City Government
Boise City Ambulance Plan On “Hold”
August 25, 2009 
In a letter to Ada Commish chair Fred Tilman ( with the Commish’s name spelled incorrectly), Boise Mayor Dave Bieter said he and the council have put their plans to get an ambulance transport license on “hold.”
They cryptically refer to the GUARDIAN revelations (and subsequent legacy media coverage) over the past three weeks as “significant attention ” and claim the attention does not paint a complete picture.
Nonetheless, Bieter wrote, “The City Council and I have directed that internal City of Boise department activities associated with these issues be placed on hold until the larger policy questions can be considered through an open and dynamic process.” Which begs the question: WHY DIDN”T THE CITY DO THAT IN THE FIRST PLACE?
He went on to ask for cooperation and support of the commishes and listed topics that need discussing including, “scene management, cost sharing, quality processes, written orders, training etc.
Meanwhile, that ordinance with the language giving the fire chief authority over medical transport has been pulled off the agenda and will not become law at this time.
In summary, even though Team Dave and the councilors refused to attend our town hall meeting or acknowledge the efforts of the GUARDIAN to shed light on the process, the ill advised push to purchase an ambulance and duplicate the services of the Ada County EMS is in OUT OF SERVICE for the time being.
Looks like it is time for a citizen commission for the fire department just like we have for parks, airport, zoning, library, etc. All these issues would have been vetted by citizens in a public forum with no need for the GUARDIAN to rent space for a town hall meeting.
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Comments & Discussion
Comments are closed for this post.
Aug 25, 2009, 4:07 pm
I think you are giving yourself way to much credit David
Aug 25, 2009, 4:28 pm
Turn on the light of public scrutiny, and the roaches scurry…
The Boise Guardian exemplifies the highest ideals of the “Fourth Estate”, and we’re damned lucky to have it!
Aug 25, 2009, 4:39 pm
Now we have Bieter quoting what the the Union said in its stetment yesterday. The Mayor and Captain…dang it did it again, Chief Doan need to stand before the public and media and state their positions, not go thru staff/minions.
Aug 25, 2009, 5:30 pm
The Fire Guys want to take over the EMS program. Let’s face it. Fire codes are now stringent enought and preventive enought that there isn’t a whole lot for them to do but polish the brass and wash the trucks.
This not to say when there is a fire we don’t appreciate their quick response and expertise at putting down the fire. What we don’t need is both the city fire guys and the EMS guys fighting over who gets to transport patients to the local hospitals.
Aug 25, 2009, 6:43 pm
Your right, we need to stop looking for the most efficient, better quality, and faster way to provide emergency services. They way things are today are the way they have been for over 20 years. Innovation truly takes too much energy. Good job David, when is your next article on another waste of taxpayers money?
Its funny that you would claim that “The Fire Guys want to take over the EMS program” because when Ada County tried to pass an Ada County Ordinance giving them complete control of the EMS system, they were “enhancing” the quality of the service.
Its become another turf battle with the taxpayer losing out. Congrats (I guess).
EDITOR NOTE– Jake you obviously are not a regular GUARDIAN reader. If you were, you wouldn’t say nasty uninformed things. You can apologize after you read these previous posts. Your anger is unwarranted and misdirected at me. You quote a reader and wrongfully attribute his remarks to me. The attempt by BFD was simply ill advised, ill timed and simply not what citizens want or need.
Use our search engine for any topic and you will find the GUARDIAN has a history of reporting and insight you will not find elsewhere. Just the stories I link below should warm your heart. Bad judgement in government knows no bounds.
https://boiseguardian.com/2006/11/28/ada-wants-ambulance-monopoly/
https://boiseguardian.com/2006/12/19/ems-monopoly-ordinance-goes-to-court/
https://boiseguardian.com/2006/12/10/ada-ems-stiffs-fire-departments/
https://boiseguardian.com/2006/12/11/ems-losing-ground-in-turf-war/
https://boiseguardian.com/2006/10/02/state-of-ada-ambulance-service/
(NOTE all images were owned and made by the GUARDIAN and have been removed due to a technical change on the site since an older post was made)
Aug 25, 2009, 6:45 pm
So does this mean that Boise is not going to flip the bill for an $80,000 ambulance?
Has the transport proposal been removed from the state?
Are they not purchasing a Gurney as the E-mail suggested or is this in attempt to remove this story from the news while all this still happens?
