City Discusses Merging Paramedics, Fire Dept. : Paramedics: A private company now runs city ambulances. But the city thinks it can upgrade the service by having firefighters do the job.

The San Diego City Council, looking for ways to control costs associated with the city’s privately operated paramedic service, Monday directed the city manager to determine if the Fire Department could provide quality emergency services at less cost.

A publicly operated system would be a dramatic departure from the present one, under which paramedic services are supplied by Hartson, a San Diego-based company under contract to provide emergency medical services through June 30, 1991.

Council members Monday authorized the city manager to determine what start-up costs the city would incur if it were to begin providing paramedic services through the Fire Department.

Hartson now uses city-owned ambulances that are dispatched through a city-owned computer and radio system. However, the 108 paramedics who provide care are under contract with Hartson. That system makes an average of 18 ambulances, each carrying two paramedics, available to provide service in San Diego.

The privately owned company provides a high level of medical care that is delivered in a manner that meets or exceeds response times mandated by the city’s contract, Hartson Chief Executive Officer Glen Roberts said Monday.

Under the city’s proposed plan, the number of paramedics would increase to 200. About 140 of those paramedics would be trained to serve both as firefighters and paramedics, and would travel to emergencies aboard fire trucks at the city’s 42 fire stations.

The remaining paramedics would continue to arrive at emergency scenes in ambulances that carry rescue equipment and that are needed to transport victims to hospitals.

“We would increase the number of (vehicles carrying paramedics) from an average of 18 to 60 under this proposal,” Deputy City Manager Maureen Stapleton said Monday.

Although the existing system, which uses ambulances to provide emergency care, gets paramedics on the scene within 10 minutes on 95% of calls, response times could be improved if paramedics were to operate out of fire stations because fire trucks usually arrive at emergencies a few minutes before ambulances, Stapleton said.

Estimates suggest that the city could save as much as $2.8 million by dropping a private contractor and operating the system through the Fire Department, Stapleton said.

Roberts on Monday took issue with the city manager’s suggestion that the city would save money by taking over the paramedic system.

“The (manager’s) report basically says there’s a big range of what the cost is, and it could fall anywhere within that range,” Roberts said in an interview. “Our argument is that, until the city negotiates with (Hartson), they really don’t know what their future costs are.”

Roberts urged the council to consider a two-year extension that would allow Hartson to continue operating the ambulance system through June 30, 1993. “The city has an option under its existing contract to extend for two years,” Roberts said. “It seems frivolous not to explore that option.”

The union that represents the city’s firefighters strongly supports the incorporation of ambulance services into the Fire Department, according to union spokesman Jeff Frazier.

Paramedics who spoke at Monday’s council meeting seemed supportive of the plan to operate emergency services through the Fire Department. However, Mike Meoli, a spokesman for the union that represents Hartson’s employees, cautioned the council against concentrating solely on cost savings.

“The key to this whole thing is . . . top-quality patient care, not . . . cost-effectiveness,” said Mike Meoli, a spokesman for the union that represents Hartson’s employees. “We have a Cadillac system now. . . . What we’re asking here today is that you don’t downgrade the system.”

Paramedics who attended Monday’s session argued that paramedics, who now operate as teams, might not be able to provide the same quality of care if they are split between ambulances and fire trucks.

Councilman Bruce Henderson, long a proponent of privatization of municipal services, Monday pledged to support the proposal to provide emergency services through the Fire Department. “Let’s get (paramedics) into the Fire Department as rapidly as possible,” Henderson said.

Similarly, Mayor Maureen O’Connor, who recently spent a night riding along with paramedics in a city of Chicago emergency vehicle, Monday argued that the city could improve service and cut costs by transferring paramedic services to the Fire Department. O’Connor said Chicago recently completed a switch similar to that being considered by San Diego.