1. Paramedic shortage statewide. Perhaps, but won't they just be able to hire the majority of EMSA medics? (At least the full time people) That is what normally happens.
I guess the true answer depends on whether Tulsa is proposing cross-trained personnel (which I imagine they would) or if they are simply creating civilian EMS employees. Civilian EMS within TFD means no changes - period - thus making no apparent reason to move the organizational chart below the fire chief. Cross-training EMSA's employees is a huge issue. The physical fitness and medical physical requirements will nearly eliminate 50 or so percent of the EMSA paramedics. Not to mention the fact that EMSA Paramedics may have zero desire to be firefighters as well. Like I mention, I am assuming this is a cross-trained scenario (Houston Model).
2. Startup costs? Who actually owns the medic units in tulsa, and anyways, since when has a government REALLY cared about that? If the percieved savings over 20 years makes up for it, they can do it.
Typical the overhead is the reason most programs don't get funded. Guess it depends on your view. As someone else mentioned the units are owned by the City of Tulsa, but we still have tons of overhead in station remodels, and indirect costs associated with finding a private service provider. This doesn't take into account the Personal Protective Equipment, Ambulance remodeling, etc that will have to occur. The workload on the city of Tulsa EMD will likely increase since "EMSA" will no longer be doing maintenance and the list goes on.
3. Housing of units. Another argument for SSM. If they guys are never in house.... Why do they need a house? Seriously - that is something that can be handled. Park them outside, and slide some more bunks inside.
And my point is one of the few benefits from TFD taking over would be the units having a "home". This assumes that the paramedics are on a 24hr shift (and if they aren't can you imagine the issues the current ff/paramedics will raise?). How would anyone like having to post and move all the time over the course of 24hrs? I think I'd put in an application to Houston and get to sleep in a bed. SSM is great for EMSA, but if TFD is going to take over the units will be housed - I have little doubt. I can't even think of a FD based EMS service that does anything similar to SSM (with cross-trained personnel) on a large metropolitan scale. Maybe fire trucks should go to SSM too if it is so great (and yes, I'm familiar with move-ups and fill-ins - rare in occurance)
4. Why does Tulsa need the blessing of those other areas? EMSA can downsize, and still cover that area, or as Commshrek has pointed out, used any of the other options available to them.
Those other areas subsidize EMSA too at the same rate Tulsa does (population base). Fire Departments have to work together and can you imagine the ripple effect that could occur if EMSA simply shut down? Simply going to a 3rd party is a joke. Look at the trouble Claremore/Catoosa has had with their private provider. Bottom line is these cities won't be left out in the cold and without EMSA serving the entire area, the funds wont be available to keep quality up.
5. Agreed. The real bucks are in the transfers, the long distance stuff. True emergency stuff is not profitable.
AGREED
6. As the program starts, who says the medics have to be firefighters? Way back in the day, when we rode dinosaurs to the calls, and used jumper cables for defibs... (Once seen on a TV show) and the Fire Department first took over EMS, the medics were not trained as firefighters, but grandfathered into the system. As the medics started to want some of the benefits of being firefighters (firefighters got the kewl hats) they started to ask for cross training.
Time always makes issues easier, agreed. However, this will have to be a question answered early on to determine whether or not these firefighters will enter the pension system and how their job will be classified. The State Pension Laws require an ALL or NOTHING rule for sworn employees, which mean that they cannot pick and choose which employees are or are not firefighters. They will have to determine if they are civilians (not cross trained) or sworn personnel so that the pensions of the current membership are not threatened.
7. If done properly, the moral will be fine. Rotation of personnel back to the suppression side is a BIG key on that.
I agree that rotation will help with moral. But, Point #1 - their is no one to rotate. Not to mention that many of the current TFD paramedics hold rank and wont be anywhere close to an EMS unit - this cuts the supply even further. Moral is always an issue with FD based EMS - hence the reason ambulances now get painted red. Paramedics who join the FD often (not always) want to be firefighters and use their medical education as leverage for their careers. If you stick firefighters on ambulances that wanted to be stuck on fire trucks applying ALS skills then you will likely lose those people or see moral take a serious drop. End of issue.
A