Aug 25, 2009, 7:52 pm
Sounds like a call to the state licensing board is in order to see if BFD has pulled their application. Any bets?
Aug 25, 2009, 8:28 pm
Paul, Acually BFD does stay busy training, pre-planning (for fires in diffent types of commercial buildings) ect besides responding to emergency calls. As for fire codesm in Idaho Fire Codes are not strict enough thanks to the state legislature and lobbyists for building contractor/developer groups.
Personally I like the idea of Fire Based EMS, I just don’t like how Bieter & Doan are going about it. If they want Fire Based EMS then go for it PUBICALLY!, with facts and data that support their position. This half steppin attempt, behind closed doors isn’t doin for BFD.
They want Fire Based EMS then bid out TEN (10) new AB’s, fully equip each rig, get more qualified Paramedics to staff Eight (8) of those rigs around the city. I picked 8 for adequate coverage for the size of Boise and 2 more for reserve rigs.
And while Doan is at it he needs to get a 4th FF for his Engine Companies, get a dedicated Heavy Rescue Company, insead of havng Engine7 cross man Rescue7, and the tech rescue truck. Doan needs to push the “2 In 2 Out” Staffing for BFD Engines, thats the national standard for large departments.
Maybe the BFD Union should take the City to court for that 4th guy, like they did to take back ARFF Coverage at the Boise Airport.
Captain…did it again, Chief Doan says on the department web page that Boise Fire is one of the most Progressive, Dynamic Fire Departments in the Nation, Well Chief start with getting with national standards for large departments, You’re surrounded with enough staff (civillian budget director, operation deputy chief, ems chief), you won’t have much to do, Just be Honest and Upfront with the Tax Payers, you’ll probably get more support.
Aug 25, 2009, 9:30 pm
Sorry Dave about the unreferenced “you” regarding past comments about Ada County’s Plans to Dominate the EMS world. I thought that the use of the direct quote from Paul was enough…wrong.
I believe I wasn’t being “angry” as much as frustrated but I find the comment about me being uninformed was a little over the top. I actually have read (and participated) in your blog fairly frequently.
After all, over the past week there have been numerous posts stating that the firefighters have not given enough information to the 50 or so people who have commented on your posts.
And yet, you have determined that, “The attempt by BFD was simply ill advised, ill timed and simply not what citizens want or need.”
I understand the need for more information but because you, NEMO, Mark, aimdee, and Fed Up don’t have the information doesn’t mean it doesn’t exist and those who are charged with the decisions have not been informed. Perhaps, the City should just defer to you all decisions.
Maybe you should hold up your opinion until you could be more informed. I know, research what has and what hasn’t occurred.
Aug 25, 2009, 10:00 pm
I am not sure where David got his information that BFD is not pursuing buying a Ambulance, I watched the council meeting and only heard Mrs. Jordan bring forth a changes in the criteria for Clean Up Language. If you think that is going to stop the Firefighters, you have never been around firefighters. BFD has worked long and hard in local politics. Local politicians long for the endorsement of the IAFF local 149, the firefighters sit down and insure the candidates share the same vision of local politics before committing to a endorsement. And unlike ACEMS, BFD is well organized, and in touch with Council. AT this time City Council Members are waffling from the position that they had expressed to BFD in the past. Council needs to Remember that BFD can not get anyone elected, but they have 240 members that will work long and hard to get someone unelected if they feel they have been crossed.
EDITOR NOTE– I quoted directly from a letter dated 21 Aug Bieter sent to Tilman with the exact words they would “put it on hold” until major policy issues were worked out.
Aug 25, 2009, 10:06 pm
A question for Jake:
Do you think a county wide EMS/Fire system is the way to do it?
You seem to think that Boise Fire has the right idea but don’t mention anything about a county wide system being a good idea. This would mean that all the fire departments would have to work together. I also don’t understand why you are against the proposal that Ada County made regarding putting a Boise Fire medic on the ambulance. According to the link to the information that I read, Ada County is planning on paying Boise Fire for using the man power. Interesting that Boise Fire didn’t accept but Merdian Fire was interested.
Aug 26, 2009, 5:21 am
Lisa,
What need is there for the additional resources that you reference? Heavy rescue? How often has that been called for in Boise? I for one, as a taxpayer, don’t support the FD buying any new toys or hiring additional crew for their toys.
