EMSA or TFD?

[Mike G]

Tulsa Mayor Kathy Taylor has announced that the EMSA trust has been renewed.

[RecycleMichael]

I think that is a wise decision. Both EMSA and the Tulsa Fire department are doing good work. I thought it would be hard to make a drastic change when everything was working smoothly.

[Rico]

quote:Originally posted by recyclemichael

I think that is a wise decision. Both EMSA and the Tulsa Fire department are doing good work. I thought it would be hard to make a drastic change when everything was working smoothly.

 

Mike your reading all her lines for her...

EMSA

[RecycleMichael]

I had no idea what she was going to do on this topic. I have many friends on the fire department and work with them often. I was kinding of rooting for them because I know how thorough and professional they are.

I only know the top guy and the PR lady at EMSA. I like and respect them both.

I asked myself, what what I do? My answer was that this was the wrong time to make a change of this magnitude. The system is working fine.

I think the Mayor made a wise decision.

[rwarn17588]

I also didn't know until this morning that there would have been a two- or three-year transition period in which both EMSA and the fire department would have been answering ambulance calls. The mayor said the city simply didn't have the money for such an expensive transition.

Based on that and other factors RM mentioned, I agree that she made the right call.

[shadows]

Sorry I have been misinformed. I was lead to believe that EMSA was another of the letterhead bureaucracies which Tulsa is famous for.  I was lead to believe that the rolling stock belong and was paid for by the citizens of Tulsa.   That the paramedics are furnished by a company on the contract basis.  
The city through the FD could continue the same system as the letterhead bureaucracy that is now operating it is using.   Being it is a desk corporation then one would assume that it is protected from the open records codes and statutes.
Course if we were to make the change then we would have to buy possibility three new desks.
An informed public has been known as a rebellious public thus it becomes where the people paying the total cost of maintaining governmental practices are kept uninformed.
We are winning the war in Iraqi!

[deinstein]

TFD

[deinstein]

I think the worst assumption in this thread that TFD would be using their fire trucks as response.

They would be using the same ambulances as EMSA is currently using...

-They would have better response times. This should be the biggest factor, period.
-You would be using one vehicle as opposed to two, this saves money.
-You have a better trained fire department.

I have no idea why EMSA is needed, and I scanned this how thread and still disagree. I think you all are just used to having EMSA around.

[shadows]

How would the FD laundry campaign funds at election times?

Is this another trash burner that the public paid for and the operators sold it to a third party?

Fool them once, fool them twice, fool them three times,......................

[Mike G]

quote:Originally posted by deinstein


I think the worst assumption in this thread that TFD would be using their fire trucks as response.

But wouldn't they?

quote:They would be using the same ambulances as EMSA is currently using...

Probably true.

quote:-They would have better response times. This should be the biggest factor, period.

1) I don't know about you, but my biggest factor is patient care.  I don't care if you can get to me in seconds if you can't save my life.

2) There is very little evidence that can support a station-based system will have better response times than our current system status management (SSM).  Now this is assuming TFD wouldn't use SSM as a method of situating trucks around town.

quote:-You would be using one vehicle as opposed to two, this saves money.

No necessarily true.  I believe most fire based EMS systems still send an engine on higher acuity calls, same as TFD does now.

quote:-You have a better trained fire department.

True, but TFD is working on getting more paramedics.  The other side to this is for TFD to staff enough paramedics to cover a city of this size adequately, they would need roughly 105-135 (this was stated by TFD).  We currently have about 55 paramedics at EMSA and we have trouble keeping up with demand.  Now take into account all of the potential paramedics that either couldn't or wouldn't join a fire department based service.  I'm not sure where you are going to find over 100 paramedics that are able to pass a fire department's requirements.  Now you have the option of making a fire-based ambulance with non-sworn personnel, but that's basically what we have.  It's no secret that there's a nation-wide shorted of paramedics.

quote:I have no idea why EMSA is needed, and I scanned this how thread and still disagree. I think you all are just used to having EMSA around.

EMSA is not just another EMS service.  EMSA is one of the best, well-known services in the country and is in the top five for services with the highest rate of cardiac arrest saves.  EMSA is also one of the cheapest EMS services in the nation since it is a private company and bills patients and not tax-payers for the bulk of the operational cost.

Let me ask you this: Do you think that if TFD took over the ambulance that your tax dollars are going to pay for your ambulance ride?  Not in your life.  TFD claimed they would have a better collection rate from MediCare/MediCaid (I assume this means they are going to bill).  I'm also not sure how likely that is, being EMSA employees one of the top, nationally awarded insurance collectors in the nation.

Now I'm not saying fire based EMS is a bad thing.  It works great in towns like Owasso and Broken Arrow.  But with the call volume with a city the size of Tulsa, it requires a lot of work to keep up with the calls, yet still provide a service that's cost effective and has the quality anyone should expect.  I can't see how the fire department, having to hire more people (double the number of EMSA paramedics) to staff ambulances can be cheaper.  Plus there's the cost of vehicle maintainence, supplies, shift length, etc...  EMSA pays for all of that themselves.  And if you think a $1.9 millon subsidy is a lot, look at what other services subsidize from their city (either fire-based or private EMS).  You're looking at figures in the range of 10 to 30 times as much for a service equal to or lesser than EMSA.

