A long standing dispute between Stockton, California and San Joaquin County has forced city firefighters to stop providing paramedic services. Starting yesteday, for the first time in 34-years, it is BLS only until paramedics arrive from a private ambulance service. Black tape is covering up the word paramedic on fire trucks and uniforms used by the Stockton Fire Department. California investigators are double checking, making sure that the firefighters aren’t providing ALS.
This may an oversimplification of a complicated issue, but the city and county have been in court for a while over who provides 911 services and EMS. This has kept the two jurisdictions from renewing an agreement that is required for the city to have paramedics.
More on this in excerpts from an article by Zachary K. Johnson in The Record:
City and county officials say they want an agreement to bring Fire Department paramedics back.
State and county officials said that the people of Stockton were safe Wednesday: firefighters provided basic emergency medical care and worked in tandem with paramedics arriving with responding ambulances. It’s a model used in other California cities.
But there was one instance Wednesday that shows what was lost, according to Stockton Fire.
In that call, firefighters arrived at a scene before an ambulance, but the firefighters were barred from giving the patient medication because that falls under the advanced-life-support list of techniques.
According to the county, an ambulance was delayed to a call because Stockton provided incorrect information to dispatchers. It was unclear Wednesday if these two incidents were the same.
Investigators from the California Emergency Medical Services Authority stationed themselves in teams of two to interview ambulance crews outside emergency rooms to ensure Stockton was not violating state rules by operating paramedic services without an agreement, said June Iljana, deputy director of the state agency. But things ran smoothly, and the investigators wrapped up early, she said. “We’ve just seen great cooperation.”
After the Stockton City Council decided to temporarily suspend paramedic services Tuesday, firefighters began removing advanced-life-support supplies before Wednesday’s 7 a.m. deadline, Deputy Chief Paul Willette said. “We did what we had to do to comply.”
Also on STATter911 …
- Early video: Another Stockton, California fire. Will it live up to the standard set by the last one? – January 6, 2012
- Stockton gets defensive: Early raw video of a house fire with evacuation tones. – January 8, 2012
- Investigation after death of elderly woman in Washington, DC. WTOP Radio reports medic on leave after failing to accompany patient to hospital. – November 29, 2011
- Early video: House fire in Stockton, California. – December 10, 2011
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WTF?? So, this isn`t even a question of lisensure or previous mishandeling of pt care? It`s just toe stepping and beurocratic BS? What a crock of you know what……What ever happened to “do what`s right for the pt”?
So the bureaucrats in CA have nothing better to do than interview medics to make sure the FD isn’t performing ALS? Don’t they have some HUGE budget issues out there?
Then, for the 2 gov’t agencies to be in court over a no-brainer such as this?
I just don’t understand the people out there.
In another FireMedic situation in California – In the opinion of the California EMS Authority:
“Paramedics are not there to determine what is or isn’t a life and death situation”
http://www.ems1.com/ems-management/articles/825069-Doing-whats-right-versus-doing-whats-allowed/
So perhaps BLS and ALS really don’t matter much either.
California has out of control government with out of control regulations.
And I though East Coast politics were bizarre. This is absurd.
BLS are not trained to handle all the emergency calls that require ALS. It may mean a difference between life and death. You are not to go beyond what you have been trained to do. I hope ALS can get to the patient who needs to be treated within the “Golden Hour”.
Kind of glad to here it actually, there is no need to first responders to be doing ALS. Get there first do BLS for the min or two it takes for an ambulance to arrive give them a report and let them do ALS and transport.
So now we have fully trained & licensed paramedics sitting on their thumbs until a private ambulance can get there & do what should already have been done? Wonder what liability the city and county have open themselves up to when something goes south on a scene.
Well living in Stockton, I’m not happy about it. They had 2 full arrests that I know of yesterday, and fire arrived well before the medics did and they couldn’t do a thing. Granted I think the county EMS department is on a power trip, but some of the responsibility belongs with the city management. If a former mayor can be believed, some city officials have it out for the fire department. Strange thing is, back when any qualified provider could provide EMS transport, we had better EMS service. Then the privates complained, they weren’t making money, so the county decided to bid out EMS transport county wide. So the result is the system we are stuck with now.