If you want to get progressive, stop pandering to the IAFF and take a look at how other countries staff their fire departments. A piece of fire apparatus being met at the scene with a van full of firefighters… interesting concept. Fire fighting crews dynamically deployed seperate from their apparatus? Isn’t the notion that the FFs have to ride to the scene on their fire apparatus a bit dated? If you dive deeper into the dynamic deplyment notion, it smells a lot like what successful EMS organizations do. It would never work here though because we are slaves to the union. Gotta have a full crew on the truck or the PFFI will have a fit. It’s tragic when public safety is held hostage to an organization with a singular vested interest.
Just my $.02
Aug 26, 2009, 8:01 am
In a previous comment I stated your voice means nothing. I still stand my that statement. It will pass without a word being said. Just wait, I am NEVER wrong. They will strike when the dust settles.
EDITOR NOTE–Brian, you are SO negative! 🙂
Aug 26, 2009, 9:29 am
Fed Up, I’m not pandering to the Union even though my husband is still a card carrying member of the IAFF, has been for over 20 years. BFD is behind in the game, now they’re trying for als transport in a economic downside…bad timing when Boise already has adequate als transport.
What I was saying was that maybe BFD should get with national standards on the FIRE side of the house THEN when the economy improves go for a full blown als transport program.
Who said anything about a “Van full of firefighters”???. Have you ever had to do CPR in the back of an AB all by yourself?, No well its not easy. Thats where a Engine Company comes in, a couple of FF/EMT’s in the back of the rig with a PM, maybe one driving the rig to the hospital. Ever had to carrya 300lb Pt down a flight of stair? didn’t think so.
Fed, maybe YOU should look at other communities of Boise’s size and get an understanding of how the Fire Service works.
BFD should improve its Paramedic program (add additional paramedics, more “Hands on” experiencse), then when the economy improves take its proposal to the people, in an open and upfront manner that way they would probably get the support for an als transport service.
Fed…I’ve been around the Fire Service since I was little, I’ve seen the Good, Bad and Ugly. I think BFD is beyond the White Pioneer Pumpers but theres always room for improvement.
Aug 26, 2009, 10:54 am
I think you do deserve credit for bringing this matter to the attention of the public. Thanks, Dave, for not letting “THE” Mayor pull a fast one on us or his council.
Aug 26, 2009, 3:43 pm
Hopefully this whole mess will do one thing….make these departments really cooperate with eachother and stop the power grabbing. There is no GOOD reason why a fire medic and a County medic can’t work side by side on an ambulance. It will only improve relations and get the fire medics more patient exposure. I see that option as the true win-win solution.
Thanks Dave for bringing attention to this matter. The public absolutely should be involved in a decision as important as this one.
Aug 26, 2009, 8:09 pm
Lisa,
My comments about different deployment models were targeted at getting FFs to a scene… on something other than on the back of a ladder truck. When you look at how other countries deploy fire personnel and equipment you realize that there really are no progressive fire services in the US. They are all tied to archaic NFPA standards and IAFF contract requirements. There’s no evidence whatsoever to demonstrate that the models used by the typical “progressive” fire service in the US is effective, it’s just the way it’s always been done.
If you haven’t, get out of Idaho, visit a few overseas locations and check it out.
I have lived in numerous other cities the same size as Boise, also some larger, some smaller… Also a few foreign countries… cities large and small. I’ve seen more progressive fire services in some developing countries… they have to be creative as they are dirt poor.
To say that Boise is “less than progressive” is about as generous as I can get.
Before someone jumps me for being an out of stater… I have an Idaho SSN… born and raised here. Just didn’t keep my head burried here.
Peace, enjoyed the banter
Aug 26, 2009, 9:56 pm
Fed, I have seen large FD”s from NYC to LACO. My dad spent 37 years in the fire service, retired chief after 37 years of a “Progressive FD, and then some. My husband retired as a Deputy Chief, City Larger than Boise. We own a business that is involved with the fire service/ems (grossed $16M last year).
As for the NFPA, its standards are continually being update year to year to year. Boise Fire has come along ways the last 30 or so years but I still think they lagged behind providing EMS. That isn’t due to the IAFF Local, some of it is past department leadership, forme politicos.
Oh and I was born and raised in Idaho, but have traveled out of the state numerous times.
