Fire-Based EMS

1. When you’ve seen one system….you’ve seen one system! The principle issue is sustainability. It isn’t which delivery system is best…rather it’s identifying which delivery system is best for each community, and how that community ensures their system’s long-term success. Fire-Based EMS

2. There are a variety of options that will produce a variety of results. Some factors to consider include: • The level of risk the community is willing to accept • The system’s objectives and the customer’s expectations • The community’s ability to fund the system Fire-based EMS—particularly ambulance service—is one option that the fire service believes is a viable alternative in many cases. Fire-Based EMS

3. Brief History • The fire service’s involvement in patient care began as far back as the 1920’s. Claude Beck, a surgeon at Western Reserve University in Cleveland, called the fire department so he could attempt to resuscitate a patient by applying “pulmotor,” (an artificial breathing apparatus). • In 1940’s, Miami was the first city to call itself a “Fire Rescue” department. It was also revolutionary in using 2-way radios to bridge physicians in the hospital with firefighters. • Miami’s first rescue truck to treat citizens “Rescue One” became operational in 1941, and was used to provide basic first aid. General Information About Fire-Based EMS

4. Brief History cont’d • By the 1960’s CPR was being taught to firefighters, and during this period the modern relationship between EMS and fire department began to develop. Fire departments were starting to provide intravenous therapy, electrocardiograph, and advanced airway intervention. • According to the U.S. Fire Administration: • The majority of the 26,468 fire departments in the country provide EMS at some level…of which almost 40% provide advanced life support • In OK, there are 709 fire departments…of which 184 provide non-transport EMS, and 34 provide ambulance service General Information About Fire-Based EMS

5. Benefits Levels of Involvement BLS First Responder ALS First Responder BLS Transport ALS Transport • Many system components already funded • Resources deployed in a manner that minimizes response time • Continuity of patient care • Stability of the service provider General Information About Fire-Based EMS

6. City Specifics Fire Department Specifics Owasso FD members- 55 92% are Paramedics Cross-trained/Dual-role Paramedic license required for employment 3 Fire Stations in service 2 Fire Stations planned (construction delayed by the economy) Total Incidents last year- 4,279 Fire - 1,149 (27%) EMS- 3,130 (73%) • Population- 30,000/45,000 • Fire District- 50 sq. miles • EMS District- 75 sq. miles • Median Income- $62,867 • Median Home Value- $151,526 • Housing Units- 11,346 • Occupied- 94.2% • Occupied by Owner- 73.7% • Occupied by Renter- 26.3% Owasso’s Fire-Based EMS Design

7. Budget (FY 2012-13) • Fire Operations: $3,937,665 • Ambulance Service: $1,267,732 • Ambulance Capital: $277,800 • Ambulance Fees • $4.00/Month per water/sewer customer • Ambulance billing (fee-for-service) • Loop Holes • Businesses • Apartments • Visitors How Owasso’s Fire-Based EMS is Funded

8. Ambulance Billing Revenue for FY2011-12 (based on billing contractor reports) : • Patients Transported: 2175 • Billed: $1,411,749 • Collected: $835,208 • Adjusted: $573,623 How Owasso’s Fire-Based EMS is Funded

9. Adjustments (by category): • Medicare $291,361 • Medicaid $48,322 • Subscriber $120,455 • Uncollectible $80,390 • Misc. $33,095 How Owasso’s Fire-Based EMS is Funded

10. Challenges: • Community Growth/Increased Call Load • Questionable Sustainability • Change in Scope of Services (Need vs. Affordability) Considerations: • Identifying the acceptable level of risk/manage community expectations • Identifying Cost Saving Opportunities (such as Fire-Based EMS and Regional Response Systems) Future Challenges and Considerations