Adequate Reforms for DC Fire and Emergency Medical Services?

Photo by PoPville flickr user Eric P.

“Dear PoPville,

I was just wondering if we could get an update on the recommendations made by the Task Force on Emergency Medical Services developed after Rosenbaum’s death in 2007.


The Mayor seems to be capitulating on actually reforming DC FEMS and looking for quick fixes that pad private sector wallets.”

From the Mayor’s office:

“Mayor Muriel Bowser presented a plan to the DC Council to reform the emergency medical response system. Year after year, the District’s Fire & Emergency Medical Services (FEMS) Department has experienced a significant increase in calls and inadequate investment in training and equipment. Annual calls have increased by nearly 28% since August 2011. Increasing call volume – setting a record in each of the last three months – and a lack of sufficient investment in training and equipment over the years is straining response and quality of care.

In order to reform the EMS system, FEMS will overhaul training for emergency medical responders, improve system processes, and enhance communications, which will ensure that the right resources are dispatched on every call. In addition, the Mayor will propose emergency legislation that will enable FEMS to work with third party providers to transport lower acuity patients. The emergency legislation will put more ambulances on the street by authorizing FEMS to contract with third party service providers to transport low-priority calls (e.g. cold symptoms, ankle sprains, and general non acute sick calls).

While emergency medical responders are dutifully serving the District, they have an aging fleet of ambulances that is unreliable. That is why, in Mayor Bowser’s first budget, the Administration invested $8 million to improve the District’s ambulance fleet in the coming year. However, the ambulances FEMS is purchasing, refurbishing and leasing only maintain the status quo as demand rises. In short, current resources are outpaced by the unprecedented demand for ambulance transport.

“My emergency legislation represents a pragmatic solution to a very real and pressing challenge,” said Mayor Bowser. “Once we have these EMS enhancements in place, FEMS can better train our providers, maintain our current fleet, and improve our dispatch and deployment. My team has looked at all the options, and this is the best way to improve quality of care.”

Emergency procurement will be open for 120 days, followed by a long-term competitive bidding process. FEMS will continue to respond to ALL 911 calls – and will determine when to request a third party service provider for transport. If a patient being transported by the service provider deteriorates and becomes a higher priority call, the provider will be required to call 911/FEMS.

“This legislation will help FEMS ramp up our ambulance availability in a short period of time,” said FEMS Chief Gregory Dean. “This will free up our current fleet for scheduled and unscheduled maintenance, and will enable FEMS to improve our EMS service delivery overall and to better train our team.”

Third party providers will have to meet high performance requirements, including response times – and will be regulated by the Department of Health, just like all transport companies that currently operate in the District for special events.”

5 Comment

  • It is astonishing that in DC, which is the fiscal envy of every major US city in the nation with its budget surpluses 13 of the past 15 years totaling more than 4 billion despite the Districts yearly budget growing at 4 times inflationary (per capita mind you) during that period, can’t manage to operate a useful ambulance operation. This is the easiest fix there is.

    New ambulances, fully equipped cost 250K. DC owns 98 ambulances but only 50 are functional on any given day. We could buy 50, brand new and fully equipped ambulances for 12.5 million bucks. How hard is that, really?

    The budget surplus last year was 220 million. It looks like we will have another 150 million surplus this year.

    We need to hire more paramedics? Great, do it. The DC region is a large place where there are countless private ambulance companies to hire from. It isn’t like we don’t pay well, and the benefits are off the charts.

  • The new chief for DCFD comes from Seattle FD where private ambulance services have been used for BLS for 40+ years. Here’s the thing – the “B” in BLS doesn’t stand for Basic – it stands for bullshit. I.E. you could have driven to the doctor but think showing up in an ambulance gets you to the front of the triage line. It doesn’t. Why should the city be using ALS/BLS ambulances and providers for stubbed toes, headaches, and upset tummies? Take a car, bus, or train to the doctor. Let the ambulances be upgraded to ALS units and more advanced care can actually be provided to those who truly need it. As for lining private sector wallets – I’m sure the private ambulances will be taking a huge chunk of out peoples insurance or their wallet instead of being subsidized by the city. Sure, it sucks getting a $1000 dollar ambulance bill. Take a taxi next time, it’s cheaper.

  • I’m not generally excited about privitization of public services, but desperate times call for desperate measures – this is one of those rare instances where a matter of policy is a literal emergency. I see the danger in letting “emergency” actions become standard procedure, but with the way political winds change around here, I can’t imagine we’ll be stuck with (or benefited by) any of this for very long.

    I haven’t looked at the whole report, but generally want to see information about how they’re going to fix 911 response problems. Doesn’t matter what kind of ambulance is involved if the vehicle is delayed or never routed in the first place.

  • Looking at it from a LEO/first responder side of things, so much ambulance time gets chewed up simply out of fear of lawsuits. Everyone who says they need to go to the hospital, outside of race occasions, gets a transport to the hospital. The same drunks who get so plastered they can’t stand? Transport to the hospital if they can’t stand. Every time we apprehend a prisoner who gets an abrasion or scratch? Transport by ambulance unless authorized to do so in a car. Someone who’s locked up who suddenly becomes allergic to bars? Transport to the hospital.

    If we decide that we’re not getting the drunk to the hospital, or the prisoner having a fake panic attack because of claustrophobia and something does happen that one time, it’ll be a lawsuit.
    I could go on and on with examples. DCFEMS would be a lot less overwhelmed if it wasn’t consumed with calls for service that are just a way for the city to avoid liability.

    And if you want better trained ALS/BLS crews, pay more and offer a higher per hour wage than the firefighters if you want to induce more fire guys to stay on the EMS side.

  • The above comment is interesting and might explain why the sound of wailing sirens permeates this city, 24/7. Never lived in a place with so many sirens, and just can’t imagine that they’re for real emergencies all the time. Do we really need to send a fire engine for someone who’s broken an ankle?

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