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Friday, September 4, 2009

Fire Transport

How will FireTransport save tax dollars?Why is FireTransport better for the patient?How does FireTransport affect EVAC?Will FireTransport affect response times?Why have we waited so long to try FireTransport?Has FireTransport been done successfully anywhere else?What guarantees does FireTransport have?Is FireTransport a Union Program?Is FireTransport a Plot to Take-Over other Fire Departments or Cities?Does FireTransport Discredit or Criticize EVAC Ambulance?Is FireTransport a New Concept?Does FireTransport Fragment the EMS System?Why try FireTransport in Daytona Beach?Is Daytona Beach’s FireTransport Program the End Product?

4 comments:

  1. How will FireTransport save tax dollars? Even with fire transport fees 10% less than EVAC charges, revenues generated will exceed program costs, allowing for significant tax relief. Minor medical problems will no longer need BOTH a fire engine AND an ambulance to respond. By combining two-tiers into a single, total-care service, wasteful duplication is eliminated.
    Why is FireTransport better for the patient? Firefighters already have the same paramedic training & certification, and provide the same Advanced Life Support (ALS) service as EVAC. Patients will get faster service, with the same caregiver throughout the encounter. No more delays waiting for a "Second-Tier" ambulance before going to the hospital--when every minute counts. And FireTransport fees are 10% less than EVAC charges. FireTransport is Faster, Cheaper, and Better.
    How does FireTransport affect EVAC? This pilot program only affects Daytona Beach… about 1/4 of EVAC’s annual patient transports. FireTransport allows EVAC to focus their service in the remainder of the county. Any downsizing in EVAC paramedics can be absorbed and cross-trained as firefighters.
    Will FireTransport affect response times? Firefighter/Paramedics already respond within American Heart Association (AHA) and National Fire Protection Association (NFPA) guidelines, providing first-response within four minutes. EVAC’s contract allows for an 8 minute 59 second response time. With FireTransport, the patient will no longer have to wait for a 2nd-Tier responder before they can be transported to the hospital. You will get there faster.
    Why have we waited so long to try FireTransport? Twenty seven years ago most fire departments were not adequately staffed or equipped to provide transport service, so it was appropriate to engage a private ambulance company that could respond county-wide. Today, virtually every fire department in Volusia County provides Advanced Life Support (ALS) service. Daytona Beach Fire/Rescue operates 7 ALS fire engines and 3 ALS rescue trucks throughout the city. Our cross-trained Firefighter/Paramedics are fully capable of providing a higher level of service at a lower cost. FireTransport now proves to be faster, cheaper, & better for the patient, and more efficient for the taxpayer than the obsolete two-tier system using a private ambulance company. Volusia County Council approval is all we need to begin.
    Has FireTransport been done successfully anywhere else? Yes. Of the 150+ fire departments providing Advanced Life Support (ALS) in Florida; more than 2/3 of them also provide patient transport. Firefighter/Paramedics providing total patient care, including transport, is a national trend.
    What guarantees does FireTransport have? EVAC transport fees are increasing; tax subsidies are increasing; available ambulances are decreasing… with more service reductions planned. This is guaranteed with the current system.Daytona Beach Firefighters have a 100 year history of rapid response and quality emergency medical care. We have been providing Advanced Life Support service with Paramedics on rescue trucks since 1975 -- years before EVAC was formed. A pilot program demonstrating the efficiencies of fire service based transport is the only opportunity to fix an obsolete Two-Tier system. Guaranteed.

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  2. Is FireTransport a Union Program? Last year City Manager Jim Chisholm issued an edict to all department heads: Re-Think the way you do business. Re-Tool for greater efficiency. Identify and eliminate waste. Create a 10% savings.Fire Chief Gary Hughes identified the duplication of our Two-Tier Emergency Medical Services system as the biggest waste of tax dollars. Currently, the fire department responds as the 1st-Tier to every medical call, uses manpower, vehicles, equipment, and medical supplies to treat the patient, and then waits for the 2nd-Tier private ambulance company to transport the patient to the hospital. None of the Fire Department costs are recoupable, yet the Ambulance company can recover their costs from transport fees. The EMS Transport Committee was formed to study the feasibility of Daytona Beach Fire Department providing patient transport service. The committee was composed of fire department personnel from all ranks, administrative, operational, and civilian.The figures have been reviewed and verified by the City’s Chief Financial Officer.Daytona Beach’s Mayor and City Commission UNANIMOUSLY endorsed this program, and passed a Resolution directing the City Manager to request a COPC&N (Certificate Of Public Convenience & Necessity) permit from the Volusia County Council to engage in FireTransport.From the Mayor, City Commission, City Manager, Chief Financial Officer, and Fire Chief: this is the Official City Of Daytona Beach FireTransport Program... NOT a union program.
    Is FireTransport a Plot by the City of Daytona Beach to Take-Over other Fire Departments or Cities? FireTransport is a pilot program for the City of Daytona Beach to demonstrate the many advantages to patients and taxpayers in having the Fire Department provide patient transport service. It is designed with sufficient capacity that we can assist EVAC and provide a faster, cheaper, better alternative to the neighboring jurisdictions upon request. We already have a contingency agreement with EVAC to provide transport service when EVAC units are unavailable, and we have been responding into neighboring jurisdictions as part of the closest unit automatic aid agreements between all fire departments for years. But this is NOT A HOSTILE TAKE-OVER of surrounding fire departments. As the City of Daytona Beach proves the success of FireTransport, other Fire Departments can establish a similar service using Daytona Beach as a model, OR they may request Daytona Beach (or any neighboring City establishing the service) provide FireTransport, OR they may elect to continue the wasteful duplication of the current two-tier system. FireTransport is a great option for other Fire Departments and Cities, NOT a mandate or take-over.

