";~r...;..
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2/25/97
MAr-'~-~' ~g.~~~
I".U4
o Cash Flows. In October 1995, Council approved the pilot program with the expectation
that it would produce a positive cash flow (where life-to-ciate revenues would elI:ceed life-to.
date expenditures within two years). The City created a separate EMT Transpon Fund to
account for the Program. Included in the Program's revenue and expenses are:
Transport Program Revenues
o Revenue irom yearl)' paramedic subscriptions
(53& pet year with aho"t 10,200 sub,aiptions
solei d"ring ,he currcnl fiscal year to date).
. Revenue from direct billing oi non-en:olIed
patients and from billing the insur.ll1ce eclT.pa..'li..
of both enrolled and non-cnrollcd patie"".
Typically, . hospital transport l"Jl1S iron: 5450:0
S7CC per event.
Transport Program Expenditures
. Re.cue personnel. '
. Payments to the General Fund ior principal ana
mterest on the origin.! loan for the l'CS(."Ue units.
. A reserve, fund to replace ,he units over :i::le.
. Payments to the Ciry's billing contractor
(Wittman Enterprises) for bill eoilcC!:o:>.
. Me.iicai suppli.. ar.d "'pit.! expenses.
11 of Transports (May '96 - Jlln '97)
Fipn s
Fig",. S .ho"" tM ....mm of "",wi,.ti4m
:rampo,," ,mM&y J!J9fs{thro"!h/."".,, /997~
OfJJH 'Tamporr.,."..... J], (11") inwI'.:#d
,".ili,';;'..", from mroiltJ homts or lnuinmts.
Figure 6 below shows that the Program's life-to.date revenues (the cumulative revenues
associateCl with the Program from Da)/ One) will meet its expenditures (the cumulative costs
of the Program, including personnel COSts. since Day One) in Summer 1997, with
projections showing that June 1997 may b~ the first month that cumulative revenues
actl:ally exceed cumulative expenditures ,:"OTE: l~nuar,.- 1997 ,lata fOl"\Vard is projected).
OED Transport Program's J ife-ta.Date Re'l..enues and Expenditures (Fsx-6)
S1,000,000
$800,000
5600.000
$400.000
$200.000
SO
0cI.1l5
Jan-"
M'Y.~d
l,)
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PAGE
! -- ROVORUM I
: ___ ExpencliturH
Oct-"
J.....7
Jun.f7
2/25/97
'Mar~26-97 OS:45A
r-.__
The next chart: (Figure 7) shows the Program's approximate monthly revenues and
expenditures. The Fire Department explains the "spike" in revenues during Fall 1996
(including October 1996 shown below) as the period during which a new billing contractor.
hired when the previous contractor filed for bankruptcy, pursued delinquent claims
associated with the bankrupt contractor. Since June of 1996 (a month not shown on the
condensed chart below), monthly revenues have consistently exceeded monthly
expenditures (NOTE: Jmuary 1997 datafnrwd is projcttcd) ,
OED Transport Program's Monthly Revenues and Expenditures (Fi",," ")
C Rlv.nu..
. !Xpend~ur..
Janoie
May.96
0.1096
Jan-9r
Jun.gr
Condu~ion
The OFD considers tne E:nergenc:: Transper: Program tv be an unqualified success after 16
:nonths in operation. I, has met the Coune::'; goals ot i:-.:pro,'ing response times. providing a
strong new se:vice.tO Orange resider;t; witn.;:;u, ne':\' taxes, and in saving the General Fund
abom 531::.:::: in stait .;om (personnel n",," i~nded with the EMT TranspOrT Fund). As
pJmned, OFD will sub)!lit a second progress repOrT on or .tbout October 1997 (the conclusion
of the two-year timeline for the TranspOrT !liiot project) to inform the Council of actual
revenue and expenditure data (r.lther than p:'c!ectionsL
f
The: OFD oiters'its tbnks to the Er.Jnc~ D~~<ctor .\I1d he~ staff for assistance in preparing this
Reporr.
H
L}
.
ITEM
PAGE
2/25/97