Fire Authority Chief Proposes Big Shift in Emergency Services

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Orange County Fire Authority Chief Keith Richter is proposing a major redeployment of emergency crews, concentrating more paramedic teams during the busiest daytime hours.

The proposal — part of the Standards of Cover and Deployment plan updated every five years — is scheduled to be considered by the independent Fire Authority’s governing board at its Feb. 27 meeting.

It would not raise costs but hopefully decrease response times for medical emergencies, which constitute about 80 percent of all 911 calls, said Richter at a news briefing yesterday.

A key aspect of the proposal involves shifting a paramedic from a four-person engine company crew to create paramedic units operating from smaller, less-comprehensive vehicles called “squad trucks.” These added units then would be available from 8 a.m to 8 p.m. when about two-thirds of emergency calls are made.

The proposal also includes tapping new computer software systems and dispatch techniques to try to better match emergency teams with medical needs.

Richter said the new paramedic deployments would involve introducing 12-hour shifts to a service that currently is all 24-hour shifts, a step that must be approved by the Fire Authority’s union, the Orange County Professional Firefighters Association.

If the board approves, Richter said, a pilot program — likely in South Orange County — would be instituted by the end of the year to test the concept.

These ideas were immediately met with resistance by the firefighter’s union, whose spokesman, Joe Kerr, said they would be deleterious to public safety. Altering the long-used model would reduce the quality of care provided during emergency calls, Kerr said.

While Richter said the union was informed that this concept soon would be introduced into ongoing negotiations for a new contract, Kerr said Tuesday he was unaware of the proposals.

“This is typical of this administration,” said Kerr after the press briefing. “It is just trying to save a buck and save his [the chief’s] job.”

The Standards of Coverage plan comes at a turbulent time for Richter, the Fire Authority and emergency services countywide.

Late last month, the Emergency Medical Services Authority, the agency near Sacramento that directs such standards statewide, ordered the Orange County Health Care Agency to take over the process of selecting ambulances for the bulk of the county.

The Fire Authority was preparing to start a request for proposals process for long-term ambulance contracts for 19 cities served by its paramedics responding to 911 calls. The ambulances transport patients to hospitals after Fire Authority paramedic care.

But state officials determined the Health Care Agency was violating legal requirements by delegating too much responsibility in the ambulance selection process to the Fire Authority.

Since then, the Health Care Agency has been drafting its own request for proposals.

According to a Feb. 7 advisory to the Fire Authority board, the Health Care Agency is planning to carve the county into five multi-city zones, then select ambulance companies to exclusively serve those zones.

This is a marked departure from having individual cities select a single ambulance company to transport Fire Authority paramedic patients from a municipality.

Cities may take issue with the five-zone plan, because it reduced local control over ambulances.

Jill Ingram, Seal Beach’s city manager who chairs a Fire Authority municipal liaison panel, said officials from partner municipalities are to learn about the county’s five-zone plan at a meeting Wednesday.

The Health Care Agency contends it “will assure uniform provision of medical transport, maximize coverage and rapid response times,” while standardizing performance, states the board advisory.

Kerr speculated that some cities will be displeased by the county’s five-zone plan because it disrupts local control.

Already in January, state emergency officials told the Health Care Agency it must require cities to select the top-ranked bidder for a municipal ambulance contract.

In the past, some cities, such as like Mission Viejo, had selected a lower-ranked bidder. Earlier this month, Medix Ambulance Service, Mission Viejo’s long-time hometown provider, went broke. On Feb. 7, Doctor’s Ambulance Service of Laguna Hills took over the remainder of the contract, which expires Sept. 1.

That is the date when contracts expire for 19 Orange County cities, for which the Health Care Agency now is selecting ambulance firms.

County officials barely have sufficient time to conduct the ambulance selection process, which Richter confirmed is being delayed by state requirements.

State emergency officials are concerned about the Health Care Agency not updating its entire emergency services plan for six years as required by law. The county hasn’t done this, because it couldn’t get agreement with some cities on ambulance selection processes.

Now state emergency officials are saying they will not give the required advance approval of the Health Care Agency’s ambulance selection process until the county has submitted an acceptable countywide emergency plan, Richter confirmed. State officials couldn’t be reached for comment late yesterday.

The Fire Authority’s new deployment plan also comes as Richter himself has come under fire, particularly from Todd Spitzer, one of two county supervisors serving on the Fire Authority’s board.

A review of Richter’s management also began about four months ago. And late last year, the Fire Authority hired management and public relations consultants to enhance performance.

But Richter said yesterday the Standards of Coverage plan was separate, an outgrowth of an assessment begun in December 2012 when Emergency Services Consulting International of Wilsonville, Ore., was engaged to shape the endeavor.

“It is management’s intent to consider ideas from all the options and recommendations submitted to achieve the optimal deployment needs,” said Richter.

Rex Dalton is a San Diego-based journalist who has worked for the San Diego Union-Tribune and the journal Nature. You can reach him directly at rexdalton@aol.com.

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