Just some food for thought.

[Jason]

quote:Originally posted by shadows

How would the FD laundry campaign funds at election times?

Is this another trash burner that the public paid for and the operators sold it to a third party?

Fool them once, fool them twice, fool them three times,......................

Or sometimes just a paranoid fool.
Since the mid 1970's EMsa has provided top notch service for costs that are among the cheapest in the nation. Relax and know that EMSA is there when you need them.

[Jason]

YOu really believe that TFD would have been a better option for the city? Here are some facts for your "assumptions".
The city does own the bulk of the rolling stock that EMSA has. However not all of it. The contractor Paramedics Plus does own a portion of the vehicles and equipment. These things were purchased by Paramedics Plus to help the city when money was tight.
As far as not using fire trucks to respond to emergencies...How is 1 ambulance in a station going to manage multiple calls alone? TFD had no plans that would allow a second abulance to move around to cover a busy area. So the truth of things is that fire trucks would be responding more.
Fast response times are very imporant. However you are misinformed if you believe that TFD's responses are faster than EMSA's. You do realize that TFD only responds to about half as many emergency calls and then is only there part of those times before EMSA. These are proven numbers. Paramedics plus is obligated by contract to respond to all calls within 8 min and 59 seconds with a 90% efficiency. And it is done. TFD used their plans to demonstrate whether they could do this....THEY FAILED. consistantly. They then increased the number of thruck they would use and.....THEY FAILED. THey had to increase their numbers by approx 25% to even get close and then it was only sometimes.
Lets talk about training. TFD uses EMSA's training dept to assist with their traing because they do not have the capability to do it on their own. TFD may be able to put out a fire better than some of EMSA's paramedics but EMSA would put their medics up against any others in the nation and are confident that they could not be matched by many.
Yo usay you scanned this thread and was still not convinced? Well fortunatley for the citizens of Tulsa it was not your decision. EMSA has once again come out the best choice for Tulsa and OKC.
By the way... You seem like a conspiracy guy...Do not believe the nonsense regarding the reasons for keeping EMSA. TFD was millions of dollars over their claimed numbers. Infact they were millions over what EMSA will be needing for the next 5 years.

[shadows]

EMSA is liken to the Tulsa Trash Burner.  They hire and are furnished paramedics through a quasi union of Paramedics Plus (who are to furnish trained personnel) and use the transportation bought and paid for by the taxpayers of Tulsa.    There was no intend to use the FD to have a fireman play the part of a nurse.    Being I was a resident of Tulsa for fifty years before EMSA came on the scene and before Medicare overcharged billing, now is time for the city to survive and in the future will be on cost efficient operations.  Heaven Forbid!

It is not my ideal situation to see the present duplication of services in a city that is rapidly becoming  over taxed and the suburbs are reaping the spoils as the money goes with them.  Neither has there ever been any intent to converter fire trucks to ambulances that I can recall.

[Jason]

I would agree that the citzens of Tulsa are overtaxed. My point is simply that the FD takin the EMS service would have caused a terrible decline in the care of those citizens who need it. If you were to ask the firefighters themselves, without their UNION or chiefs present, I know that most would say that it would have been bad to move the EMS care to them.
As far as a "quasi union". I truly can not understand what it is you are saying. Paramedics Plus does not in any way resemble a union. It is a company who provides not only trained personel but manages and operates all prehospital emergency medical care for the city. OKC paramedics are infact union and have been longer than Paramedics plus has existed. Tulsa medics have repeatedly refused to have a union. The FD, as I am sure you know, Does have a union and have held the city "hostage" more than once for more money. I promise you that keeping EMSA has saved money but more importantly, lives.
Why don't we try and save money somewhere else like city transportation. How many city employees drive city cars? How many Fire chiefs take home fire dept vehicles? How many police take home their cars? How many attractions has passed Tulsa to go to other communities because narrow minded people are afraid to spend money for the city to grow? Tulsa has many problems. EMSA is far from one of them.

[Jason]

By the way....The outlying communities do pay a subsidy for EMSA's services. And I never said anything about converting fire trucks to ambulances either. I believe the Fire dept should not respond to any health emergencies. EMSA should be doing their own first response.
I think the big problem is that we as Americans see Firefighters as Americas heroes. Don't get me wrong, they are. However, they are not all powerful. How many Paramedics died on 9/11? more than a dozen. Not to mention the hundreds who assisted that day in New York and at the Pentagon. No one ever mentions them. Why is that? Paramedics are allowed by law to provide more care than most RN's and yet they make sometimes less than half the money. Paramedics are required ever 2 years to renew their licenses by providing proof of more than 50 hours of training. RN's have to send a check and a signed application with no proof of continuing education training.
Paramedics save lives more often than any firefighter anywhere. In some of the worst conditions. All without complaint. They do ask for a little respect. Something which even the fire dept gives them. Now if only the narrow, close, minded public, who knows very little of what they are talking about would give some respect.