The really infuriating portion of this debacle is that it will result in 5 responses on call logs when they go for budgetary increases next year!
We will listen to the top officials ask for more money because ” just look at the calls we have to respond to!”

Most likely *not* driving that monster for three or four miles could save enough money to make a payment or two on a small, efficient vehicle that could get the fire folks there quicker, too (wouldn’t have to wait for four or five lanes of traffic to get stopped before it could turn a corner, for one thing).
I also have seen fire trucks arrive at a medical call *after* the ambulance was already there. Yet they say the reason for sending a fire crew to a heart attack or chocking call is because the fire trucks happened to be closer. And I can’t even guess why *two* police cars showed up. (Don’t those guys have radios anymore?)
Whole system seems to need a bit of review and a dose of common sense.
Thanks to the Guardian for helping to get the ball rolling.

And to be clear: I’m definitely not criticizing the firefighters, ambulance crews or cops for the way these things happen. They’re all doing their best to help us when we need help. Any implied criticism in my note is aimed squarely at those who should have figured out by now how to coordinate things so scenes like this wouldn’t occur.

Sounds to me like a bunch of “armchair quarterbacks” trying to sound like they know what they are talking about. Yes, there may a little overkill now and then, but wouldnt you rather have it that way if they were responding to an emergency call at your residence or business?

EDITOR NOTE–Jane, the issue is really coordinating the responses and providing a more reasonable vehicle to get the same people to the scene. Fire stations are scattered around the city, but they are all full of FIRE trucks which handle up to 80% medical responses…like sending ambulances to fire calls.

I think LJ hit the nail right on the head, except that Eagle fire has started using fire engines to respond to medical calls. The other “quarterbacks” really should get all of the facts before they talk.

Usually, I don’t feel the need to respond to senseless remarks however the fact that people are speaking with out all of the facts is infuriating.

The particulars on this call per the dispatch – Initially 911 was dialed do to a possible intoxicated person, hence the police response. Once they arrived on scene they determined that it required a medical response. So they asked dispatch for medical assistance. In Boise when there is a medical call a fire unit and ambulance are dispatched. The ambulance usually carries two people one is at least an EMT-basic the other a Paramedic. An engine carries two FF/EMT-basics and one Captain/EMT-basic, in some stations one of the firefighters is a Paramedic as well. In this instance Engine 5 was unavailable so Engine 8 (Overland and Orchard) was dispatched instead. The call happened to be just down the street from Station 5 also home to Truck 5. The captain on Truck 5 must have heard the call realized that it was just down the street and that the truck, although slower than an engine, could beat engine 8, thus improving the EMS service to this Boise citizen in need.

Although I am not 100% sure as to how the Guardian would run EMS in this city/county I do believe I have a general idea and some questions. Lets just say that Station 5 is staffed with 1 squad (a ALS trained crew of 2), 1 engine (3 Firefighters), and 1 Ladder Truck (4 Firefighters.) And this same incident occurs, the squad is assigned elsewhere and a second call comes in just blocks from the station. Does the engine then respond to the call or do they sit idle while a second squad from farther away responds past the station to the call? If there is a third call in this area and it does happen…does the ladder truck sit idle and let another unit from further out respond in? And if these squads are running all over the city who will be covering their district should a call come in? Also is it cheaper to buy at least 16 more apparatus and hire two more firefighters to staff those apparatus then to run as we are today and use the ladder trucks for an occasional call. This money may be better spent by placing a fourth firefighter on the engines to provide more hands on an emergency scene, better efficiency, better firefighter safety and to meet NFPA standards.

I like when the BFD drives the fire truck to the store to buy a frozen pizza for dinner. That is a good use of tax payer money!

TNT, the reason they take the truck is that they are required to. If a call comes in they can respond immediatly without having to go back to the station to get their truck.

I do agree with the other posters here that EMS should be merged into the fire department.

As far as the cops showing up there is no real expense there as they are on patrol anyways, maybe it even saves some money since they actually park and get out of their cars on these calls.

God forbid when someone picks on the Fire Department of the Police!
They sure have you all educated that they shouldn’t be messed with.
I do have to ask though. If it’s such a bad nasty dangerous job. Then why when there’s a opening they have 100s and 100s of Applications.

BlazingSaddle – You’re right – you are no expert. Using your logic, since doctors rely on nurses and techs to assist in pt care, then we don’t really need the doctors either.

You do realize that ACEMS actually transports the patients to the hospital and provides all care from the time that they arrive on scene, right? So if you want them to “turn in their keys,” who would you like to take over? If your answer is fire departments, the patient might still receive a bill for services (see Phoenix FD and Philadelphia FD, among others,)and they are going to need a bigger budget for all the shiny new ambulances and new paramedics on the payroll. And, guess where those paramedics will be hired from (hint, it will be the same ones providing care right now through ACEMS).