Aug 26, 2009, 11:48 pm
Fed, you talk out of both sides of your mouth to the point that you truly show you ignorance on the subject! What is your definition of a progressive fire Department?? You can throw around acronyms such as NFPA and IAFF but can you tell me one thing that either one of those organizations stand for that bog down the level of service that American FD are able to provide?? You speak of deployment systems that centrally locate fire personnel and have single man resources respond to incidents and wait for personnel, WOW you are cutting edge, that sounds like the same progressive model as many combination paid volunteer departments are using all over rural Idaho such as Star, Mountain Home, and Horseshoe Bend.
Let me give you just a few thing that I would consider progressive in the fire service; Working towards compliance with NFPA 1710, which dictates Equipment, Infrastructure, and Manning that is required to perform safe and effective firefighting operations for both the Firefighters and the Citizens of the community. Forming Relationship By Objective Committees that put both Management and labor together in the decision making process of policy, procedures, and day to day operations, and save the city tens if not hundreds of thousands of dollars in needless grievances and arbitrations.
Fed just remember what goes with Progressive……..Money, and from reading you post, you’ll whine about that.
Aug 27, 2009, 4:05 am
I don’t think we are “there” yet, but a combination City/County government would go a long way toward resolving many of these – should I say – conflagrations. Just think, one council for all of the cities and the county, one fire department, one law-enforcement department, one library system, one parks and recreation service. Makes too much sense to get adopted until things really are messed up, at which time it will be over-due and folks will be saying – why didn’t we do this years ago.
Aug 27, 2009, 8:39 am
Even better we can have one big federal fire dept, police, and everything. Oh wait, a bigger government never works
Aug 27, 2009, 9:18 am
Matt, we arnt talking socialism here, just unification…
You have to admit it would solve some of the power grab problems. Some of them.
Aug 27, 2009, 11:05 am
Actually consolidation would lead to a smaller I.E. less amount of Government employees. You could get rid of the amninistration of all of the city Fire Departments and have ONE fire cheif, one training department, one maintenance division, one purchasing department, one payroll department. There would be less overhead administration needed. Fire, EMS and police could co-habitat at all facilities. Maybe I am wrong. But One fire cheif Vs. five cheifs. That would save money. I know pipe dreaming
Aug 27, 2009, 2:49 pm
One mild correction…One EMS/Fire chief, not one fire chief..
I think that if we were to hire a “fire chief” (subtle distinction) with EMS responsibilities…we would trade one set of problems for another. Look at DC Fire/EMS or FDNY and their issues with support of their EMS functions.
If we hired a proper chief who truely recongized EMS as 70-80% of the job (as Chief Brucinni put it, an EMS department that does fire supression”) then that would be an improvement, not someone who sees EMS as a means to an end.
No, I’m not talking aboutthe ACP director or anyone in particular (well maybe one person…), but stressing an important point to remember if we progress down a COUNTY WIDE consolidation road someday.
Aug 27, 2009, 8:41 pm
Doc and Lisa,
You both make me smile. I offer that you are strangled by convention and you both come back with comments based purely on the party line; parroting the conventional wisdom from “progressive” organizations from within the US. Go back and review my previous posts and you will see that my point all along is that there are NO progressive fire services in the US.
Box (sorry the term “Doc” is earned… not by going to paramedic school either)… the NFPA is cutting edge huh? You are kidding, right? (back to your box)
Lisa… you get a bye on this one because you were raised in the system and can’t be expected to see it any other light.
Don’t get me started on the way that we deploy EMS in the US eitehr because we have it all backwards and upside down as well. AS least there are a few EMS organizations in the US that are starting to figure it out. Too bad the Aussies and Canucks are way out in front of us.
Peace!
Aug 27, 2009, 10:41 pm
Nemo, Its BRUNACINI. Bruno is a hoot, we had dinner with him and Rita a few months ago in Phoenix.
Al also once said about Fire Based EMS (Paramedics on Engines “Delivering EMS on a Engine is like Delivering Pizza with a Cement Truck”.
Fed Up, (shaking head)…Never Mind.
Aug 28, 2009, 1:49 pm
Lisa, thanks for the correction. I was working on low sleep and meant to spell check his name and simply forgot.
That said my point remains on the selection of a chief to run a county wide department.
Also interesting point about the cement truck analogy.
I was reading the way they treated Chief Brunacini after his retirement, and the way Phoenix is “reverting”….shame.
I have to admit the man understood customer service.
