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.

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.

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!

Good points, and I agree ALL emergency service should be under a metro style system, including law enforcement. We could save tax payers a LOT of money by using several large buildings and running fire/ems/police out of it, instead of having all the multiple fire stations, paramedic stations, and police departments within a few blocks of eachother.

Now we just need a public official to begin this process, and administrators to quit protecting their jobs and do what is right for the tax payers.

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!!

EDITOR NOTE–That’s what they do now. We are suggesting adding one firefighter per station and something like an Expedition or Suburban, leaving the big rig to respond to fires UNLESS there is a 2nd medical in the district. For fire alarms BOTH the big rig and the small “medical car” would respond. If it is a real fire they have an extra man and if it is not, the medical guys can leave immediately for other calls.

Essentially it doubles the coverage and decreases fire engine responses by about 70%–hence saving wear and tear. The SUVs cost about $40,000 vs $400,000 for a big rig.