If your answer is a private service, then the patient still has to pay a bill for transport and the fire department will still go on calls to assist, but the proficiency of ALS care will most definitely decrease with the lower pay and higher turnover that comes with an AMR, Rural Metro, NPA etc.

Oh and by the way, BlazingSaddle, Ada County Paramedics exist just fine without the fire department, and frequently cancels them when they are not needed. This is not to imply that the fire department is useless or they should “turn in their keys.” The area fire departments have a role and do a good job providing assistance.

What I find most incredulous about this entire situation is the ignorance about taxpayer dollars being wasted. The property tax rate for ACP is something in the area of 10 dollars per 100K. The cities take a lot more to fund the expensive fire departments. True, you don’t get a bill from the fire department when your house goes up in flames, but then again, your house doesn’t get saved either.

On the other hand, if you are in cardiac arrest, there is a real chance that you could be saved by ACEMS. For a tax of 20-40 bucks a year (for most people), I can live with that.

Whine all you must to bring significance to your life… When you need help and dial the number they will come. Day, night, rain, snow, disasters, and even some of the scariest moments on earth. Yes it is their job, yes they get paid by your taxes, doesn’t mean you own them… For god sakes you expect service at dinner and you even tip the waitstaff… Fire, police, hospital, and medics don’t get tips.. Quit thinking you have the right to have it your way! You do whatever it is you do, safe, tucked behind a desk… Complaints when you don’t need them… Complaints when you do. These people have specific training and ability few could ever fathom. They have worked hard to get the opportunity to be micromanaged.

Why do some think that individuals with the highest of training; who have gone through background checks, and feel the calling to work for less than most, need to be looked down on by a probable idiot – who worries about who came to help, and what they drove.

I would love to see just one day where all 911 services went away… Just one day…

I think a greater appreciation would be had for things most truly don’t understand!

Hey cyclops,

Lets not forget the ones who wont be picked up by BFD…Females, Minorities, and well, anyone who doesn’t tow the union line. Notice that nowhere in there is any mention of medical competence.

In fact, some of the best medics at ACEMS are ones who couldn’t pass the FF physical, not because they are slobs or lazy, but because of age (you have to be 36 or less by most FD standards, regardless of health) and lets face it, most 20 year olds have trouble with it, never mind the females and the “para-saureses” who, like John Fog, have forgotten more about helping people that BFD will ever learn.

People any agency should actively recruit, people ACEMS is lucky to have, people BFD is afraid to hire.

But then again, being a medic is about the medicine and helping people, but being a fire medic is just about being on the fire department.

SO lets figure it out, 12 million or so for 22K calls (approx) and a 40% cardiac arrest survival rate (compared to most Califronia FIREMEDIC departments that push like 5%), or 30 million for (approx) 10 k calls (many of which are multiple responses to the same incident) with very few (if any) structure saves…..

So in this time of fiscal hardship locally and nationally , considering that BFD has a huge budget already that will ony grow if it takes over EMS, and that BFD will hire more young, inexperienced medics at the expense of seasoned quality medics, and considering the fire services history in general of discrimination against women (of which ACEMS is about 40%) and considering that ACEMS does an EXCELLENT job of quality EMS….

Why is it that BFD supporters HATE ACEMS?

Oh yes, because its in the interest of their union job security and their union pay check and their multi-million dollar Mc-Mansion style stations to do so. Especially in these times of fiscal hardship when the taxpayer will start looking for waste.

Again…12 million for 22K calls, or 30 million for 10K calls (or less)…….

Hmmmmmm

EDITOR NOTE–
We will let this one slip through, but please don’t respond to this comment. It is too much like the Daily Paper crowd baiting each other.

There is no age limit to get hired with the BFD, Just to be clear.

Well it looks like the war has started again, I quess no one read Brads comments. Sorry Brad I thought you totally put this whole article into perspective. I don’t care if you show up in a garbage truck to help me if you are the closest one to me. Sara when you need help make sure when you are talking to 911 that you ask for the vehicle that gets the best gas mileage to come help you. And believe it or not Sara and Nemo just made the argument for BFD to continue to do the great job that they do. Nemo stated that ACEMS has a 40% cardiac arrest survival rate, well we all know that you just don’t walk in the door and start pushing drugs, you have to get that heart primed first, good BLS skills, and since BFD is first on scene 90% of the time, it goes to figure that ACEMS is lucky BFD is there stabilizing their patients as Sara said. That is what you said isn’t it? So for every citizen of boise who is reading this whenever you call 911 no matter who you get, you are going to get the best possible care. What I find ABSURD is that the Fire Chief had to sit down and discuss a more resonable approach to doing business with the Guardian editor. Because of course the editor knows all about the fire dept. so he is an expert on what is resonable. What the editor should of done is found out the facts first about this incident, but unlike the daily paper that he always rips, I am finding alot of your articles seem to be written off of half-truths and heresay. Please get back to being a good source of info, not the Boise Enquirer.