Aug 28, 2009, 2:05 pm
DnB,
Whay Fed Up was likely referring to is the fact that there are several locations in europe that are VERY SUCCESSFULLY using either motorcycles or 2 man fast attack trucks (kinda like brush trucks).
Since most fires are garbage can size or smaller, they can be handld by “a man with a 10 pound can” fire ext. I have read of one fire service that uses Motorcycles with Compressed foam systems on them.
In these systems, they have “heavy” resources with their trucks, tankers, and ladders in farther (10 minute or so)locations that respond and dump on any given fire. Remember that this works and I would wager they have more fires than us due to their older buildings. Here, in the US, especially the west…where Major fires are less of an occurrence, it makes even more sense. Their initial response is as fast or often quicker than US Fire Departments.
And these systems cost significantly less. And they work very well.
On the EMS side, the UK, Parts of Canada, and the Aussies all have higher standards for paramedics (degrees), they have cost saving Advanced Practice Paramedics providing well checks on frequent fliers, and many other innovations that would work well over here we can just “open our eyes”.
And by the way, in these systems, the fire service is well respected too, but they simply stay with BLS care. No friction. And excellent medicine.
That is what Fed is speaking of. (we must read the same journals, list serves, and research.)
Aug 28, 2009, 4:51 pm
Nemo, I’m really not sure what FedUp was trying to say other than FD’s in the U.S. are screwed up so I didn’t really pay much attention to his last post since he doesn’t appear to know the fire service in the U.S.
I never seen a CAFS (Compressed Air Foam System). Interesting side note here on CAFS. Phoenix FD was one of the first FD’s in the U.S. to use CAFS for initial attack on structure fires, again under Bruno’s watch. Bruno also started what today is ICS (Incident Command System) but PFD called it “FireScope”.
I don’t think Europe can take credit for 2 Person fast attack truck. LACO has been using 2 person “Squads” since the early 70’s, where as LA City Fire has their own “Recue Ambulances.
No I don’t think FedUp is up to speed on U.S. Fire Advances, he’s probably been watching “Emergency” re-runs on TVLand. They don’t even make Ward Lafreance Ambassador Pumpers anymore…Ward Lafrance went belly up over 20 years ago.
Aug 28, 2009, 6:24 pm
Nemo… finally a voice of reason!
Amazing how we Americans hold so firmly to our way of doing things as the “right way”.
Box… Would the systems in Europe that Nemo elluded to meet NFPA standards? No… Would the IAFF entertain allowing an aparutus to roll without being fully “manned”? Heck no… Is there any science behind the “standards”? Heck no!
Lisa… Allow your mind to break out of the box it currently lives in AND smile… it’s all good!
Aug 28, 2009, 10:05 pm
I have seen the sytstems in Europe, which are grab and run. Japan has working for years to duplicate the tiered service and emergency room set up we have in the US. They are actually ahead of us with some interventions like neuro surgery rooms just off the ED to deal with stroke and head injuries, their #1 and #2 killers. Collaboration with them has been excellent.
We have a model service here, with tiered response and shared governance. I get the idea that the issues are at the top and not between line fire services and paramedics, focused on care and not turf issues. Physicians are active and support the current service. If physicians have to reestablish trust, we risk the chance that they may not happen. Understanding the physiologic issues facing the human body undergrowing stess is complex. The ears and eyes of the physicians in the field is what saves lives. We will be set behind three years, if the chain of field command is changed, I have seen this happen and lives will be lost.
What takes preciednt on EMS call or a fire call. The recent Saturday morning 2 alarm further down town would logically stress medical coverage. Diluting the county system threatens back up.
Overall, we need to be sold on the beter, faser cheaper argument. Differant EMs servces will be very costly, unless we see a realistic
plan that suppots the change, threatening the loss of highly qualified indivifuals with lower cost fire personnel – which does not appear to be fact.
Everybody needs to take a breath and get rational, versus enotional. Running dats is not that challengng. One needs o compare the costs and create a viable plan. I am not saying it cannot be done. I just need to see it, as should evey other citizen paying taxes to the agencies.
Tiered response saves lives. I dare anyone to refute that statement with facts. Keep it working in the same choreograohe systend as we see it is today, unless a need an presented and debated
Aug 28, 2009, 10:26 pm
Lisa… got my fill of Emergency on TV when I was in High School… don’t need to watch reruns.
