Wednesday, December 19, 2007

What is going on here?

Over on www.CvilleNews.com, a commenter (hey Karl) asks 'what is the backstory here?' with respect to the new EMS program at the fire department.
A good place to start is the presentation by the chair of the oversight committee and the report the committee created.

You know the saying, "the ends justify the means"? It is kind of what is going on here. I am going to take this story backwards since at the end here it started to make a little sense.

The Chair of the Committee (MaryLooseDeviney- and I know I butchered her name, apologies) was the one who described it best- when she visited the emergency communications center on a weekday- all the ambulances (3) were out on calls at some point (she got there at 8, the time all ambulances were on calls was 9:15). She then details her thoughts, if at that time, one of her customers falls on the downtown mall, what would happen, who would come to their aid?

In reality- a first responder would until an ambulance was cleared. Cville/Albemarle (and many other jurisdictions) have a tiered response system- fire engine goes first with a medic/EMT onboard to administer care. The ambulance comes next.
Notice she didnt mention anything about response times? Funny...
In fact she stated there is no problem with the response times on CARS end. (the report [pdf] indicates the CFD has some issues with response times, but apparently is outside the scope of inquiry).

There is this lovely thing called ambulance utilization yadda ya- it is a metric, the metric for Cville is 3.5 ambulances (I am not an expert on this stuff), CARS has three ambulances during the day. The report indicates this metric standard is used widely but "much debated." um, ok.

Again nothing to do with response times.

What the CFD is pleased about is getting rid of the tiered system, they are seeking to collapse the tiers into one, one in which they will be the only ones to respond, I suppose CARS will still respond too since CFD is only seeking 2 ambulances ($530,000 over ten years) and 6 paid medics (high level training). Will this translate into quicker response times? I dont think it matters for CARS since that is not an issue for them, but for CFD? I hope so.

Finally the emergency communication center will still have to ask tier questions for County calls. An argument made by Taliferro is 'you never trust the person on the phone to be as accurate as an impartial observer' about the condition of the patient. And here I absolutely agree with him. But I dont think it is worth spending all of this money on since the same tier system questions will likely still be asked of every caller.

A great aspect of the Oversight Committee is the creation of standards for performance. I know everyone will benefit from that.

So despite the means being about CARS response times, the ends of creating an taxpayer subsidized ambulance service justified that tarnishing of CARS (I jest of course). I wish the CFD had approached it in a better, more honest way.

The question left unanswered by everyone "how are these recommendations going to change the response times for first responders?" Lynch asked some good questions that were answered in very circular fashion thus creating frustration and confusion by those of us who thought the questions were reasonable.

I know reasonable people differ, I respect the folks who created this new service and hope it does create a better service for the community since we are spending so much money on it. My opinion is ultimately the committee didnt need to rely on the 'four' chiefs to come up with a proposal, an innovative, more cost effective plan could have been achievable and workable. I will gladly change my thoughts on the subject if I see a dramatic improvement, so stay tuned.

8 comments:

Talking Head said...

Speaking of conspiracy therories...is it just me, or does anyone else think that Fire Chief Charles Werner bears a striking resemblance to Hinrich Himmler? Not that that means anything. I'm just sayin'.

Patience_Crabstick said...

I feel very disappointed in the whole thing. Will it affect my life in any meaningful way? Probably not, but I feel that Kevin Lynch, at Monday's city council meeting, proposed a good alternative to a city-funded rescue squad.

Doolittle said...

Thanks for the rundown, Jennifer. I feel very badly for CARS- an organization that has served us so heroically for so long- and think they've been shabbily treated.

Why doesn't Council feel that funding should go to CARS in order to make the improvements Council thinks are necessary? This is the part I just can't understand.

TrvlnMn said...

Jennifer wrote: "the report [pdf] indicates the CFD has some issues with response times..."

So instead of laying the poor response time blame where it belongs on the CFD they make it about CARS.

Jennifer wrote about MaryLooseDeviney: She then details her thoughts, if at that time, one of her customers falls on the downtown mall,...

I'm curious since it was mentioned - What's her business? A fall at a nursing home is more likely to require an ambulance than one at a restaurant or overpriced gift shop. Right away this sounds like adding more Trophies to Charlottesville's trophy shelf.

Jennifer wrote: "What the CFD is pleased about is getting rid of the tiered system, they are seeking to collapse the tiers into one, one in which they will be the only ones to respond."

Sounds more like an a government union/profession trying to get a larger share of the market and a bigger budget. (Caveat: I am not implying the CDF is a government union but it's the best analogy of how this appears).

I suppose CARS will still respond too since CFD is only seeking 2 ambulances ($530,000 over ten years) and 6 paid medics (high level training)."

I hope they don't. I think CARS should cut the city of Charlottesville off and cease service with the effective beginning of the City's Ambulance program. The City has absolutely no right to expect CARS to augment a "City Funded" parallel service for free.

Kenneth said...

It's funny that CARS can operate with only a $850,000 budget this year. Compare that to the initial City's cost which will grow as the program expands.

Jennifer said...

DeViney owns Tuel Jewelers. Couple of more things as I consider everyone's thoughts-
1. It is not necessary to have a paramedic on every medical call, it is an expensive and inefficient use of resources (cut on finger, sprained ankle etc) Many calls are minor calls.
2. Geographic - CARS does have a culture of centrality and with growth in the southern area of the City/County the culture isnt serving the surrounding community (devil's advocate argument). But I believe it is possible to create a workable partnership between CARS/CFD with the new Fontaine station.
3. Seminole Trail was created by volunteers who were marginalized by the CFD in the 70's. The CFD and many professional fire departments are openly hostile to volunteers. Alb County because of its budget crunch and history of strong volunteerism means volunteers are professional and used in dramatic and interesting ways that keep volunteers on board.
4. Volunteers have the same professional standards as professionals. Any argument stating otherwise is a red herring.

Jennifer said...

Dave Norris commented on the EMS thing on Coy's show today, be sure to check it out when it comes out on Cville Podcasting Network. He always makes everything sound good. Very talented guy.

Anonymous said...

Taliking Head your an idiot.