The city of Sacramento quietly took ambulances staffed with paramedics out for a six-month test drive – and it went smoothly.
That should lower the volume on public safety concerns raised by the local firefighters’ union, which has steadfastly resisted the idea of having anything other than two firefighters in every city ambulance.
And it should embolden elected officials to show some spine and push hard for wider use of paramedics, saving taxpayers boatloads of money.
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As studies done for the city have repeatedly pointed out, the current system makes little sense and soaks taxpayers. Medical emergencies make up about 60 percent of all service calls to the fire department. Ambulances are staffed by “dual-role” firefighters, who also respond to fires and who get paid extra for paramedic duty. Using “single-role” paramedics instead would save an estimated $400,000 a year per ambulance.
The cost savings seems even clearer based on the eye-popping amount of overtime that firefighters are racking up. The city auditor found that in 2015, the fire department paid out more than $13 million in overtime, on top of $44 million in regular pay. In all, firefighters worked more than 250,000 OT hours, including more than 90 who logged at least 1,000 extra hours beyond the regular 3,000.
This test of paramedics wasn’t planned and wasn’t publicized; I didn’t know about it until a reader alerted me.
Last December, the fire department discovered that six diesel-powered ambulances were beyond repair, so it asked Sacramento Metro Fire for help under mutual aid. Until the replacement vehicles hit the streets on July 1, the department borrowed two Metro Fire ambulances and staffed them with city firefighters.
Metro Fire, in turn, has a contract with American Medical Response, a private ambulance company, for “surge protection” during the busiest times. So for about six months, three AMR ambulances staffed with paramedics were on alert for 12 hours a day and responded to emergency calls in Sacramento that otherwise would have been handled by city firefighters.
A fire department spokesman says the AMR crews performed fine, just as they do when AMR and Sac Metro ambulances help out at other busy times. AMR regional spokesman Jason Sorrick said that given the company’s long relationship with Sac Metro, it was “seamless” to provide the additional coverage.
Jeff Harris, who has been crusading on this issue since coming on to the City Council in late 2014, says the AMR experience will help his case.
“I’ve been convinced since my first day on the council that there are efficiencies and cost savings to be had,” Harris told me. In addition, hiring paramedics will more quickly bring more racial diversity and young people into the department, he says. And he and others say it’s not safe to have firefighters at the end of 48-hour shifts responding to medical emergencies.
Harris wants to staff all 15 city ambulances with paramedics and emergency medical technicians. In the meantime, he says new Station 15 in south Natomas could be a test for single-role ambulances.
But unless Sacramento Area Firefighters Local 522 agrees to reopen its contract early – which it says it won’t – any changes won’t happen until negotiations toward the new contract, which would take effect in June 2018.
Roberto Padilla, spokesman for Local 522, said while the AMR crews didn’t have any problems, they were only needed because the diesel ambulances were leaking fumes into the cab and endangering firefighters. He also said that single-role paramedics would not reduce overtime costs and that the focus should be on adding firefighters to improve service to the public.
It’s too bad that the union hasn’t been willing to budge on ambulance staffing. Then again, maybe it doesn’t have to, given the political influence it wields in Sacramento through prized endorsements and big donations – though you’d hate to think that would stop elected officials from doing what’s best for their constituents.
Local 522 paid for most of the campaign for Measure U, the half-cent sales tax that voters approved in 2012 to restore fire and police service cuts during the Great Recession. The union will likely be counted on again next year to bankroll the ballot measure to renew the tax, without which the city will be in deep financial trouble. Yet at the same time, generous pay and retirement benefits for firefighters and other city employees are adding to the city’s looming budget deficit.
Maybe Mayor Darrell Steinberg, who wasn’t endorsed by the firefighters last year and doesn’t owe them anything, can help break the logjam. His spokeswoman says he wasn’t aware of AMR’s role, but wants a full and transparent public debate about the savings and possible service impacts of single-role paramedics.
At this point, that should be the bare minimum that Sacramento’s taxpayers get.