- The Washington Times - Sunday, July 13, 2003

D.C. Fire and Emergency Medical Services Chief Adrian H. Thompson has quietly begun a massive reorganization that will merge the firefighting and EMS divisions, after a 14-year effort, and revolutionize the way emergency medical care is delivered.

Chief Thompson said during his March confirmation hearing that fixing the EMS system, which has been beset by staff shortages and lengthy response times, would be his first priority.

In two separate orders issued in the past two weeks, Chief Thompson laid the groundwork for creating one uniformed department, with firefighter-paramedics riding all of the city’s fire engines, and ambulances staffed with one paramedic and one advanced-protocol-trained EMT. The new staffing schedule will double the number of units that can provide advanced life-support care.

“I believe what we’re doing is going to be a model for the rest of the country,” Chief Thompson said yesterday.

In the first of the orders on July 2, Chief Thompson announced that between Monday and Aug. 15, EMS workers will be allowed to resign from the EMS division and apply for positions in the firefighting division. Currently, uniformed firefighters and civilian medics work different shifts, are represented by different unions, and have separate pay and benefits schedules.

“Either through this or through attrition we intend to have one, unified department,” Chief Thompson said.

Kenny Lyons, president of the American Federation of Government Employees Local 3721, which represents the city’s medics, said asking his members to become firefighters “demeans, demoralizes and disenfranchises” them, while disrespecting the service they provide as medical providers.

“Their intent is to undermine this local,” Mr. Lyons said. Medics who resign from EMS will have to leave the medics’ union and join the firefighters’ union.

But Chief Thompson said he worked closely with the Office of Personnel and the Office of Corporation Counsel to make sure the moves were legal. He said he expects it to take at least five years to fully merge the two departments.

Lt. Ray Sneed, president of the D.C. Firefighters Association, said unifying the two divisions was first proposed in 1989, and he applauded Chief Thompson for putting it in motion.

“As the chief I give him all the credit,” he said. “It’s a long time coming.”

Chief Thompson plans to use the paramedics on fire engines, which respond to emergencies about three minutes faster than ambulances. The Washington Times reported in April that the number of critical medical calls responded to within eight minutes plummeted from 76 percent to 55 percent after the city’s six paramedic engine companies were taken out of service in December to cut costs. The national standard is 90 percent.

Two of those engines have since been restored, and Chief Thompson said he expects a third to be restored before the end of the fiscal year. Instead of civilian EMS workers riding the engines as a fifth crew member acting in a support role during fires, only four firefighters, one of whom is a certified paramedic, ride the engine.

Medics are expected to be lured to the firefighting division by the opportunities for advancement and the better retirement benefits. D.C. firefighters hired after 1987 are eligible to receive 67 percent of their salary as a pension at retirement. Medics receive from the city an annual contribution of 4 percent of their base salary to a “defined contribution” retirement account — like a 401(k) — that they can use for investments.

EMS workers who join the firefighting division will attend the Fire Training Academy and be paid what they currently earn, but they will have to serve the mandatory 25 years as firefighters to earn their pension. However, their service to the EMS division would be calculated into the pension.

The second order issued June 26 modifies staffing on advanced life-support ambulances that respond to the most critical calls. Beginning July 27, instead of two paramedics, the ambulances will be staffed by one paramedic and one advanced EMT.

The move is in response to a growing paramedic shortage. According to federal guidelines adopted by the District in October, paramedics must complete a two-year associate’s degree rather than a certificate program that lasted about six months. The stricter guidelines have set off a nationwide scramble for paramedics.

Mr. Lyons said hiring EMS paramedics for the firefighting division is just a “shifting of bodies” and that it doesn’t address the shortage of EMS personnel.

He said it will “increase the potential of personal injury to patients.”

Chief Thompson said there is no evidence that the standard of care would diminish under the new configuration.

He said the health department was “lukewarm” to the modified staffing plan at first, but embraced it on the condition that quality-assurance records be submitted on a monthly basis to ensure that the level of care is not declining.

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