EDITOR NOTE–Joe, the issue is NOT this particular run. The issue is about use and delivery of emergency services. I would be happy to take a lump or two if the chief disagrees with the thrust of my remarks. We were on the same page and I think he has some good ideas and intentions…with time he will also be experienced in management.

I am just a simple Idaho native who doesn’t understand all this big city crap. Can someone please explain why unions are necessary in 2008? So let me get this straight, the fire fighters don’t fight fire, they assist paramedics that make half as much as they do. But they are represented by a union which collects dues and lobby’s to make sure they stay in the union business. Meanwhile somebody is producing these big red fire engines and they have wisely highered a lobbying group to make sure every city has 25 big red fire engines to answer all those fender benders, and bar fights.

Back on the farm the rest of us pay are taxes. The Jungle is a very old book, Unions once saved the working man, now it is killing the working man.

Eberm, you made me chuckle. In Idaho the farm lobby is HUGE! Fire lobby ,not so huge. I know what you are saying. “Right to Work” has done our state so well.(Sarcasm) But, Thats a different post

Eberm:

The reason they have all those “big red fire engines” is so they can get to your house within a matter of minutes when it catches on fire. Perhaps you are still asleep with your family and a neighbor called in the fire, or perhaps no one is home. Either way they often can contain the spread of the fire within your house, and save some of your most prized possession, even your life.

I think the funniest thing of all is that the call is a 3-wood from the fire station.

This is all a repeat of the last time. You can not argue with a couple of things. The system as it is, works very very well. The cities with the highest save rates are what this tiered response system is modeled after. When I sat in my paramedic class there was a number of individuals who could not believe that there was people in my paramedic class that wanted to be paramedics. What I was told was that most every paramedic class from here to the west coast is full of people that want to be firefighters. Getting your paramedic puts you far a head of anyone else to be hired as a firefighter. I was one that just wanted to be a paramedic, nothing more. I truly don’t care who signs my checks, I just want to do medicine.

I am not being negative towards any fire service but when they have a fire, their fire/medic is fighting fires. Ada Co. usually has to respond to perform Patients care if there are any Patients. None of the fires I have been on have the fire/medics done medicine, they have fought fire. Hence the name ‘fire/medic’, not medic/firefighter.

When Ada Co. has a hiring test 10 people is a huge turn out. Fire deptartments get thousands of applicants. Not very many people want to put up with what paramedics have to deal with, espescially for lower pay. Wiping the diarrhea off of some strangers back side, helping them change into a fresh pair of pants after that, Cleaning up a homeless person so the hospital might treat them kinder, geting puked on, holding the hand of a mother that just gave birth to a still born infant, talking to someone that you know is going to die in the next few hours, telling someone that their mother, sister, brother, father, or cousin is dead and letting them cry on you. There are some other aspects that are unspeakable that for taste reasons I will leave out. No one should see, hear, smell or have to deal with some of the things that paramedics (and firefighters) have to deal with. No one I know is a paramedic for the money, you can’t do that job for pay, its not worth it. You have to want to do it.

I know there are great fire/medic single provider services, but that is not how the system was set up here.

The data that show who arrives on scene first is so screwed up, that it is ridiculous to base anyone’s budget or response times on it. Every call that goes to a DR’s office, surgery center, nursing home, ETC, where a fire truck is not initially dispatched to, gets a Boise (BFD) Meridian (MFD) Eagle (EFD) etc. dispatch number. Even though they have not even been dispatched to or turned a wheel for the call. But they still get credit for that run number. For a time Ada Co. (ambulances) could not confirm on air to dispatch that they were on location, because certain fire departments who shall remain unnamed would put them selves on scene (that instant) even though they were not on scene yet. I know we have some paramedics that do the same thing too. So the times that they cite, the numbers of incidents are so screwed up that they are useless. But it goes both ways, Ada county still shows a run if the Fire department cancels them prior to arrival on scene. Numbers as they are used are USELESS!

Ada co. EMS recieved 3 million and change from property taxes. The other 9 million in change is REVENUE (making the 12mil budget total). Very very few public services make any revenue at all. I don’t know if the fire department makes any revenue or not. I don’t know. I also know that I paid five times in taxes for a library than what I paid for EMS taxes. EMS just built a new station in Meridian. The first new building in 30 years?? It is very very nice. The only other building that EMS owns is the station on Glenwood. The remainder of our locations are graciously given to us by fire departments, and hospitals. So they are clearly not spending a lot of money on housing.

