Fire Union to Push Paramedics Debate : Health: Owner of the county’s ambulance contractor says the call for firefighters’ certification is a labor issue.

Ventura County Fire Capt. Wayne L. Pulley was jogging with fellow firefighters in an open field near the Saticoy station when an emergency call came in. As the men raced back to the station, Pulley suddenly collapsed.

The 27-year-old captain had suffered a heart attack. Firefighters immediately applied cardiopulmonary resuscitation but failed to revive Pulley and he died. That was Aug. 21.

Since then questions have been raised as to whether or not Pulley might have lived if there had been paramedics at the fire station to provide advanced life support procedures or if there had been heart defibrillators available to provide electroshock treatment.

Although there is no certainty that Pulley would have lived if such equipment and personnel had been immediately available, county fire and health officials agree that his chances for survival would have been greater.

And yet, two years after the county grand jury recommended that firefighter-paramedic service be established and two years after the Board of Supervisors agreed to set aside $250,000 to purchase 43 defibrillators and to train firefighters in their use, nothing has happened.

County officials say there is no money to establish paramedic service within the Fire Department and Pruner Ambulance Co., which contracts with the county to provide emergency service throughout the region, says there is no need.

The Ventura County Firemens Assn. disagrees and says it is determined to bring the issue to the forefront in the supervisors’ election in June. Supervisors Maggie Erickson Kildee, Susan K. Lacey and John K. Flynn are all up for reelection.

“We’re going to make it a political issue,” said Ken Maffei, president of the 400-member firefighters union. “Some board members may be reelected or not based on this issue.”

The vast majority of the county’s 400 firefighters are trained emergency medical technicians who can provide basic life support, such as supplying oxygen or performing CPR. Paramedics, on the other hand, can dispense medication, administer intravenous fluids and work directly with doctors.

Although there are currently 13 firefighters who are trained paramedics, they are not certified to apply the lifesaving techniques because there is no county-sponsored paramedic program, fire officials said.

Maffei said firefighters are almost always first to arrive at the scene of an emergency and therefore should be allowed to provide advanced life support procedures.

Maffei, as well as officials from Oak Park and Leisure Village in Camarillo, have also raised questions about Pruner response time and the quality of emergency care provided by the company. Maffei said that Pruner tends to hire young, inexperienced medical technicians, not certified paramedics, in order to keep costs down.

The county is in the process of evaluating Pruner’s service. A report is expected to be released in January.

Donald Pruner, owner of the ambulance company, said the firefighters are simply trying to create new job opportunities for themselves. He said that firefighters trained as paramedics can expect to be paid 10% to 15% more than other firefighters.

“This has been a labor issue from Day One,” said Pruner, who has operated his Thousand Oaks-based ambulance company without competition for 28 years. “There are not a lot of fires. So what do you do if your business starts dropping down? You look for other things to get into.”

Pruner said his employees are adequately trained. He said that although his contract with the county only requires him to provide emergency medical technicians, he has been employing paramedics for about 17 years.

Pruner presently employs 33 paramedics and 40 medical technicians to man seven ambulance stations countywide. Two other companies provide emergency service in Oxnard and Ojai.

Despite the union’s complains, Maffei said it is not the firefighters’ intention to drive Pruner out of business. The goal, he said, is to enhance emergency service in the county.

The majority of the supervisors said they support a paramedic program in the Fire Department. But they said there is no money to implement it.

“These are hard times to be talking about raising the level of services,” Flynn said, adding that the county just last week imposed a hiring freeze and warned of severe cutbacks.

In a letter sent last month to Leisure Village residents demanding paramedic service, Erickson Kildee suggested that the union set up special assessment districts to pay for the service or have individual cities subsidize it.

“I am opposed to raising taxes,” Erickson Kildee stated in the letter, “and special districts or city subsidies would require taxpayer support.” Erickson Kildee will meet with fire officials, Pruner and Leisure Village residents on Jan. 3 to discuss the issue.

So far the union has been successful in persuading the city of Moorpark to institute a one-year firefighter-paramedic program. The City Council voted unanimously in September to set aside $125,000 for the pilot program and is now awaiting approval from the Board of Supervisors.

The action was prompted by repeated complaints from residents about slow response time and inadequate care by Pruner.

But Supervisor Vicky Howard, who represents Moorpark and Simi Valley, is reluctant to support the paramedic program. She said she wants to wait until two studies being done by the county to evaluate Pruner’s service are completed before she takes a formal position.

“I applaud Moorpark for putting up the money, but the question is are they going to do it for more than one year,” she said.

