The public’s growing concerns surrounding the District’s Fire and Emergency Medical Services department were made manifest at a D.C. Council oversight hearing on Wednesday, while panels of public witnesses bemoaned the status quo.
FEMS has faced increased scrutiny after its medical director, Jullette Saussy, resigned earlier this month. When her highly critical resignation letter became public, Mayor Muriel Bowser, who’d appointed Chief Gregory Dean from Seattle’s fire department last year, retorted that her administration did not expect to reform FEMS within only several months. Saussy, who had occupied her role for roughly seven months when she stepped down, testified on Wednesday.
“While changing culture takes time, there are simple ‘system fixes’ that can occur rapidly,” she said, alluding to FEMS’ “toxic culture” she described in her resignation letter. “It is those system fixes that have been met with resistance and a lack of urgency…It became obvious that I was not in a place where my expertise was going to be used appropriately. “
Nearly four-in-five calls the agency receives are related to medical rather than fire situations. At today’s hearing, Saussy again called for better and more frequent training for EMS personnel, a focus on “time-sensitive illnesses” like cardiac events and major trauma, more-robust metrics to track the department’s performance, and more-reliable technology. She testified that she was not permitted to make policy and operational changes by FEMS leadership during her brief tenure. “It’s very difficult to run a system when you have no input into the nuts-and-bolts of the system,” Saussy stated.
The Council’s hearing followed an announcement by FEMS this week that it had hired American Medical Response to provide additional ambulances for treatment and transport for basic life support cases, or minor illnesses and injuries. Bowser had proposed such a plan on an emergency basis in 2015, and the Council unanimously approved it in October. Under the forthcoming set-up, FEMS will continue to respond to 911 calls and make patient-assessments on the scene.
The oversight hearing also arrived on the tails of various media reports recounting patients who died after insufficient responses by FEMS. Councilmembers who sit on the Committee on the Judiciary today seemed to give weight to many of the criticisms by Saussy and her peers, commenting that the situation is “urgent” and residents lack faith in FEMS.
“The Council, when faced with such allegations, has the duty to investigate,” Ward 3 Councilmember Mary Cheh said from the dais, referring to the allegations published in Saussy’s resignation letter. “This hearing is just the beginning.”
At-Large Councilmember Elissa Silverman, who is not on the committee, called the status quo “unacceptable,” adding that she does not see a “sense of urgency” from FEMS. “On a day-to-day basis, we do not have the capacity to deal with our medical calls at the same level of skill” as fire calls, she explained. “We need to build capacity, and having medically-trained supervisors equivalent to fire-suppression trained supervisors will help level that playing field.”
When Dean finally testified late in the hearing, he said he does not believe the depiction of FEMS that has emerged is “accurate.” The long-standing challenges the department faces are “fundamental,” he said: “Because of this, we cannot expect to overcome our larger challenges without first fixing the basics that underpin everything we do. This has been our focus over the last nine months and will continue to be our focus in the short-term.” He added that he “disagreed” with Saussy’s portrait that she did not have any say in policy or operational issues, and that he wants monthly training.
On the third-party ambulance provider anticipated to roll out in four to six weeks, Dean said it is “only the first step in EMS reform,” needed to address a 33 percent increase in call volume since 2007 without a concurrent rise in resources. Putting extra vehicles on the streets (for $9 million in fiscal year 2016 contingency funds) will allow FEMS to work on improving response times, train EMS staff, better triage patients, and conduct fleet maintenance, Dean added.
It remains to be seen whether the additional equipment and time for agency personnel to get EMS training bears fruit.
“We can’t afford to keep making these types of mistakes,” Ward 5 Councilmember Kenyan McDuffie, who chairs the Committee on the Judiciary, explained. “There are way too many people dependent on our folks at EMS to get it right.”
Photo by Darrow Montgomery