Lubbock Mayor Tom Martin says it's inevitable that Lubbock firefighters will take over EMS services from University Medical Center. UMC says it's not broke, so don't fix it.
Meanwhile the firefighters' association says one part of it is broken, but not for the reasons the Mayor says. The firefighters' association says a complete takeover of EMS is not necessarily the fix.
Not Fast Enough, Mayor Says
Martin says EMS response times are not fast enough. Years ago, in order to improve response times, the City began to send fire trucks, with firefighters trained as Emergency Medical Technicians, to the scenes of many medical emergencies.
Martin says, "Here we are 15 years later and we're still running big ole' fire trucks to the scene of every medical emergency in addition to ambulances."
For the Mayor, it's personal. In the time before his dad passed away, Martin says he needed to call 911 and both times the fire department response was much quicker than EMS.
"Lubbock is getting to be a big city, and in virtually every big city, the ambulance service is run by the fire department," Martin says.
UMC disagrees about response times, saying instead that response times average 4.85 minutes - which is within the national standard of five minutes.
And while it's cliche to ask how much is a life worth, the fact is taking over EMS services has a very tangible cost.
There Is A Big Price Tag
University Medical Center says the budget for EMS was $9.4 million last year. The ambulance service was able to collect $5.8 million, for a net loss of $3.6 million, not including depreciation.
EMS operates not only inside Lubbock, but provides nearly $600,000 of support for ambulance service in all of Lubbock County, including Slaton, Wolfforth, Shallowater, New Deal, Abernathy and Idalou.
"We don't think it's inevitable," says Jeff Hill, Vice President for Support Services at University Medical Center. "We think this model has served our community well for over 35 years. We believe the process isn't broken and we should continue to move forward with that well into the future."
Just as the issue is somewhat personal for the Mayor, likewise it is also personal for UMC.
"I think this was the first service we provided as a hospital district," Hill says, "It's very important to us. It's laid the foundation for what has become, we believe, a very good organization for our community and for West Texas."
Hill says a $4 million loss is acceptable because it's not about making money. It's about saving lives.
As a quick aside, UMC purchased eight new ambulance units in 2010 at a cost of $1.7 million.
UMC can and does levy a property tax specifically to offset unpaid medical costs or "charity care" as it is sometimes called. The tax is not just inside the city, but county-wide, something the city cannot do outside its own borders.
What Do Firefighters Think?
The issue is personal for the firefighters as well. There are 26 who are trained as paramedics, 12 trained as EMT-Intermediates, and more of them learning advanced skills right now. Another 260 firefighters are trained as EMT-Basics. Everyone admits firefighters are sometimes on the scene of an emergency first.
But because of an agreement between the city and UMC, fire department paramedics are not allowed to start an IV, complete a trach (tracheotomy tube), or administer a wide range of drugs normally available to a paramedic.
Nick Wilson, a trustee with the Lubbock Professional Firefighters Association, says some of the firefighters are downright mad about not being allowed to use their skills and training to perform advanced life-saving techniques.
"It's all because of a piece of paper. That's the issue that we face," Wilson says.
Negotiations to change the affiliate agreement between Lubbock and UMC are ongoing.
Wilson says, "I think that we're headed in a positive direction."
Hill agrees, saying, "We're in the process of working that out with them and hope we can do so."
EMS also has between three to six "Fox Trucks" - pickup trucks posted at various locations other than the six Lubbock EMS stations so that a paramedic can be on scene even before an ambulance arrives. Nevertheless, sometimes firefighters are there even before the Fox Truck.
So what about a complete takeover of ambulance services?
"I'll say this and I want to make this very clear because I think there seems to be a misconception out there," Wilson says. "The Lubbock Professional Firefighters Association does not have the position that we want to take over EMS, that we want to put ambulances in the fire station or that we want to transport patients within the City of Lubbock. That is not the position of the Lubbock Firefighters Association."
Wilson says there are individual firefighters who make the case for taking over ambulance services.
"The most important thing is getting that [agreement] signed in a way that allows us to do our job," Wilson says.
What About A Compromise?
Having examined the debate from three different points of view, KCBD NewsChannel 11 asked the Mayor and Jeff Hill if maybe there is compromise to be found.
Both were asked, if Lubbock provided space for an ambulance at every fire station, and UMC put an ambulance at all 16 fire stations (not including the airport fire station), would that be an acceptable solution?
Mayor Martin says, "Some arrangement where EMS had additional units and were staffed at the fire stations, that is certainly something we should take a look at."
Jeff Hill says, "I believe the answer to that is yes. We'd have to work out the terms of that. But I think that's a very doable solution and a possibility."
Martin says in many cases the fire stations already have room for an ambulance.
"The fire stations that we've rebuilt and refitted have room for additional apparatus such as an EMS unit," Martin says.
If such a compromise were worked out, EMS would go from 9 units in use at any one time inside the city to 16 units inside Lubbock (soon to be 18 because of one new fire station under construction and one more in the planning stage).
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