City officials said that will depend on how well the program works and if it proves to be cost effective. Howard said she is worried that if Moorpark implements the pilot program other jurisdictions will want to do the same. She said the county will then have to come up with the money to pay for it, money that it doesn’t have.

“I have to look beyond just Moorpark and look at the entire county,” she said. “If we provide paramedic service in one community, then we have to do the same in other communities.”

Howard, who received campaign contributions from Pruner in the November, 1990, supervisorial race, said that has not influenced her views on the paramedic issue. The firefighters union backed her opponent, Simi Valley Councilman Bill Davis, who made the paramedic program one of the central themes of his campaign.

“I’m not on anybody’s side,” Howard said. “I represent the taxpayers, and I have to make certain that we are getting the most effective use of their tax dollars.”

Moreover, Howard said that the union, not the county, has been responsible for holding up the defibrillator program.

The county has yet to purchase the machines because of a dispute with union officials over that types of machines should be used. The union said it was concerned about firefighters using machines equipped with voice-activated tape recorders, which would be used as a teaching aid as well as for keeping accurate medical records.

Maffei said firefighters were worried that the tape recordings would be used against them if the question of liability arose in a lawsuit.

Howard said “it is a given” that liability will fall to the county.

“I’m very disappointed in the firefighters because they have been unwilling to institute something that everybody knows will help save lives,” she said.

Maffei said the union reached an agreement last January with the Fire Department about the use of the machines. He said the reason the defibrillator program has not been instituted is because Fire Department administrators have not made it a top priority.

“They’ve been dragging their feet on this issue,” he said.

Chief George Lund denied the charge, saying that negotiations between the department and the union have continually stalled over the liability issue and demands for increased pay for firefighters trained to use the lifesaving machines.

Maffei said if his men are required to learn new skills they should be compensated for it. Formal contract negotiations between the union and the department began last week.

Lund said the defibrillator program should be put in place first--possibly by June--and then evaluated to see if a paramedic program is still warranted.

Donald Pruner said it is up to the firefighters union to prove that such a service is needed and show where the money is going to come from to pay for it.

“What is it going to cost?” he said. “I think they are going to have to show there is really a need. And I think the taxpayers are going to look at it real close.”

Pruner said he believes that the city of Moorpark is making a mistake in its efforts to place firefighter paramedics in the city’s two fire stations next year. He pointed out that his company stationed an ambulance in the city in October at no cost, cutting average response time from eight minutes to about 4 1/2.

He said the city would be wasting $125,000 to duplicate paramedic service in the Fire Department.

“It definitely would be a gift of public funds at this stage of the game,” he said.

Chief Lund said he is inclined to agree.

“I think the city is having its paramedic needs met at this time,” he said.

However, city officials said they are still interested in pursuing the firefighter-paramedic program. They said they believe that it will ultimately be the way the county will want to go.

“The council made a commitment and we’ll follow through on that,” Moorpark Mayor Paul Lawrason said.

Pruner originally said that it would keep an ambulance in Moorpark on a temporary basis, but the company now says it will stay indefinitely.

But Pruner’s troubles are not over. Although the company meets all state guidelines for response time throughout the county, according to the county’s Public Health Services Department, some officials question if those guidelines are out of date.

For example, Pruner under county regulations must respond to emergencies in Oak Park within 15 minutes 90% of the time. Regulated response times are based on the size of a city or unincorporated area.

“That may have been appropriate a decade or two ago, but that is certainly not appropriate now,” George Anterasian, a member of the Oak Park Municipal Advisory Council, said of the 15-minute response time.

Anterasian, who is a physician, said the response guidelines should be changed. He said under current regulations Oak Park is considered rural, even though it has more than 10,000 people and is considering becoming a city.

Anterasian said that the American Heart Assn. recommends that advanced life support procedures be delivered to heart attack victims within eight minutes. Within this time frame there is a 43% survival rate, compared to a 19% survival rate with response occurring between eight and 16 minutes, and 10% after that, according to the association.

Anterasian said the county should follow the recommendations of the heart association, whether it be through a firefighter paramedic program or by requiring Pruner to locate an ambulance and paramedic in Oak Park. There is one fire station in Oak Park.

Donald Pruner said he averages one call a month in Oak Park and that it would not be cost effective to station an ambulance there. He added that once the defibrillator program is implemented, there will not be a need for a paramedic stationed in the community.

Pruner said the same is true of Leisure Village, where a large percentage of the population are senior citizens.

Meanwhile, the firefighters union in the city of Ventura has begun talking about establishing its own paramedic program.