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  3. Does FireTransport Discredit or Criticize EVAC Ambulance? The current two-tier system was created over 27 years ago, at a time when many fire departments in Volusia County could not provide Advanced Life Support (ALS), some fire departments did not respond to medical emergencies at all, and Volusia County Fire Service was not consolidated, and largely volunteer.At that time, EVAC provided a vital service. The founding members of the Emergency Medical Foundation, and the Volusia County Council of 1981 are to be commended for their bold leadership. Their willingness to try something new saved thousands of lives.But the world did not stand still for 27 years. The fire service county-wide evolved, and now virtually every fire department provides rapid first-tier EMS response, 24/7, with professional, fully certified paramedics providing Advanced Life Support service. Today the two-tier EMS system using a separate private ambulance company to transport patients to the hospital after the fire department provides first-tier response and care is a wasteful duplication of service. During the last three years alone, taxpayers had to subsidize EVAC with over $10 Million dollars, while EVAC collected another $35 Million dollars in transport fees. A quarter century ago EVAC filled a critical void in the EMS system, and every firefighter, patient, and resident appreciates their contribution. The City of Daytona Beach applauds EVAC’s service and the County’s bold leadership of the past. But it is a different world today, and we ask for that same bold leadership again.
    Is FireTransport a New Concept? There are over 120 fire departments providing complete patient care, including transport service, in the State of Florida alone. Two-Thirds (2/3) of of Florida's certified Paramedics are firefighters. FireTransport is a nation-wide trend, a natural evolution of the fire service driven by the inherent healthcare, operational, and economic advantages. Pompano Beach began FireTransport in 1992. Fire Chief Harry L. Small writes: “Eliminating the duplication of a separate private ambulance company reduced the number of emergency vehicles travelling through our local streets by 50 percent… The first six months of transport netted around $450,000 for the city… This is not a condemnation of private ambulance companies, but merely an economic reality… Commissioners have been overwhelmed with praise from the public, and returning to the previous two-tier system would now be unthinkable.”Orange County Fire Department’s FireTransport program began with a pilot program in 1997. Today, their FireTransport program has grown to serve all but a very small section of the county. (The last expansion was in 2008.)Marion County began FireTransport in 2008. Fire Chief M. Stuart McElhaney writes:”I am happy to state that we are delivering a much higher level of service at a lower cost than that of the previous EMS provider. The department has increased the number of available ambulances serving the community and has been able to reduce response times in the urban, suburban and rural response areas.”

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  4. Does FireTransport Fragment the EMS System? The current Two-Tier EMS system is already fragmented, with Fire Department 1st-Tier responders forced to "Hand-Off" every patient to the 2nd-Tier private ambulance company. Each patient is evaluated, interviewed, and treated by two (2) different agencies during the course of their prehospital care and transport... that's fragmentation. Continuity of Care is provided when the first responder provides total patient care, including transport, so that the same paramedic that first evaluates, interviews, and treats the patient, also provides transport and continues patient care all the way to the hospital. No “Hand-Off” prevents:
    Redundant or lost information
    Unnecessary delays
    Possible cross-contamination
    Patient discomfort Closest Unit Response, automatic aid, and mutual aid agreements provide a seamless network of contiguous rapid response to both Fire and EMS incidents throughout Volusia County. Patients do not experience any delay in first-tier response, regardless of jurisdictional lines. The current Two-Tier EMS system is fragmented by artificially separating the natural final step of patient care (transport to the hospital) from all other prehospital medical care (which the fire department is already performing). FireTransport CURES fragmentation.

    Why try FireTransport in Daytona Beach?
    Daytona Beach Fire Department is the oldest professional fire department in Volusia County, with 100 years of experience to draw from.
    First to provide certified Emergency Medical Technicians and Basic Life Support (BLS) medical service in 1974.
    First to provide certified Paramedics and Advanced Life Support (ALS) medical service in 1975. (This was six years before EVAC was created.)
    First to provide certified Paramedics and ALS service from Fire Engines (1985).
    Daytona Beach Fire Department has been transporting City employees to the hospital for years. Sick or injured police officers, firefighters, and general employees receive the very best prehospital care, including transport. Why not you?
    Daytona Beach has one of the highest percentages of homeless, indigent, under-insured, and uninsured in Volusia County. We expect our collection rate to be lower than almost anywhere else in the County. When FireTransport is proven successful here, it will be under the worst conditions.
    Daytona Beach has a fully developed program ready for implementation
    The City of Daytona Beach assumes all of the financial risk.
    The FireTransport program provides MORE transport units with a higher availability and lower Unit Hour Utilization than currently provided by EVAC.
    COPCN application has been submitted to County Staff
    All we need is Four (4) Council Votes for Approval.
    Is Daytona Beach’s FireTransport Program the End Product? FireTransport’s success in Daytona Beach will serve as a model for the fire service throughout Volusia County, and a catalyst for further levels of cooperation and additional opportunities for efficiency. Fire Departments of the future will provide a faster, better, lower cost, alternative; not only for transport to the hospital, but treat & release programs, follow-up care visits, immunization programs, and partnership clinics for healthcare access when & where you need it. Your firefighters are helping to solve the healthcare crisis.FireTransport is the next step in the evolution of the Fire Service, providing faster, cheaper, better patient care, greater efficiency, and real savings to taxpayers.

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