This case may have ramifications throughout the state. Traditionally the county or regional EMSA’s have had the right to designate ALS and BLS providers in exclusive operating areas, it appears that the county also wished to determine who would be the PSAP for call taking also. If the judge rules against the county EMSA, this could allow individual cities who feel they aren’t being served by their current providers to opt out and provide their own ALS service.
SWEET! I only wish DC would do this so we could get back to doing what we do best.
To Anonymous, the firefighters union is now offering to try to work out a deal with County to get their ALS status back.
To Mike W, the difference in this case, is that this not about transport. It about whether City fire paramedics have to follow County standards or if the city can have their own standards. Stockton Fire provided paramedic service prior to there being a county EMSA. Later they agreed to follow county standards, but didn’t include any escape clause if they wanted to go back to their own standards,
They saved my life more than once. They saved other lives more than once. If someone dies, because of politics, aren’t they opening themselves wide open for lawsuits??? I can see letting a druggie or alkie die because of overdose, but what about the real people?
They had 2 full arrests that I know of yesterday, and fire arrived well before the medics did and they couldn’t do a thing.
They could do the only things actually proven to make a difference in a cardiac arrest- high-quality CPR and AED.
I can see letting a druggie or alkie die because of overdose, but what about the real people?
Nice. With friends like these….
ME: your an idiot! We have been providing ALS services for yrs in the state of California. Lets not forget it was FD’s that started the Paramedic programs in Calif. not the Ambulance Co’s.
AND FYI ME: 99% of the time, the FD’s are onscene well before the ambulances..Hence, thats why we do ALS. So the citizens dont have to wait for emergency care.
ME: your an idiot!
God to see calm, rational debate from our firefighting bretheren.
99% of the time, the FD’s are onscene well before the ambulances
Uh huh. And how many departments design their systems that way- making sure the ambulance gets dispatched AFTER the FD?
So the citizens dont have to wait for emergency care.
And you can demonstrate that doing so improves their outcomes? Because quite a few people with a lot of letters after their name have come to the conclusion that it doesn’t.
CBEMT, you are spot-on accurate. EVERY study that has been conducted by a legitimate source on Pt outcome in relationship to response times have proven that an extra 5 minutes makes no difference whatsoever. In fact, these ALS first responders are harming the patient by focusing on ALS care rather than good strong BLS care first. This too has been well document, most prominently in USA Today which did a week long review that clearly showed the more paramedics you have in your system, the less your survival rate was. Now I’m sure my comment will spur the rant of any FF reading this so let me say, before you spout off about being the heroes and providing ALS service in CA first, and being on scene first, please show me the proof that you are making a difference. Show me a study that proves your point. All I have ever found was a hack-job white paper from the Ca Fire Chiefs Assn (a bit biased) which had no factual basis for their claims.
Plain and simple, a Paramedic can NOT work without a Medical Director. This FD does NOT want to sign the ALS agreement with the county and the Medical Director. They seem to feel they do not need to work under a Medical Director since they have made no attempts at an alternative plan in the 4 years since the bid and contracts were done with SFD no longer being the sole provider for Stockton.
You can read the statements here from the medical director of the county. This medical director, the county and the state should have taken action on this matter long ago.
http://www.sjgov.org/ems/
Of all the lamebrain, ridiculous things I have ever heard of. The entire reason for tiered response was for the the ultimate benefit of saving lives. In my 22+ years of EMS I have never seen such a story in my area. For the majority of us, we are all working for the same end result. PATIENT CARE!! If a city entity sees fit to provide for their citizens the care that all should receive what’s the harm. If they send or allow their personnel to better their training for the department and the citizens who is losing out except those in the business for profit. If care can be given while awaiting transport why should these citizens be denied. My biggest complaint in working on the profit side of EMS… Profit always seemed to come first. I refuse to not provide the due care to someone because it’s just too expensive to do a particular skill set. This must be resolved for..REMEMBER…the citizens we serve.