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Almost six months after the D.C. Council passed emergency legislation authorizing the District’s Fire and Emergency Medical Services Department to hire a third-party provider, a fleet of 35 ambulances will hit the streets next Monday to help accommodate record 911 demand.
The initiative, proposed by Mayor Muriel Bowser and FEMS Chief Gregory Dean, will cost the District about $9 million in contingency funds from fiscal year 2016 and target low-priority (“basic life support”) calls for service, which have partly overwhelmed the city’s regular fleet of 25 ambulances and 14 medic units. According to FEMS spokesperson Timothy Wilson, 25 of the 35 ambulances on contract from company American Medical Response will be answering calls at a given time. Roughly 200 workers will staff these units, Wilson explains.
“They are strategically positioned throughout the city based upon the EMS system status, availability of ambulances, and time of day,” he writes in an email to City Desk. “The training for EMTs is consistent and regulated by state and national guidelines.”
In February, FEMS announced the contract, which Bowser and Dean have said will allow the department to focus on training D.C. personnel and take some of the burden off responders who need to focus on advanced life support cases (heart-attack patients, for example). “While this is an important step forward, it is only one step of a broader plan,” Dean, hired by Bowser in 2015, said in a statement at the time. “We still have a lot of work to do to reform our system and improve patient outcomes.”
According to Wilson, the AMR EMTs will make about $20 an hour, a little below the average starting salary for an FEMS firefighter/EMT of $23 an hour. FEMS staff are cross-trained to handle fire and medical cases. (“FEMS hasn’t hired EMTs in more than a decade,” Wilson states. “All firefighters have EMT certifications.”) That system has resulted in cultural challenges, critics say.
Early last month, FEMS’ medical director, Jullette Saussy, stepped down just half a year into the job. In her widely reported resignation letter, Saussy alleged that FEMS had a “toxic” culture, later testifying in a D.C. Council hearing that it doesn’t place sufficient emphasis on properly training staff to respond to medical situations. “People are dying needlessly because we are moving too slow,” she wrote. At the hearing, Saussy added that her attempts at reform had been met with “resistence and a lack of urgency.”
“We cannot expect to overcome our larger challenges without first fixing the basics that underpin everything we do,” Dean testified at the same hearing. “This has been our focus over the last nine months and will continue to be our focus in the short-term.”
Officials say the third-party ambulances are part of that effort. According to an FAQ on them that FEMS published in February, the ambulances will be in service seven days a week, from 7 a.m. to 1 a.m. While FEMS will still respond to all 911 calls for “pre-hospital medical care and transportation” and assess patients, AMR will transport low-acuity patients during this “high-call volume” period; FEMS vehicles will transport ALS patients and those who call during low-call volume hours to area hospitals and medical facilities.
AMR’s ambulances will be required to arrive at the scene “within 10 minutes of being dispatched,” according to the FAQ. FEMS will send patients their bills for transport. “To file a complaint against a private ambulance provider,” individuals can call (202) 673-3331.
Photo by Darrow Montgomery