Sounds like you need to get out more… Squad 51… lol
Seriously though, are you suggesting that LACO rolls fire apparatus with 2 on board? An engine with 2 on board? That would seem to be a contradiction to NFPA1710 wouldn’t it? For instance NFPA 1710.5.2.2.1.1 and 5.2.2.2.1:”These companies shall be staffed with a minimum of four on-duty personnel” NFPA 1710.5.3.3.4.4, et. al. allows 2 person EMS responses, but not fire apparatus.
Aug 29, 2009, 9:43 am
Emergency/High School? Wow he must really be from the Pioneer Era. My opion is that BFD is quite capable of operating a ALS Transport service with CAPABLE Leadership & Public Support. BFD should of started ALS/Transport years ago like other career FD’s in the state. You can compare different departments all you want from journals, internet, or old tv shows but this isn’t FDNY, Europe, Canada or Australia.
SouthWest Ambulance (RuralMetro) has the city ambulance transport contract for Salt Lake City, SLCFD runs Paramedic Engines and Rescues…NO Problems. Lewiston (Id) FD runs ALS Transport for 4 counties in Idaho and Washington with 4 ALS Ambulances…NO Problems. Idaho Falls Fire covers 3 counties (pop. 100+K) with 5 ALS Ambulance…No Problems.
Meridian was considering contracting a private ambulance service for transport in city limits (if the Kuna vs Ada County lawsuit went bad), WHY?…They weren’t satisfied with the attempt by ACEMS to take over EMS Authority County Wide. Over 80% of the Career, Combination and Volunter FD’s in the country operate ambulance services…Sounds like somebody in the fire service is doing something right.
Aug 29, 2009, 11:25 am
Good luck in Boise, but is it is the same across the country. Dedicated EMS professionals who have choosen this career are being forced out of their careers because of politics and misinformation. EMS needs to be organize and speak with one voice. EMS is still in its infancy phase but we continue to grow and gain respect. I think nationally agencies are realizing that fire based ems is not the way to go and it is not cost effective. Once these agencies stop “drinking the kool-aid” they will come to realize that EMS third service providers are the best and most effective way to provide EMS.
Aug 29, 2009, 12:08 pm
Lisa… Pioneer era… yea I was born in the back of a covered wagon, back before microwaves.
Most fire departments do dabble in EMS; no argument there. The leadership within the fire circles woke up and saw the writing on the walls years ago that they were becoming irrelevant. Doing something because you have to doesn’t make it right. What’s your point?
I think if you explore the more efficient (less drain on the taxpayer) EMS services around the country, you will not find them in the fire service. Fire Departments, by their very design (based on legacy) are bloated, inefficient organizations.
Could BFD run an efficinet EMS service (as you said, with different leadership structure, etc…)? Sure they could. When you throw out all of the entrenched leadership that they currently have, it would work great!
No problems in Lewiston?! Have you been reading the news?! lol. The Lewiston Fire EMS debaucle is all over the local news up there.
Idaho Falls… they are reliant on an ordinance very similar to the one you slammed ACEMS for trying to put in place. If the ordinance were challenged in court, it would go the way of Kuna/Ada County and Idaho Falls would lose their monopoly.
Pleasure as always. Peace
Aug 29, 2009, 12:51 pm
Lisa, sometimes we agree and sometimes we dont, but I will agree with a previous post that perhaps you are colored by what you have apparently been exposed to the most, fire service EMS. I mean that respectfully. I once fell into that trap too. In fact, when I started EMS, I was actually pro-fire based EMS.
Washington DC FD/EMS is perhaps the worst for poorly managed fire based EMS, but elements of what they have done wrong can be found in many fire based EMS systems, and to not keep an open mind to that possibility here in Boise is somewhat blind. I have been around in many systems over my career. I can tell you there are problems with many fire based EMS that are specific to fire running the show, on top of the problems that face all EMS. These have been discussed here ad nausem before.
There are no (zero, nada, nich, nein) ….safegaurds in the BFD to prevent a similar flawed and dysfunctional system from starting here. In fact, there are plenty of signs that that is exactly what will happen here.
And just because ACP is not fire based does not mean its not doing an excellant job. In fact , a 91.4% (If I recall correctly) response time success and 41% cardiac arrest save rate speak to that. There are many systems , including fire based systems , that would love to have that.
SO I would submit that perhaps to your lists of Lewiston, Idaho Falls, and other examples of EMS you admire, perhaps you should add Ada County too?