Fire, ambulance districts still discussing mergers
Merging fire departments and ambulance services might not be as simple as people would like to believe, says Lyn Morgan, manager of the Eagle County Ambulance District.
“I don’t think it’s a good thing at all for health care,” Morgan says. “You’ll have a jack-of-all-trades but a master of none if you cross-train firefighters and paramedics.”
The Eagle County Ambulance District, the Eagle River Fire Protection District and two members from the community have been discussing the possibilities of merging fire and ambulance services.
“A total merger of fire and ambulance doesn’t make any sense,” says Donna Barnes, who served as the head of the Eagle County Coroner’s Office for about 25 years. “Cooperation between the two entities makes sense.”
Yet the goals for merging the two services are different, public safety officials said. It’s a difference between cost savings and health care, financial security and patient care.
“The levels of service would certainly change under an integration,” says Dr. Larry Brooks of Vail Valley Emergency Physicians. “I’m not for tearing (those services) down.”
But the fire districts say it’s worth a study, at least, adds Charlie Moore, chief of the Eagle River Fire Protection District.
Levels of service
Brooks says it boils down to levels of service.
“No one knows how it’s going to affect health care,” Morgan adds.
Both entities agree a merger would give firefighters and paramedics more responsibilities and opportunities.
“A merger could create more opportunities for firefighters to train as paramedics someday. It’s a good thing for their career, and it could provide more opportunities and ability to advance in their career,” says John Gulick, chief of the Vail Fire Department. “It doesn’t mean that every firefighter needs to train as a paramedic or every paramedic should train to be a firefighter. But it may make sense with the way the valley is growing.”
The firefighters are trained with a basic level of emergency medical services now, says Moore.
“We see a potential for efficiency that we’d like to take a look at,” he adds. “Why can’t firefighters be paramedics? If anything, we would be saving the overhead in buildings. There’s an element of having to build new buildings without having to duplicate things.
“I think these are compelling reasons to study (a merger), and flush it out with the pros and cons.”
Right now, he says, there’s no agreement even to begin a study.
Yet, Morgan adds, “People are bringing up financial issues, but we need to think of a way for building sharing, because we do need to address it without reducing the care of the patients.”
Location, location, location
Locations of buildings is one aspect the agencies are looking at, Barnes says. The agencies are talking about purchasing joint pieces of land with plans for a joint building, combining fire and ambulance services.
“We want to do what makes sense,” Barnes says. “Sometimes, for fire, it’s not always about saving money by moving.”
The buildings are situated now based on the volume of calls the agencies receive per day, she says. The location of the ambulance and fire districts are arranged based on “the best response time in the area for the quality standard of care.”
“You choose where you live, (and) you choose where you live based on the access to certain services,” she says. “In some areas, you may not have access to those services. Having ambulance services closer to the hospital and the mountain makes sense, especially in the winter.”
The Vail Fire Department is designing a West Vail fire station, Gulick says.
“With the new West Vail fire station, the ambulance districts are welcome to put EMS in that station,” Gulick says. “We all work together so well in the field that it may make sense. We may end up sharing the same building some day, but it’s all preliminary talk right now about more proficiency in providing services.”
Dedicated care kept separate
However, emergency physicians still say there are a lot of problems with it.
“Crew need to keep their skill levels up,” Brooks says. “Combining services cuts the skill level down on my side. We’re not talking about the patients then.”
The ambulance district gives the best delivery system for medical care, says Morgan.
“We think the world of the firefighters, but we just want the best delivery system,” he says. “We’re totally focused on the patient 24 hours a day.”
The fire departments are part of the first response after receiving a call from the dispatchers, he says. Public-safety responses are designed from a two-tiered system, beginning with the fire departments. For instance, if the dispatchers receive a call from a hotel with a sick guest, the fire departments will arrive first, take the patients information, blood pressure and speak with his or her doctor, he says. When the paramedics arrive, the patient has the right to choose whether he or she wants to go to the emergency room and get released.
“Paramedics are trained for specialized care,” he says. “They are dedicated to the patients, and all of our paramedics have four-year degrees. They have 10 times the training than an EMT. We would decrease the health care for our patients if we cross-train.”
Apples and oranges
“You can’t mix apples and oranges to produce a better product. To dilute EMS with fire services is inappropriate,” Brooks says. “It’s a mixed blessing by having the agencies separated, because they do good service. We just need to keep them separated.”
Barnes adds: “You don’t want to dilute medical care. It’s life or death. People are trained well who do things a lot.”
On the other hand, combining services is just a potential option for down the road, says Gulick.
“If it’s so bad, then why are so many communities doing it?” Moore asks. “Why are so many communities embracing it?”
Brooks says: “You can talk to any physician who deals with this in a hospital and know that they wouldn’t be happy with this. You can’t give up medical care to save the fire departments some money. Our goals are too different.”
Christine Ina Casillas can be reached at 949-0555, ext. 607 or at email@example.com.