Unless Idaho law changes the Counties are responsible for Emergency medical services, not the cities.

The ideal fix (I think) would be a public safety department, rural/metro system. FIRE, EMS and Paramedics under one umbrella. This alone would chop a lot of fat of off the top of all of the sevices. I.E. management. One public safety chief, (elected position) One fire chief not 6, one sheriff, (not three police chiefs), one EMS chief. This has repeatedly been shown to be the most cost effective use of services county wide. The Fire departments have several times during blue ribbon commitees been told that there consolidation would save money. Consolidating ALL public saftey agencies would save millions of dollars in overhead alone. Would any of the cities give up their slice of the pie to a county wide service? doubtful, but there is no debating this would be the most ecconomical solution.

One last thought I do appreciate the fire dept. we paramedics could not do our job with out them most of the time.

I would rather have most of the firefighters in the county helping me code a Pt. in a Dr’s office than the Dr. or nurses that works in a clinic and sees ear infections and colds the majority of the time.

I also want them to know that there is nothing in my house save for my family that is worth any one breaking a back, leg, arm, getting burned or heaven forbid losing their life, my house is just full of stuff. No ones life is worth any thing in my house. I appreciate that they willingly take those risks, but it is just stuff. Maybe if I were richer I might feel different, but I don’t

In closing the system works great, every time some one who has enough spare time to take a picture of something to gripe about, or complain about they take focus away from the services, and start silent wars between agencies, not particularly helpful. I do like the one observation that when you are having a heart attack, you are watching someone you love die, you have been shot, your house is on fire, your leg is pinned under a car you will not give a D@MN how anyone got to where you are to help you, or what they drove. I guarantee it!!

I just spent the last half-hour reading all these comments and i still feel the need to add my two cents. I have seen 911 systems in other parts of the US, and abroad. The 911 system in Ada County is very good. The paramedics are top-notch in training and performance, and the ERs and doctors do a good job on being involved, making sure the SYSTEM stays that way, and the area FDs are also integral do a great job assisting with medical calls.

All citizens should sleep well tonight knowing that whatever emergency happens, the outcome will be the absolute best outcome possible, because the FFs and paramedics, and EDs are working together to solve your problem. Nothing needs to change in Ada County. It is impossible to really understand how great this system is unless you see it in action. Call the ambulance people or FD and schedule a ride-along!

Wow, some excellant comments, even thouhg I dont agree with allof them, still good.

One comment about paramedics and FDs sharing staions, besides the cultural issues it causes….

I personally believe that IF you are not willing to deploy AED resonse capable units in a cost effective way (i.e. cop cars and roving BLS units) then seperating out the FDs and Ambulances in smaller stations increases the 4 min BLS response circles.

Yes, this is MUCH more expensive than other plans, and Im not a fan of it, but the point is we can do much more to increase BLS response time that simply isnt being done because some parties have focused on upgrading to ALS levels, thinking it relieves them of the need for a good BLS base.

BTW, I am NOT favoring an approach known as “system status”, simply because this has been shown to be (much) more expensive in wear and tear on veicles, increasing injuries (backs = $$$$), and simply it is a huge moral killer. (and you cant attract quality people to a system status system.)
What I am saying is take Unitsd that are on the road all the time anyway, and use them. In other systms this has been effective.

And second, improve the BLS base/foundation of respponse units.

Honestly, not that the current tax burden would allow it, but Ada County (as an area, not as a goverment) could use about 10 -15 BLS/ILS transport units, then maybe consolidate the ALS units into double medic units…with an improvement in care and with out a decrease in response times to critical calls….but thats just my opinion for a dream.

Nemo –

You seem to be very opinionated and like to point fingers. “some parties have focused on upgrading to ALS levels, thinking it relieves them of the need for a good BLS base.” If a person were to sit back and actually look at the system, they would see that although the fire department has added ALS people to areas where ALS response times are slow and high volume medical areas, they still run at least two BLS crew members on every apparatus. Thus, allowing both BLS and ALS care to occur long before an ambulance arrives on scene. A much different approach then that of ACEMS operating 1 person ALS cars.

Also most of the fire stations are strategically placed to allow for a four minute response time the majority of the time. Oh and by the way all of those apparatus carry an AED with well trained BLS members. This sounds very close to the system in which you dream of except these crews have a place to eat, sleep and work when they are not out there caring for the citizens of this great valley.

To add on your thought about the BLS units. Maybe ACEMS should turn all of the transporting units into those much needed BLS units and the fire departments should run the calls if it should happen to go ALS. I know that non of the agencies would relinquish any power for that to happen and it probably isn’t the best option but I thought it might fire poor Nemo up a little bit.